Trend analysis of suicide among children, adolescent and young adults in Ecuador between 1990 and 2017
DOI:
https://doi.org/10.23938/ASSN.0394Keywords:
Suicide. Epidemiology. Adolescent. Child. Ecuador.Abstract
Background. Analyze the long-term sex specific trends in suicide rates for Ecuadorian children, adolescents and young people, as well as to describe the evolution of the male/female ratio between 1990 and 2017.
Method. Population and mortality data were obtained from the National Institute of Statistics and Censuses of Ecuador. Suicide rates were calculated for each year, age group (10-14, 15-19, 20-24 years) and sex. We used the Joinpoint Regression Program 4.6.0.2 to analyze temporal trends and report annual percent change (APC) by each age group and sex.
Results. An average of 313 suicides per year happened in Ecuador between 1990 and 2017, with increases of 480% in young boys and 322 % in girls aged between 10-14, 111% in male adolescents and 57% in young adults, while there was a decrease in adolescent girls (19%) and young adults (37%). The suicide rate increased annually among boys (APC = 5.10%) and girls (2.57%), as well as for male adolescents (3.07%) and young adults (10.42%), while for female adolescents (0.81%, not significant) and young women (1.16%) the trend decreased after reaching a peak around 2006. While up until the beginning of the XXI century young females aged between 10 and 19 years had higher suicide rates, during the last decade men had higher rates across all age groups (between 1.5:1 and 4.3:1 in 2017).
Conclusions. Suicide in the population under 25 years in Ecuador is a major public health issue and increased between 1990 and 2017, particularly among children, and males between 15-24 years. The intersectorial strategy proposed in 2018 in order to reduce suicide is pending further evaluation and interpretation.
Downloads
References
SINYOR M, TSE R, PIRKIS J. Global trends in suicide epidemiology. Curr Opin Psychiatry 2017; 30: 1-6.
MC LOUGHLIN AB, GOULD MS, MALONE KM. Global trends in teenage suicide: 2003-2014. QJM 2015; 108: 765-780.
MASCAYANO F, IRRAZABAL M, EMILIA WD, SHAH B, VANER SJ, SAPAG JC et al. Suicide in Latin America: a growing public health issue. Rev Fac Cien Med Univ Nac Cordoba 2016; 72: 295-303.
QUINLAN-DAVIDSON M, SANHUEZA A, ESPINOSA I, ESCAMILLA-CEJUDO JA, MADDALENO M. Suicide among young people in the Americas. J Adolesc Health 2014; 54: 262-268.
Organización Mundial de la Salud. Prevención del Suicidio: Un imperativo global. Washington DC: Organización Panamericana de la Salud 2014. Disponible en: http://www.who.int/mental_health/suicide-prevention/world_report_2014/es/. Consultado el 20 de Octubre del 2016.
KÕLVES K, DE LEO D. Regions with the highest suicide rates for children and adolescents – some observations. J Child Adolesc Behav 2014.
KÕLVES K, DE LEO D. Suicide rates in children aged 10-14 years worldwide: changes in the past two decades. Br J Psychiatry 2014; 205: 283-285.
GONZALEZ-ANDRADE F, LÓPEZ-PULLES R, GASCÓN S, GARCÍA-CAMPAYO J. Epidemiological issues reagarding suicide in Ecuador: an 8-year report. J Public Health 2011; 19: 161-169.
SOOLE R, KOLVES K, DE LEO D. Suicide in children: a systematic review. Arch Suicide Res 2015; 19: 285-304.
BARZILAY S, APTER A. Psychological models of suicide. Arch Suicide Res 2014; 18: 295-312.
MILNER A, HJELMELAND H, ARENSMAN E, DE LEO D. Social-environmental factors and suicide mortality: a narrative review of over 200 articles. Sociology Mind 2013; 3: 137-148.
FREY LM, CEREL J. Risk for suicide and the role of family: a narrative review. J Fam Issues 2015; 36: 716-736.
MANCEAUX P, JACQUES D, ZDANOWICZ N. Hormonal and developmental influences on adolescent suicide: a systematic review. Psychiatr Danub 2015; 27: 300-304.
MIRKOVIC B, LAURENT C, PODLIPSKI MA, FREBOURG T, COHEN D, GERARDIN P. Genetic association studies of suicidal behavior: a review of the past 10 years, progress, limitations, and future directions. Front Psychiatry 2016; 7: 158.
CHANG BP, FRANKLIN JC, RIBEIRO JD, FOX KR, BENTLEY KH, KLEIMAN EM et al. Biological risk factors for suicidal behaviors: a meta-analysis. Transl Psychiatry 2016; 6: 1-8.
CANETTO SS, SAKINOFSKY I. The gender paradox in suicide. Suicide Life Threat Behav 1998; 28: 1-23.
SCHRIJVERS DL, BOLLEN J, SABBE BG. The gender paradox in suicidal behavior and its impact on the suicidal process. J Affect Disord 2012; 138: 19-26.
NOCK MK, BORGES G, BROMET EJ, CHA CB, KESSLER RC, LEE S. Suicide and suicidal behavior. Epidemiol Rev 2008; 30: 133-154.
PAYNE S, SWAMI V, STANISTREET DL. The social construction of gender and its influence on suicide: a review of the literature. J Mens Health 2008; 5: 23-35.
RHODES AE, BOYLE MH, BRIDGE JA, SINYOR M, LINKS PS, TONMYR L et al. Antecedents and sex/gender differences in youth suicidal behavior. World J Psychiatry 2014; 4: 120-132.
MCKAY K, MILNER A, MAPLE M. Women and suicide: beyond the gender paradox. Int J Cult Ment Health 2014; 7: 168-178.
TURNER SG, KAPLAN CP, ZAYAS L, ROSS RE. Suicide attempts by adolescent Latinas: an exploratory study of individual and family correlates. Child Adolesc Soc Work J 2002; 19: 357-374.
ZAYAS LH, BRIGHT CL, ÁLVAREZ-SÁNCHEZ T, CABASSA LJ. Acculturation, familism and mother–daughter relations among suicidal and non-suicidal adolescent Latinas. J Prim Prev 2009; 30: 351-369.
BEAUTRAIS AL. Gender issues in youth suicidal behaviour. Emerg Med 2002; 14: 35-42.
GERSTNER R, SORIANO I, SANHUEZA A, KESTEL D, CAFFE S. Epidemiología del suicidio en adolescentes y jóvenes en Ecuador. Rev Panam Salud Pública 2018; 42: e100.
WASSERMAN D, CHENG Q, JIANG G-X. Global suicide rates among young people aged 15-19. World psychiatry 2005; 4: 114-120.
GERSTNER R. Factores predictores y protectores para tendencias suicidas en adolescentes en una zona afectada por el terremoto del 16 de abril en Ecuador. Tesis de Máster en Salud Pública. Universidad San Francisco de Quito. Quito, 5 de mayo de 2017. http://repositorio.usfq.edu.ec/handle/23000/21.
GERSTNER RMF. [Factores de riesgo y factores protectores para el riesgo suicida en adolescentes ecuatorianos de Santo Domingo de los Tsáchilas]. Tesis de Máster. Universidad de Tübingen, 2012.
Ministerio de Salud Pública del Ecuador. Manual del Modelo de Atención Integral de Salud-MAIS. Ecuador: Ministerio de Salud Pública; 2012.
Ministerio de Salud Pública del Ecuador. Modelo y Plan estratégico de Salud Mental (Acuerdo Ministerial 00004927). Ecuador: Ministerio de Salud Pública; 2014. https://aplicaciones.msp.gob.ec/salud/archivosdigitales/documentosDirecciones/dnn/archivos/ac_00004927_2014%2025%20jul.pdf.
Instituto Nacional de Estadísticas y Censos (INEC). Defunciones generales. 2016. http://www.ecuadorencifras.gob.ec/sistema-integrado-de-consultas-redatam/.
Instituto Nacional de Estadísticas y Censos (INEC). Estimaciones y Proyecciones de Población. 2018. http://sni.gob.ec/proyecciones-y-estudios-demograficos.
KIM HJ, FAY MP, FEUER EJ, MIDTHUNE DN. Permutation tests for joinpoint regression with applications to cancer rates. Stat Med 2000; 19: 335-351.
TIWARI RC, CRONIN KA, DAVIS W, FEUER EJ, YU B, CHIB S. Bayesian model selection for join point regression with application to age adjusted cancer rates. J R Stat Soc Ser C Appl Stat 2005; 54: 919-939.
PALAZUELOS A, VILLARREAL MC. Más allá de las remesas: transformaciones socioeconómicas y proyectos de migración y desarrollo en Ecuador. Migr Desarro 2013; 11: 107-132.
RAMOS E. Dolor y gozo: La estructura psíquica de las familias transnacionales. Migr Desarro 2012; 10: 163-183.
RUIZ-PEREZ I, RODRIGUEZ-BARRANCO M, ROJAS-GARCIA A, MENDOZA-GARCIA O. Economic crisis and suicides in Spain. Socio-demographic and regional variability. Eur J Heal Econ 2017; 18: 313-320.
KÕLVES K, DE LEO D. Adolescent suicide rates between 1990 and 2009: analysis of age group 15-19 years worldwide. J Adolesc Heal 2016; 58: 69-77.
Ministerio Coordinador de Desarrollo Social. Sistema de indicadores sociales del ecuador: Indicadores relevantes 2016. http://www.siise.gob.ec/agenda/index.html?serial=13.
United Nations Development Program. Human development reports 2017. http://hdr.undp.org/en/countries/profiles/ECU.
MÖLLER-LEIMKÜHLER AM. The gender gap in suicide and premature death or: why are men so vulnerable? Eur Arch Psychiatry Clin Neurosci 2003; 253: 18.
ANGST J, ERNST C. [Diferencias de género en Psiquiatría]. En: [Idea femenina en transición. Estudio General 1989/1990]. Heidelberg: Ruprecht-Karls-Universität; 1990: 69-84.
Banco Mundial. Ecuador: panorama general 2018. https://www.bancomundial.org/es/country/ecuador/overview. Consultado el 24 de septiembre de 2018.
HAW C, HAWTON K, GUNNELL D, PLATT S. Economic recession and suicidal behaviour: Possible mechanisms and ameliorating factors. Int J Soc Psychiatry 2014; 61: 73-81.
VÄRNIK P. Suicide in the world. Int J Environ Res Public Health 2012; 9: 760-771.
GOÑI SARRIÉS A, ZANDIO ZORRILLA M. El suicidio: un reto para la prevención. An Sist Sanit Navar 2017; 40: 335-338.
Downloads
Published
How to Cite
Issue
Section
License
Copyright (c) 2019 Anales del Sistema Sanitario de Navarra
This work is licensed under a Creative Commons Attribution-ShareAlike 4.0 International License.
La revista Anales del Sistema Sanitario de Navarra es publicada por el Departamento de Salud del Gobierno de Navarra (España), quien conserva los derechos patrimoniales (copyright ) sobre el artículo publicado y favorece y permite la difusión del mismo bajo licencia Creative Commons Reconocimiento-CompartirIgual 4.0 Internacional (CC BY-SA 4.0). Esta licencia permite copiar, usar, difundir, transmitir y exponer públicamente el artículo, siempre que siempre que se cite la autoría y la publicación inicial en Anales del Sistema Sanitario de Navarra, y se distinga la existencia de esta licencia de uso.
