Fatores de risco e prevenção do suicídio na Atenção Primária à Saúde em tempos de pandemia por COVID-19
revisão integrativa da literatura
DOI:
https://doi.org/10.5712/rbmfc17(44)3164Palavras-chave:
Suicídio, Atenção primaria à saúde, COVID-19, Prevenção primária, Serviços de saúde mental.Resumo
Introdução: O suicídio constitui-se em uma das principais causas de morte evitáveis. A pandemia da COVID-19 pode contribuir para reforçar os fatores de risco e a ideação suicida em razão da diminuição da capacidade de enfrentamento emocional ante a crise sanitária mundial. Ao mesmo tempo, os serviços de Atenção Primária à Saúde (APS) foram demandados a construir uma resposta rápida a questões relacionadas à saúde mental. Objetivo: Refletir sobre os fatores de risco e as possíveis intervenções para a prevenção do suicídio na atenção primária no contexto da pandemia da COVID-19. Métodos: Trata-se de uma revisão integrativa pautada na construção de uma análise crítica da literatura internacional sobre os fatores de risco e a prevenção do suicídio na APS durante a pandemia do novo coronavírus. Esta revisão foi construída por meio do levantamento de evidências na literatura internacional, feito pelo acesso às bases de dados científicas Web of Science, Science Direct e Scopus usando os descritores suicide AND prevention AND COVID-19 AND Primary Health Care. Foram incluídos artigos científicos disponibilizados entre dezembro de 2019 e setembro de 2020 e publicados em português, inglês e espanhol. Resultados: O corpus de análise foi composto de 15 artigos, com predominância da descrição de fatores de risco, da implementação e das adaptações de estratégias de intervenções específicas mediadas por recursos de tecnologia da informação e comunicação para oferecer cuidados de saúde mental. Conclusões: Os cuidados colaborativos pautados pelos atributos essenciais da APS destacaram-se como estratégias prioritárias para ofertar cuidados contínuos e longitudinais no contexto da pandemia.
Downloads
Métricas
Referências
Wan W. The coronavirus pandemic is pushing America into a mental health crisis. Washington Post, May 4, 2020. [acessado em 11 nov. 2020]. Disponível em: https://www.washingtonpost.com/health/2020/05/04/mental-health-coronavirus/
Hollyfield A. Suicides on the rise amid stay-at-home order, Bay Area medical professionals say. ABC News, May 21, 2020. Disponível em: https://abc7news.com/suicide-covid-19-coronavirus-rates-during-pandemic-death-by/6201962/
Strakowski SM, Ghaemi N, Keller AB. New projections on suicide, substance abuse, and COVID-19. Medscape, May 8, 2020. Disponível em: https://www.medscape.com/viewarticle/929632
Garg S, Kim L, Whitaker M, O’Halloran A, Cummings C, Holstein R, et al.. Hospitalization rates and characteristics of patients hospitalized with laboratory-confirmed coronavirus disease 2019 – COVID-NET, 14 States, March 1-30, 2020. MMWR Morb Mortal Wkly Rep 2020;69(15):458-64. http://doi.org/10.15585/mmwr.mm6915e3 DOI: https://doi.org/10.15585/mmwr.mm6915e3
Sher L. Are COVID-19 survivors at increased risk for suicide? Acta Neuropsychiatr 2020;32(5):270. http://doi.org/10.1017/neu.2020.21 DOI: https://doi.org/10.1017/neu.2020.21
Davis C. The trauma of the coronavirus pandemic could cause a nationwide spike in alcohol and drug use, experts say. Insider, Mar 30, 2020. Disponível em: https://www.businessinsider.com/experts-say-coronavirus-may-cause-spike-in-alcohol-abuse-2020-3
Thompson A. Coronavirus: loneliness of isolation may suppress the immune system, experts fear. Yahoo! News, Mar 30, 2020. Disponível em: https://news.yahoo.com/coronavirus-covid19-isolation-loneliness-immune-system-155414351.html
Gunnell D, Applebay L, Arensman E, Hawton K, John A, Kapur N, et al. Suicide risk and prevention during the COVID-19 pandemic. Lancet Psychiatry 2020;7(6):468-71. http://doi.org/10.1016/S2215-0366(20)30171-1 DOI: https://doi.org/10.1016/S2215-0366(20)30171-1
Schuck FW, Weber GMF, Schaefer CK, Reinheimer MW, Rockenbach DM. The influence of the COVID-19 pandemic on suicide risk. Braz J Hea Rev 2020;3(5):13778-89. http://doi.org/10.34119/bjhrv3n5-194 DOI: https://doi.org/10.34119/bjhrv3n5-194
Haw C, Hawton K, Gunnell D, Platt S. Economic recession and suicidal behavior: possible mechanisms and ameliorating factors. Int J Soc Psychiatry 2015;61(1):73-81. http://doi.org/10.1177/0020764014536545 DOI: https://doi.org/10.1177/0020764014536545
Economou M, Peppou LE, Soulitotis K, Konstantakopoulos G, Papaslanis T, Kontoangelos K, et al. An association of economic hardship with depression and suicidality in times of recession in Greece. Psychiatry Res 2019;279:172-9. http://doi.org/10.1016/j.psychres.2019.02.058 DOI: https://doi.org/10.1016/j.psychres.2019.02.058
Ruiz-Pérez I, Bermúdez-Tamayo C, Rodríguez-Barranco M. Socio-economic factors linked to mental health during the recession: a multilevel analysis. Int J Equity Health 2017;16(1):45. http://doi.org/10.1186/s12939-017-0518-x DOI: https://doi.org/10.1186/s12939-017-0518-x
Demirici Ş, Konca M, Yetim B, Ílgün G. Effect of the economic crisis on suicide cases: an ARDL bounds testing approach. Int J Soc Psychiatry 2020;66(1):34-40. http://doi.org/10.1177/0020764019879946 DOI: https://doi.org/10.1177/0020764019879946
Phillips JA, Nugent CN. Suicide and the great recession of 2007-2009: the role of economic factors in the 50 U.S. states. Socical Science & Medicine 2014;116:22-31. https://doi.org/10.1016/j.socscimed.2014.06.015 DOI: https://doi.org/10.1016/j.socscimed.2014.06.015
Posner K, Brown GK, Stanley B, Brent DA, Yershova KV, Oquendo MA, et al. The Columbia-Suicide Severity Rating Scale: initial validity and internal consistency findings from three multisite studies with adolescents and adults. Am J Psychiatry 2011;168(12):1266-77. https://doi.org/10.1176/appi.ajp.2011.10111704 DOI: https://doi.org/10.1176/appi.ajp.2011.10111704
Fowler JC. Suicide risk assessment in clinical practice: pragmatic guidelines for imperfect assessments. Psychotherapy (Chic) 2012;49(1):81-90. https://doi.org/10.1037/a0026148 DOI: https://doi.org/10.1037/a0026148
Stanley B, Brown GK. Safety planning intervention: a brief intervention to mitigate suicide risk. Cognitive and Behavioral Practice 2012;19(2):256-64. https://doi.org/10.1016/j.cbpra.2011.01.001 DOI: https://doi.org/10.1016/j.cbpra.2011.01.001
Brown GK, Have TT, Henriques GR, Xie SX, Hollander JE, Beck AT. Cognitive therapy for the prevention of suicide attempts: a randomized controlled trial. JAMA 2005;294(5):563-70. https://doi.org/10.1001/jama.294.5.563 DOI: https://doi.org/10.1001/jama.294.5.563
Jobes DA, Wong SA, Conrad AK, Drozd JF, Neal-Walden T. The collaborative assessment and management of suicidality versus treatment as usual: a retrospective study with suicidal outpatients. Suicide Life Threat Behav 2005;35(5):483-97. https://doi.org/10.1521/suli.2005.35.5.483 DOI: https://doi.org/10.1521/suli.2005.35.5.483
Luxton DD, June JD, Comtois KA. Can postdischarge follow-up contacts prevent suicide and suicidal behavior? A review of the evidence. Crisis 2013;34(1):32-41. https://doi.org/10.1027/0227-5910/a000158 DOI: https://doi.org/10.1027/0227-5910/a000158
Action Alliance. Clinical Care and Intervention Task Force. National Action Alliance for Suicide Prevention. Department of Health and Human Services, Substance Abuse and Mental Health Services Administration (SAMHSA), Center for Mental Health Services.. [acessado em 6 fev. 2021. Disponível em: http://actionallianceforsuicideprevention.org/sites/actionallianceforsuicideprevention.org/files/taskforces/ClinicalCareInterventionReport.pdf
Brenner LA, Breshears RE, Betthauser LM, Bellon KK, Holman E, Harwood JEF, et al. Implementation of a suicide nomenclature within two VA healthcare settings. J Clin Psychol Med Settings 2011;18(2):116-28. https://doi.org/10.1007/s10880-011-9240-9 DOI: https://doi.org/10.1007/s10880-011-9240-9
Nelson PA, Adams SM. Role of primary care in suicide prevention During the COVID-19 pandemic. J Nurse Pract 2020;16(9):654-59. https://doi.org/10.1016/j.nurpra.2020.07.015 DOI: https://doi.org/10.1016/j.nurpra.2020.07.015
Crosby AE, Ortega LV, Melanson C. Self-directed violence surveillance: uniform definitions and recommended data elements. Atlanta: Centers for Disease Control and Prevention; 2011. Disponível em: https://www.cdc.gov/suicide/pdf/self-directed-violence-a.pdf
Bernert RA, Hom MA, Roberts LW. A review of multidisciplinary clinical practice guidelines in suicide prevention: toward an emerging standard in suicide risk assessment and management, training and practice. Acad Psychiatry 2014;38(5):585-92. https://doi.org/10.1007/s40596-014-0180-1 DOI: https://doi.org/10.1007/s40596-014-0180-1
Banerjee D, Kosagisharaf JR, Rao TSS. ‘The dual pandemic’ of suicide and COVID-19: a biopsychosocial narrative of risks and prevention. Psychiatry Res 2021;295:113577. https://doi.org/10.1016%2Fj.psychres.2020.113577 DOI: https://doi.org/10.1016/j.psychres.2020.113577
Que J, Yuan K, Gong Y, Meng S, Bao Y, Lu L. Raising awareness of suicide prevention during the COVID-19 pandemic. Neuropsychopharmacol Rep 2020;40(4):392-5. https://doi.org/10.1002/npr2.12141 DOI: https://doi.org/10.1002/npr2.12141
Zalsman G, Hawton K, Wasserman D, van Heering K, Arensman E, Sarchiapone M, et al. Suicide prevention strategies revisited: 10-year systematic review. The Lancet Psychiatry 2016;3(7):P646-59. https://doi.org/10.1016/S2215-0366(16)30030-X DOI: https://doi.org/10.1016/S2215-0366(16)30030-X
Wasserman D, Iosue M, Wuestefeld A, Carli V. Adaptation of evidence-based suicide prevention strategies during and after the COVID-19 pandemic. World Psychiatry 2020;19(3):294-306. https://doi.org/10.1002/wps.2080 DOI: https://doi.org/10.1002/wps.20801
Rosenberg S, Mendoza J, Tabatabaei-Jafari H, Pandemic-Mental Health International Network (Pan-MHIN), Salvador-Carulla L. International experiences of the active period of COVID-19 – Mental health care. Health Policy Technol 2020;9(4):503-9. https://doi.org/10.1016/j.hlpt.2020.08.016 DOI: https://doi.org/10.1016/j.hlpt.2020.08.016
Pfender E. Mental health and COVID-19: implications for the future of telehealth. J Patient Exp 2020;7(4):433-5. https://doi.org/10.1177/2374373520948436 DOI: https://doi.org/10.1177/2374373520948436
Reger MA, Stanley IH, Joiner TE. Suicide mortality and coronavirus disease 2019 – a perfect storm? JAMA Psychiatry 2020;77(11):1093-4. https://doi.org/10.1001/jamapsychiatry.2020.1060 DOI: https://doi.org/10.1001/jamapsychiatry.2020.1060
Roncero C, García-Ullán L, de la Iglesias-Larrad J, Martín C, Andrés P, Ojeda A, et al. The response of the mental health network of the Salamanca area to the COVID-19 pandemic: the role of the telemedicine. Psychiatry Res 2020;291:113252. https://dx.doi.org/10.1016%2Fj.psychres.2020.113252 DOI: https://doi.org/10.1016/j.psychres.2020.113252
Deady M, Tan L, Kugenthiran N, Collins D, Christensen H, Harvey SB. Unemployment, suicide and COVID-19: using the evidence to plan for prevention. Med J Aust 2020;213(4):153-154.e1. https://doi.org/10.5694/mja2.50715 DOI: https://doi.org/10.5694/mja2.50715
De Leo D, Trabucchi M. The fight against COVID-19: a report from the Italian trenches. Int Psychogeriatr 2020;32(10):1161-4. https://doi.org/10.1017/S1041610220000630 DOI: https://doi.org/10.1017/S1041610220000630
Molloy S. The silent death toll of COVID-19 revealed: Huge 25 per cent jump in suicides each year. News.com.au, Jul 25, 2020. Disponível em: https://www.news.com.au/lifestyle/health/health-problems/the-silent-death-toll-of-covid19-revealed-huge-25-per-cent-jump-in-suicides-each-year/news-story /b4154626a16c9cc25c3b79b7880041ef
Singh R, Baral KP, Mahato S. An urgent call for measures to fight against increasing suicides during COVID-19 pandemic in Nepal. Asian J Psychiatr 2020;54:102259. https://doi.org/10.1016/j.ajp.2020.102259 DOI: https://doi.org/10.1016/j.ajp.2020.102259
O’Connor RC, Kirtley OJ. The integrated motivational-volitional model of suicidal behaviour. Philos Trans R Soc B Biol Sci 2018;373(1754):20170268. https://doi.org/10.1098/rstb.2017.0268 DOI: https://doi.org/10.1098/rstb.2017.0268
Klomek AB. Suicide prevention during the COVID-19 outbreak. Lancet Psychiatry 2020;7(5):390. https://doi.org/10.1016/S2215-0366(20)30142-5 DOI: https://doi.org/10.1016/S2215-0366(20)30142-5
International Conference on Primary Health Care. Declaration of Alma-Ata. WHO Chron 1978;32(11):428-30. PMID: 11643481
Starfield B. Atenção primária: equilíbrio entre necessidades de saúde, serviços e tecnologia. Brasília: UNESCO/Ministério da Saúde. Brasília; 2002. Disponível em: https://www.nescon.medicina.ufmg.br/biblioteca/imagem/0253.pdf
Nabuco G, Oliveira MHPP, Afonso MPD. O impacto da pandemia pela COVID-19 na saúde mental: qual é o papel da Atenção Primária à Saúde? Rev Bras Med Fam Comunidade 2020;15(42):2532. https://doi.org/10.5712/rbmfc15(42)2532 DOI: https://doi.org/10.5712/rbmfc15(42)2532
Jobes DA, Crumlish JA, Evans AD. The COVID-19 pandemic and treating suicidal risk: the telepsychotherapy use of CAMS. Journal of Psychotherapy Integration 2020;30(2):226-37. https://doi.org/10.1037/int0000208 DOI: https://doi.org/10.1037/int0000208
APA Work Group on Psychiatric Evaluation. The American Psychiatric Association Practical Guidelines for Psychiatric Assessment of Adults. 3rd ed. American Psychiatric Association; 2020. https://doi.org/10.1176/appi.books.9780890426760. Disponível em: https://psychiatryonline.org/doi/pdf/10.1176/appi.books.9780890426760
World Health Organization. Preventing suicide: a global imperative; 2014.
World Health Organization. Mental health action plan 2013-2020. Geneva: World Health Organization; 2020. Disponível em: http://www.who.int/mental_health/publications/action_plan/en/
World Health Organization. Health in 2015 from the MDGs millennium development goals to the SDGs sustainable development goals. Geneva: World Health Organization; 2015. Disponível em: https://apps.who.int/iris/bitstream/handle/10665/200009/9789241565110_eng.pdf?sequence=1&isAllowed=y
Platt S, Arensman E, Rezaeian M. National suicide prevention strategies – progress and challenges. Crisis 2019;40(2):75-82. https://doi.org/10.1027/0227-5910/a000587 DOI: https://doi.org/10.1027/0227-5910/a000587
Arensman E, Scott V, De Leo D, Pirkis J. Suicide and suicide prevention from a global perspective. Crisis 2020;41(Suppl 1):S3-S7. https://doi.org/10.1027/0227-5910/a000664 DOI: https://doi.org/10.1027/0227-5910/a000664
World Health Organization. Preventing suicide: a community engagement toolkit. Geneva: World Health Organization; 2018. Disponível em: https://apps.who.int/iris/bitstream/handle/10665/272860/9789241513791-eng.pdf?sequence=1&isAllowed=y
International Association for Suicide Prevention. The International COVID-19 suicide prevention research collaboration; 2020. Disponível em: https://www.iasp.info/research-collaboration-icsprc/
Simon G. Detecting and assessing suicidal ideation during COVID-19. The Joint Commission, Jun 24, 2021. Disponível em: https://www.jointcommission.org/resources/news-and-multimedia/blogs/improvement-insights/2021/detecting-and-assessing-suicidal-ideation-during-covid-19/ DOI: https://doi.org/10.1016/j.jcjq.2021.04.002
Gonçalves DA, Ballester D, Chiaverine DH, Tófoli LF, Chanzan LF, Almeida N, et al. Guia prático de matriciamento em saúde mental. Brasília: Ministério da Saúde, Centro de Estudo e Pesquisa em Saúde Coletiva; 2011. Disponível em: https://bvsms.saude.gov.br/bvs/publicacoes/guia_pratico_matriciamento_saudemental.pdf
Downloads
Publicado
Como Citar
Edição
Seção
Licença
Copyright (c) 2022 Eder Paulo Reis Ornelas Silva , Hebert Luan Pereira Campos dos Santos, Fernanda Beatriz Melo Maciel , Edi Cristina Manfroi, Nília Maria de Brito Lima Prado
Este trabalho está licenciado sob uma licença Creative Commons Attribution 4.0 International License.
Ao submeterem um manuscrito à RBMFC, os autores mantêm a titularidade dos direitos autorais sobre o artigo, e autorizam a RBMFC a publicar esse manuscrito sob a licença Creative Commons Atribuição 4.0 e identificar-se como veículo de sua publicação original.