Epidemiology of suicides in Brazil: a systematic review

Abstract

------Abstract Objective: Find and review data about suicide prevalence and incidence in Brazil. Materials and methods: This is a systematic review that used PRISMA protocol and has PROSPERO registration at the number CRD42021288299. Using PubMed, Scielo databases, Brazilian Ministry of Health, and World Health Organization (WHO) documents, 245 manuscripts (metaanalysis, systematic reviews, cohorts, cross-sectional, and government documents) published from 2010 to 2021 were initially selected, of which 46 remained in the review. The risk of bias was assessed by the Cochrane Bias Risk Assessment tool. Results: The data showed that suicide rates in Brazil range between 4.6 and 6.6 per 100,000 inhabitants, from 2000 to 2020. It showed an increased risk of death from suicide in all regions of Brazil, highlighting the South and Midwest. Overall, suicide in Brazil is more prevalent among those aged 15 to 45 years (and there is an increase in adolescent mortality rates), unmarried, males, and those who present mental disorders, and this is associated with unemployment and economic deprivation. Indigenous people have elevated levels of suicide compared to non-indigenous people. Hanging and poisoning were the most common methods used and the suicide most often happen at home. Portuguese publications were included in the present work. All studies published in the different periods were included. Some biases were observed: some studies had restricted eligibility criteria and different measures, others failed to adequately control confound variables. We protected the quality of this research paper by excluding studies where bias could compromise interpretation. Conclusion: The consolidated information from this present systematic review about suicidal behaviour in Brazil may contribute to the assessment of the current situation and future planning of public health interventions, especially better prevention efforts.