论文部分内容阅读
Background: Since this new century there has been an increase in the number of suicide rates in Portugal, from approximate 5/100,000 inhabitants to 10/100,000.Furthermore, suicide in Portugal is a phenomenon occurring predominantly among the elderly, while parasuicide is more relevant in adolescence.In particular, the case of teenage girls deserves special attention within the European context (approximate annual rate =600/100,000 inhabitants).This scenario brings us some doubts and questions about the prevention and intervention during this period with the young people.The Suicide Research and Prevention Unit of the Coimbra University Hospitals began its activity in 1992, and since then has observed and followed over 1000 patients, including 460 younger (age < 25; 109 males and 351 females) which are the focus of the present study.Most of these are discharged after four or five consultations, until the suicidal crisis has been overcome, and are thereafter attached to an open-door scheme.Methods: Some of the adolescents who attempted suicide, admitted at the Emergency Room of the Coimbra University Hospitals, was afterwards referred to the Suicide Research and Prevention Unit.In order to characterize better their environment, antecedents and suicidal ideation these patients are assessed through the Suicidal Behaviour Evaluation Interview (SBEI), a semi-structured questionnaire developed by the Unit and comprising 11 parts and 77 questions.In this study we emphasize the social environment: development characteristics, family interaction and social circumstances.Results: In this sample of 460 youngers who attempted suicide, we found, with respect to socio-demographic variables, a predominance of females (77%) and lower social classes (80%).All these figures are higher than the ones relative to the general population.The samples mean age is about 19 years, and 54 % are students.Abnormalities during childbirth (28%), mainly hypoxia, and psychomotor development (26%) are relevant.The absence of one (usually the father, 80%) or both parents in education is also frequent.History of child abuse (31%), sexual abuse or rape (14%) is frequently reported.Poor family relationships (60%) and descriptions of authoritarian father and / or overprotective mother (80%) are very relevant.Emotional / affective and academic problems are relevant.Academic failure, absence of a confidant, non-engagement in group activities is very common.Antecedents of smoking habits, alcohol and drug abuse and psychiatric disorders within the family, are frequently found.Bereavement, recent medical consultations, psychotropic drugs prescription and the frequency of suicidal behaviours in the family and in the community should be noted (genetic factors and Werther effect).Conclusion: The family and social environment plays an important role in suicidal behaviours among young people in Portugal.The therapeutic intervention cant be only with the young but should include also the family in order to prevent recurrent behaviours and suicide.