Suicide trends and self-harm in Panama: results from the National Mortality Registry and hospital-based data

Abstract

Purpose

We aimed to (1) to investigate mortality trends due to suicide in Panama at the national and regional levels from 2001 to 2016, (2) to describe the sociodemographic and clinical characteristics of admitted patients with non-fatal self-harm from 2009 to 2017 in a regional hospital, and (3) to examine the association between mental health diagnoses and intentional self-harm, lethality, self-harm repetition and all-cause mortality within this population.

Methods

Using the national mortality registry, annual percentage changes (APC) with 95% confidence intervals (CI) were estimated to evaluate suicide trends over time. Self-harm cases were assessed by trained psychiatrists at a referral hospital through interviews. Logistic regression models were used to estimate the association between mental diagnosis with intent-to-die and lethality, expressed as odds ratios (OR) and 95% CI. Cox proportional hazards models were used to calculate hazard ratios (HR) with 95% CI for self-harm repetition and all-cause mortality.

Results

The trend of suicide in women declined, with an APC of − 4.8, 95% CI − 7.8, − 1.7, while the trend began to decline from 2006 in men; APC − 6.9, 95% CI − 8.9, − 4.9. Self-harm repetition over 12 months was 1.8%. Having a mental health diagnosis was associated with intentional self-harm (OR 1.5; 95% CI 1.0–2.4) and self-harm repetition (HR 2.7, 95% CI 1.3–5.8). Medication overdose was the preferred method for self-harm, while intentional self-harm by hanging was the preferred method for suicide.

Conclusions

Strategies for prevention and early intervention after self-harm deserve attention. Our findings highlight the importance of data to inform action.

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Data availability

The data that support the findings of this study are available on request from the corresponding author. The data are not publicly available due to privacy or ethical restrictions.

Code availability

Stata version14.

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Acknowledgements

This work was supported by an institutional research grant from Panama. IMV is supported by the Sistema Nacional de Investigación (SNI), Senacyt, Panama.

Funding

Ministry of Economy and Finance (MEF), Panama.

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Correspondence to Ilais Moreno Velásquez.

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Conflict of interest

The authors declared that they have no conflict of interest.

Ethical approval

Ethical approval to conduct the study was obtained from the Ethics Review Committee of the Gorgas Memorial Institute for Health Studies (No. 754/CBI/ICGES/18 and No. 708/CBI/ICGES/19). Permission to conduct the study was obtained from the Ministry of Health of Panama and the medical director of the participating hospital.

Consent to participate

Data was retrieved from hospital and mortality registries.

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Moreno Velásquez, I., Castelpietra, G., Higuera, G. et al. Suicide trends and self-harm in Panama: results from the National Mortality Registry and hospital-based data. Soc Psychiatry Psychiatr Epidemiol (2020). https://doi.org/10.1007/s00127-020-01895-9

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Keywords

  • Suicide
  • Self-harm
  • Panama
  • Epidemiology