Letalidad y reincidencia en la conducta suicida

Résumé

Objective: The purpose of this thesis is 1) to evaluate the possible association between lethality and recidivism, by examining the variables that are independently associated with these factors, 2) to analyse the relevance of therapeutic adherence in preventing further suicide attempts and, 3) to study suicide in a subpopulation as specific as the physician population and 4) evaluate the appearance of suicidal ideation in physicians during the pandemic. Method: This thesis consists of four articles in which four populations are analysed. In the first sample, the clinical and demographic characteristics associated with fatality and recidivism and their association between them are evaluated in a cross-sectional manner. In the second sample, the clinical and demographic factors associated with recidivism in a population of suicides treated with special emphasis on therapeutic adherence are evaluated longitudinally. In the third sample, the differences between suicide in the medical profession and the general population are evaluated and finally, in the last study, the appearance of suicidal ideation in physicians during the pandemic is investigated. Results: Recidivism and lethality are independently related to some sociodemographic variables, but we have not found a relationship between them. Therapeutic adherence is not associated with a lower recidivism in follow-up patients with suicidal behaviour. Physicians have a higher suicide mortality than the general population, especially the female gender. Female physicians are at higher risk of suicidal ideation during the pandemic than other health professionals. Conclusions: The description of the risk factors associated with recidivism and lethality and the absence of a relationship between them, as well as the need to complement therapeutic adherence during follow-up to prevent repeated suicidal behaviour, are useful data in preventive strategies within the healthcare environment. It is very important to highlight the vulnerability of physicians to suicidal ideation in stressful circumstances such as the pandemic to encourage preventive programs specifically designed for this group and to consider a gender perspective.