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Parasuicide in a low-income country: results from three-year hospital surveillance in Nicaragua

Department of Mental Health, University of Leon UNAN, Leon, Nicaragua, Department of Clinical Sciences, Division of Psychiatry, WHO Collaborating Centre, UmeÅ University, UmeÅ, Sweden

Andrés Herrera

Department of Preventive Medicine and Public Health, University of León UNAN, León, Nicaragua, Department of Clinical Sciences, Division of Psychiatry, WHO Collaborating Centre, UmeÅ University, UmeÅ, Sweden

Ellinor Salander Renberg

Department of Clinical Sciences, Division of Psychiatry, WHO Collaborating Centre, UmeÅ University, UmeÅ, Sweden, ellinor.salander.renberg{at}psychiat.umu.se

Gunnar Kullgren

Department of Clinical Sciences, Division of Psychiatry, WHO Collaborating Centre, UmeÅ University, UmeÅ, Sweden

Aims: A study was undertaken to assess the incidence of parasuicide in Nicaragua, to identify groups at risk, and to describe the characteristics of parasuicides, such as methods used and seasonal and diurnal patterns. Method: All hospital-admitted parasuicide cases in the area of León, Nicaragua, were assessed over a three-year period using standardized instruments. Results: Two hundred and thirty-three parasuicide cases were identified in the catchment area giving a parasuicide rate of 66.3/100,000 inhabitants per year based on the population 10 years and older. Corresponding figure for 15 years and older was 71.3. A majority were females (68.8%), who were significantly younger than the males (mean 20.8 years vs. mean 24.6 years). The highest rates were found in the age group 15 - 19 years with a female rate three times higher than the male rate (302.9 vs. 98.9). Pesticides, a highly lethal substance, were used as method in 19.1% of the attempts. Consistent seasonal variation with peaks in May - June and September - October were found over the years. Among parasuicide cases, 46.5% had been in contact with the healthcare system within 6 months before attempting suicide. Conclusions: Parasuicides represent a significant health problem among young people in Nicaragua. Preventive efforts should be directed especially towards the life situation for young girls, limitation of availability of suicide means, increased awareness in schools concerning suicidal problems, as well as improved management of patients with mental health problems within primary healthcare.

Key Words: hospital surveillance • Nicaragua • parasuicide • seasonal pattern • sociodemographic characteristics.

Scandinavian Journal of Public Health, Vol. 32, No. 5, 349-355 (2004)
DOI: 10.1080/14034940410029496


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