Óbitos por suicídio associados a agentes tóxicos no Ceará

Abstract

Suicide accounts for approximately 700,000 deaths annually worldwide. There are many contributing factors, such as age, gender, psychiatric disorders, and substance use. Substances like medications and pesticides are commonly used in self-inflicted deaths. In these fatalities, a forensic autopsy is mandatory to determine the cause of death. This investigation requires toxicology knowledge, especially in cases involving suspected chemical substances. In Ceará, Brazil, toxicological analyses for these cases are conducted at the Forensic Toxicology Nucleus (NUTOF) of the State Forensic Institute (PEFOCE). This cross-sectional study aimed to characterize the victims’ sociodemographic factors and the toxic agents involved in suicide cases sent to NUTOF/PEFOCE from 2020 to 2023. Data was collected from PEFOCE’s Galileu registration system. Statistical analyses were performed using Jamovi software, version 2.3.28. Regarding suicide cases where chemical agents were involved and confirmed by toxicological analysis (N=82), the following results were obtained: victims were predominantly male (N=60; 73.2%), aged 30 to 49 years (N=37; 45.1%), single (N=50; 61.7%), with complete high school education (N=26; 33.8%), and worked in the production of goods and services in industrial, agricultural, or retail sectors (n= 22; 57,9%). Regarding toxic agents, medications were most frequently implicated (N=53; 64.6%), followed by drugs of abuse (N=13; 15.8%), such as cocaine and delta-9-tetrahydrocannabinol (THC), and combinations of different toxic agents (N=16; 19.5%), including cocaine + ethanol (n=8; 50%), cocaine + medications (n=6; 37.5%), pesticide + medication (n=1; 6.25%), and cocaine + pesticide + medications (n=1; 6.25%). In terms of chemical agents, 178 substances were identified, with the highest proportion being anxiolytic medications (n= 39; 21.9%), followed by drugs of abuse (n= 27; 15.2%) and antidepressants (n= 26; 14.6%). Therefore, the results presented in this study are relevant for the healthcare system, as they can contribute to the development of specific suicide prevention and control measures, particularly in the state of Ceará.