AGING AND SUICIDAL BEHAVIOR IN MEXICO • Guilherme Borges*, Ricardo Orozco*, Maria Elena Medina-Mora*, Jorge

Villatoro*, María de Lourdes Torres Ortega**

• *Instituto Nacional de Psiquiatría Ramón de la Fuente Muñiz, Ciudad de México

• **FLACSO México

• 2017-International Conference on Aging in the Americas-ICAA

• UNIVERSITY OF SOUTHERN CALIFORNIA / LOS ANGELES, CALIFORNIA / SEPTEMBER 20–22, 2017.

SUICIDE IN MEXICO

UNIVERSITY OF SOUTHERN CALIFORNIA, LOS ANGELES, CALIFORNIA, SEPTEMBER 20–22, 2017 3

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Suicide death rates by age groups . México, 2015

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Mujeres

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2015 Total Males FemalesDeaths 6,408 5,130 1,278Rates 5.30 8.69 2.06

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Evolution of suicide death rates in Mexico, by sex, 1970-2015

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esEvolution of suicide death rates in Mexico, by age groups.

México 1980, 1990, 2000, 2010 y 2015

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IDEATION & SUICIDAL BEHAVIOUR AMONG THE ELDERLY IN MEXICO

9INTERNATIONAL CONFERENCE ON AGING IN THE AMERICAS

Suicide ideation, plan and attempts among the elderly in Mexico

10INTERNATIONAL CONFERENCE ON AGING IN THE AMERICAS

lifetimeprevalence of suicide ideation of 13.5% among a represen-tativesample of 1,992 aged 65+ years +from urban and rural catchment areas.2-week prevalence of 4.2%.

11INTERNATIONAL CONFERENCE ON AGING IN THE AMERICAS

The common factors associated with both lifetime and 2-week prevalence were having a large number of physical disorders (lifetime prevalence ratio = PR and 95% confidence interval = CI; PR=2.23, CI= 1.63–3.06), depression (PR=1.92, CI= 1.36–2.70) and anxiety (PR=2.23, CI=1.68–2.97) and screening positive for psychosis (PR = 1.64, CI = 1.15–2.34).

12INTERNATIONAL CONFERENCE ON AGING IN THE AMERICAS

Dementia plays a minor role on suicide ideation after the other aforementioned variables were taken into account.

13INTERNATIONAL CONFERENCE ON AGING IN THE AMERICAS

12-month suicide ideation and behavior in Mexico–2016 Encuesta Nacional de Consumo de Drogas, Alcohol y Tabaco (ENCODAT-2016, for its acronym in Spanish –National Survey on Consumption of Drugs, Alcohol and Tobacco).

IN PROCESS!!!!!

UNIVERSITY OF SOUTHERN CALIFORNIA, LOS ANGELES, CALIFORNIA, SEPTEMBER 20–22, 2017 14

ENCODAT interviewed a total of 56,877 respondents (12-65 years old), representative of national urban and rural households. We focus here on the 50-65 years old.

Respondents were asked about 12-month experiences of suicidal ideation (‘Have you seriously thought about committing suicide?’), suicide plans (‘Have you made a plan for committing suicide?’), and suicide attempts (‘Have you attempted suicide?’). Those positive for a 12-month suicide attempt were further asked whether this attempt led to a hospitalization or medical treatment for the injuries.

The overall prevalence of suicide ideation was 2.3%, 0.8% reported a plan and 0.7% reported a suicide attempt.

UNIVERSITY OF SOUTHERN CALIFORNIA, LOS ANGELES, CALIFORNIA, SEPTEMBER 20–22, 2017 16

Table 2a. Prevalence of suicide behaviors (ideation, plan and attempt), by sex and age group.Ideation Plan Attempt

N n % X2 p n % X2 p n % X2 pTotal 56877 1497 2.3 - - 532 0.8 - - 497 0.7 - -Males

Age category (years)

12-17 6299 100 1.5 4.1 0.706 40 0.7 20.0 0.077 35 0.5 13.4 0.15418-49 12767 235 1.6 75 0.5 71 0.550-65 4754 88 1.8 16 0.2 16 0.2

Sub-total 23820 423 1.6 131 0.5 122 0.4Females

Age category (years)

12-17 6137 324 5.0 160.9 <0.001 148 2.1 109.4 <0.001 144 2.2 137.6 <0.00118-49 19943 569 2.6 202 1.1 179 0.850-65 6977 181 2.3 51 0.6 52 0.7

Sub-total 33057 1074 3.0 401 1.2 375 1.0Chi-square tests with 2 d.f.Unweighted n's; weighted percentages

UNIVERSITY OF SOUTHERN CALIFORNIA, LOS ANGELES, CALIFORNIA, SEPTEMBER 20–22, 2017 17

Table 6. Association of sociodemographic factors and suicide behaviors

Ideation Plan Attempt

aPR 95% CI p aPR 95% CI p aPR 95% CI p

Age category (years)

12-17 ref. ref. ref.

18-49 1.01 (0.72 - 1.41) 0.960 0.84 (0.48 - 1.47) 0.540 0.58 (0.38 - 0.89) 0.013

50-65 0.88 (0.59 - 1.30) 0.519 0.36 (0.19 - 0.69) 0.002 0.32 (0.18 - 0.56) <0.001

Sex

Male ref. ref. ref.

Female 2.09 (1.65 - 2.64) <0.001 2.77 (1.76 - 4.38) <0.001 2.19 (1.53 - 3.13) <0.001

Education (years)

0-6 ref. ref. ref.

7-9 0.81 (0.65 - 1.01) 0.060 0.88 (0.59 - 1.31) 0.518 0.71 (0.50 - 1.00) 0.049

10-12 0.55 (0.40 - 0.76) <0.001 0.47 (0.30 - 0.74) 0.001 0.54 (0.35 - 0.83) 0.005

13+ 0.21 (0.15 - 0.30) <0.001 0.10 (0.05 - 0.20) <0.001 0.06 (0.03 - 0.13) <0.001

Marital status

Married/cohabiting ref. ref. ref.

Separated/divorced/widowed 1.06 (0.80 - 1.42) 0.674 1.30 (0.84 - 2.02) 0.243 1.44 (0.89 - 2.32) 0.137

Never married 1.66 (1.22 - 2.25) 0.001 1.95 (1.05 - 3.61) 0.035 1.62 (1.01 - 2.60) 0.044aPR - Adjusted Prevalence Ratio; CI - Confidence Interval; ref. - reference category* Global Adjusted Wald Tests for State are: Ideation F(31, 1752)=2.57, p<0.001; Plan F(31, 1752)=1.89, p=0.002; Attempt F(31, 1752)=1.93, p=0.002a Each state is compared to the national prevalence

UNIVERSITY OF SOUTHERN CALIFORNIA, LOS ANGELES, CALIFORNIA, SEPTEMBER 20–22, 2017 18

Table 2b. Prevalence of plan and attempt (planned and unplanned) among ideators, by sex and age group.

Among ideators (n=1497)Plan Attempt

n n % X2 p n % X2 p

Total 1497 532 35.8 - - 497 32.4 - -Males

Age category (years)12-17 100 40 45.0 2268.3 0.007 35 37.1 1558.9 0.03018-49 235 75 30.5 71 30.750-65 88 16 13.6 16 13.6

Sub-total 423 131 29.1 122 27.9Females

Age category (years)12-17 324 148 42.6 861.0 0.049 144 43.0 650.5 0.09318-49 569 202 41.2 179 31.850-65 181 51 24.6 52 30.4

Sub-total 1074 401 39.1 375 34.6

UNIVERSITY OF SOUTHERN CALIFORNIA, LOS ANGELES, CALIFORNIA, SEPTEMBER 20–22, 2017 19

SUMMARY

Suicide in Mexico peaks among the youth and young adults and (for men) increases latter at older ages (decreases for females). Suicide among the elderly has not increase since 1990.

One research for suicide ideation among the elderly in México!!!! As elsewhere, physical disorders, depression, anxiety and symptoms of psychosis increased the risk. Dementia was not related to ideation.

One research on 12-month ideation, plan and attempt among 50-65 years old. Prevalence of plan and attempt decrease with age. Lower likelihood of plan and attempt among the elderly was found, but no differences in medical consequences or intent.