Resultados de la aplicación de la autopsia psicológica al estudio del suicidio de niños y adolescentes en Uruguay

Hugo Rodríguez Almada; Irene García Maggi; Calíope Ciriacos

Authors

Hugo Rodríguez Almada Universidad de la República, Facultad de Medicina, Departamento de Medicina Legal, Profesor Adjunto. Doctor en Medicina. Especialista en Medicina Legal
Irene García Maggi Universidad de la República, Facultad de Medicina, Clínica de Psiquiatría Pediátrica, Ex Asistente. Doctora en Medicina. Especialista en Psiquiatría Pediátrica
Calíope Ciriacos Universidad de la República, Facultad de Medicina, Departamento de Docencia en la Comunidad, Ex Profesora Adjunta. Doctora en Medicina. Magíster en Epidemiología

Keywords:

AUTOPSY, SUICIDE, TEENAGER, CHILD

Abstract

Suicide in Uruguay has been defined as a public health problem. Although the specificity of child and adolescent suicide there is no particular national literature. Worlwide, psychological autopsy has increased suicide study findings, especially in the child and adolescent suicide field.
Objectives: a) to conduct the first national psychological autopsy study in order to analyze child and adolescent suicide, b) to profile this specific population that commited suicide during 2002, family members and social environment, c) to determine the characteristics of suicide act and d) to compare results with international literature.
Methods: we conducted a comparative study of children and adolescents aged up to 19 years who had commited suicide during 2002 in Uruguay. Death certificates, police records, judicial notices, clinical records, diaries and suicide notes were studied as family members, friends, teachers and therapists were interviewed.
Results: Most of the 38 cases that filled the criteria were males (n = 27), mean age was 17 years. Among youth aged up to 15 years there was a female predominance. Only 12 of the total population were students and the majority of the youth suicide completers were not included in the educational or labour systems.
Multiaxial assessment showed high psychiatric desorders index. In axe I there was a predominance of anxiety and mood desorders while in axe II type B personality.
The majority (n = 30) was not treated at the time of decease. The few treated (n = 4) suffered depression, but only one had current prescription for antidepressive medication. Multiple stress events were detected. Among those occurred the previous month, conjugal problems, moving home, legal problems and parental involved arguments were predominant.
Gunshot followed by hanging were the method most used. Intoxication was seen only in females. Almost half of the youth had a history of suicide threats and one third had a history of suicide attempts.
Conclusions: psychological autopsy was an important tool to study child and adolescent suicide in Uruguay. The results generally agree with the information coming from international studies. The study showed some differences: 1. Feminization of the population. 2. High percentage of youth out of the educational and labour systems. 3. Low percent of psychologic or psychiatric consultations compared to high percents of psychiatric desorders, previous suicide threats and suicide attempts. 4. The majority of the cases involved in mental health treatment did not received antidepressive therapy.

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