Suicide attempts in Spain according to prehospital healthcare emergency records.

Yolanda Mejías-Martín,Candela Rodríguez-Mejías,Juan De Dios Luna,Celia Martí-García,M Paz García-Caro,Juan Pablo Valencia-Quintero

doi:10.1371/journal.pone.0195370

Abstract

ObjectiveTo analyze the number and characteristics of suicide attempts by reviewing records of the public emergency healthcare service information system.MethodA retrospective observational study was conducted of emergency telephone calls received between January 1 2007 and December 31 2013 throughout the Andalusia region (Southern Spain). Cases were selected based on phone operator or healthcare team labeling. Data were analyzed on the characteristics of the individuals, the timing and severity of attempts, their prioritization, and their outcome.ResultsBetween January 1 2007 and December 31 2013, 20.942 calls related to suicide attempts were recorded, a rate of 34.7 attempts per 100,000 inhabitants. Most cases were classified by the public emergency healthcare service (Empresa Pública de Emergencias Sanitarias, EPES) as code X84 (The International Statistical Classification of Diseases, tenth revision, ICD-10) or 305(The International Statistical Classification of Diseases, ninth revision, ICD-9). Attempts were more frequent in the 35-49-year age group and there were similar proportions of males and females. The lowest number of calls for suicide attempts were in 2007 and the highest in 2013. Calls were more frequent during the summer months, at weekends, and between 16:00 and 23:00 h. The likelihood of evacuation to the hospital emergency department was almost two-fold lower in over 65-yr-olds than in younger individuals.Significant (ƿ = 0.001) gender differences were found in call outcome and prioritization. The most influential factor for evacuation to a hospital emergency department was the code assigned by the attending healthcare team.ConclusionsInformation obtained from extra-hospital emergency services provides valuable data on the characteristics and timing of calls related to suicide attempts, complementing information from hospital emergency departments or population surveys. There is a need to standardize the definition and recording of a suicide attempt.

Highlights

During 2012, suicide represented 50% of violent deaths in males and 71% in females worldwide [1]
Between January 1 2007 and December 31 2013, 20.942 calls related to suicide attempts were recorded, a rate of 34.7 attempts per 100,000 inhabitants
Most cases were classified by the public emergency healthcare service (Empresa Publica de Emergencias Sanitarias, EPES) as code X84 (The International Statistical Classification of Diseases, tenth revision, ICD-10) or 305(The International Statistical Classification of Diseases, ninth revision, ICD9)

Summary

Introduction

During 2012, suicide represented 50% of violent deaths in males and 71% in females worldwide [1]. Suicide has been the most frequent external cause of death in Spain since 2008, according to the National Statistics Institute [2]. The risk of suicide is considered higher for individuals who have made a previous attempt than for those who have not, regardless of age and sex [3, 4]. The WHO has reported that the prevalence of self-reported suicide attempts is around 4/1,000 adults [1]. Suicide attempts have major personal, family, social, and economic repercussions [1, 5]. The identification of a suicide attempt is complex, hampering data gathering [8], because of difficulties in establishing its true intent [9]. The International Statistical Classification of Diseases, tenth revision (ICD-10) labels voluntary poisoning and self-harm behaviors with the codes X60-X84

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Results

Conclusion