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Abstract(s)
Introdução: O suicídio é um assunto ainda visto como tabu em muitas comunidades. A Organização Mundial de Saúde (OMS) reportou uma taxa global de 11,4 per 100.000 pessoas que cometeram suicídio em 2012, sendo considerada uma das dez maiores causas de morte. Em Portugal, os números são também preocupantes, indicando-se, em 2014, 1.154 mortes. A zona do Alentejo é a que apresenta índices mais elevados, com taxas de mortalidade de 34,4 por cada 100.000 habitantes do sexo masculino.
O objetivo desta dissertação é apresentar a epidemiologia do suicídio, quais os fatores de risco e de protetores, a sua relação com as consultas de medicina geral e familiar e como intervencionar de forma a reduzir as tentativas de suicídio. A implementação de planos de prevenção pode ter um grande impacto na redução da incidência de suicídio. Existem campanhas de prevenção do suicídio que visam a educação da população, contudo apenas estão descritas medidas gerais de prevenção e não específicas no âmbito dos cuidados de saúde primários (CSP) em Portugal.
Metodologia: Foi efetuada uma revisão da literatura baseada em pesquisas em bases de dados como Medline, organizações oficiais, como OMS, DGS e SPS. Os termos usados para a pesquisa foram: “suicide”, com “prevention”, “depression”, “elderly”, “geriatric” e “primary health care”. Foram analisados 45 artigos, tendo sido excluídos artigos que se centravam em distúrbios psiquiátricos que não eram depressão, estudos com populações com idade inferior a 65 anos, e estudos que destacassem outras especialidades e serviços de saúde, que não os CSP.
Resultados: Em Portugal, existe o Plano Nacional de Saúde Mental (PNSM), que incorpora um plano nacional de prevenção do suicídio, com medidas para grupos de risco. Contudo, não são estabelecidos guidelines específicas de abordagem em CSP. Foi encontrado um plano proposto pela Joint Commission, que aborda o suicídio com medidas mais específicas.
Discussão e conclusão: Serão necessários estudos para se analisar a eficácia do PNSM, bem como a necessidade de implementação de medidas adicionais. Além disto, apresenta-se o plano americano, que poderá ser estudado e possivelmente adaptado para a realidade portuguesa. Surge, por fim, uma questão relevante: considerando que as características e demografia da população portuguesa, quão importante será a elaboração de guidelines específicas para idosos e dirigido aos CSP? Será que a sua aplicação terá resultados mais positivos na prevenção do suicídio? Sugere-se então estudos que possam responder a estas questões, e, eventualmente, resolver este problema polémico.
Introduction: Suicide is a matter that remains a tabu topic in many comunities to this day. According to the World Health Organization (WHO), a global ratio of 11,4 per 100.000 habitants commited suicide in 2012 thus, making suicide one of the top 10 leading causes of death. In Portugal, the numbers are also quite alarming, reporting 1.154 deaths, in 2014. Alentejo is considered the most startling region, showing suicide mortality rates of 34,4 per 100.000 male habitants. The main purpose of this dissertation is to present the suicide epidemiology, risk factors, the relationship with primary care consults and how to intervene, thus reducing suicide attempts. The application of prevention plans may be of great importance in reversing the situation. Many prevention campaigns already exist, such as booklets distribution and population awareness education, however specific guidelines haven't been implemented in primary health care. Methodology: The research for this revision was based on a focused web search in data bases such as Medline and official organizations, such as WHO, DGS and SPS. The specific terms that were searched were: “suicide”, “prevention”, “depression”, “elderly”, “geriatric” and “primary health care”. 45 articles were assessed, and excluded if focused on psychiatric disorders, other than depression, in populations younger than 65 years old, and other health departments other than primary health care, were excluded. Results: In Portugal, a national prevention of suicide plan has been introduced and incorporated to the country's mental health care system. Although it includes a variety of measures for the majority of risk groups, specific guidelines haven't been established. Based on this research, a plan by the Joint Commission has been found, that approached suicide in a more specific manner. Discussion and conclusion: Studies will need to be held in order to evaluate the eficacy of the suicide prevention plan and adjustments of which measures will be necessary in the future will need to be made. This revision suggests a plan proposed by the American Suicide Prevention Center, that could be studied and possibly adapted for the portuguese reality. Finally, a question emerges: considering the caracteristics and demografics of the portuguese population, how important is the creation of specific guidelines for elderly and primary care? Will its aplication have more positive outcomes? More studies are suggested to answer these questions and eventually, solve this issue.
Introduction: Suicide is a matter that remains a tabu topic in many comunities to this day. According to the World Health Organization (WHO), a global ratio of 11,4 per 100.000 habitants commited suicide in 2012 thus, making suicide one of the top 10 leading causes of death. In Portugal, the numbers are also quite alarming, reporting 1.154 deaths, in 2014. Alentejo is considered the most startling region, showing suicide mortality rates of 34,4 per 100.000 male habitants. The main purpose of this dissertation is to present the suicide epidemiology, risk factors, the relationship with primary care consults and how to intervene, thus reducing suicide attempts. The application of prevention plans may be of great importance in reversing the situation. Many prevention campaigns already exist, such as booklets distribution and population awareness education, however specific guidelines haven't been implemented in primary health care. Methodology: The research for this revision was based on a focused web search in data bases such as Medline and official organizations, such as WHO, DGS and SPS. The specific terms that were searched were: “suicide”, “prevention”, “depression”, “elderly”, “geriatric” and “primary health care”. 45 articles were assessed, and excluded if focused on psychiatric disorders, other than depression, in populations younger than 65 years old, and other health departments other than primary health care, were excluded. Results: In Portugal, a national prevention of suicide plan has been introduced and incorporated to the country's mental health care system. Although it includes a variety of measures for the majority of risk groups, specific guidelines haven't been established. Based on this research, a plan by the Joint Commission has been found, that approached suicide in a more specific manner. Discussion and conclusion: Studies will need to be held in order to evaluate the eficacy of the suicide prevention plan and adjustments of which measures will be necessary in the future will need to be made. This revision suggests a plan proposed by the American Suicide Prevention Center, that could be studied and possibly adapted for the portuguese reality. Finally, a question emerges: considering the caracteristics and demografics of the portuguese population, how important is the creation of specific guidelines for elderly and primary care? Will its aplication have more positive outcomes? More studies are suggested to answer these questions and eventually, solve this issue.
Description
Keywords
Cuidados de Saúde Primários Geriatria Prevenção Suicídio Velhice