Tentativas de suicídio em Coari, Amazonas: análise comparativa dos períodos pré e pós-pandemia da COVID-19 (2015–2025)

Abstract

Introduction: Suicide attempt is a major public health issue and one of the strongest predictors of completed suicide. It is a multifactorial phenomenon influenced by biological, psychological, social, and environmental factors. In the Amazon region, geographical barriers, socioeconomic vulnerabilities, and limitations in access to mental health services may exacerbate this condition. Furthermore, the COVID-19 pandemic intensified factors associated with psychological distress, highlighting the need to investigate its impact on suicidal behavior. Objective: To analyze the epidemiological profile and severity of suicide attempts recorded in Coari, Amazonas, Brazil, comparing the pre-pandemic period (2015–2019) with the period during and after the COVID-19 pandemic (2020–2025). Methods: This was an observational, retrospective, cross-sectional, descriptive, and analytical study based on the review of medical records of patients hospitalized following suicide attempts at the reference hospital in Coari, Amazonas, between 2015 and 2025. Sociodemographic, clinical, and psychosocial variables were collected. The severity of suicide attempts was retrospectively assessed using the Scale for Assessment of Lethality of Suicide Attempt (SALSA), adapted according to the information available in the medical records. Statistical analyses were performed using Statistical Package for the Social Sciences (SPSS) version 25.0. Descriptive statistics and the independent Student's t-test were used to compare mean SALSA scores between the study periods, adopting a significance level of 5%. Results: A total of 194 suicide attempt cases were analyzed, revealing more than a fivefold increase in hospitalizations between the two study periods. Most cases involved females (68.5%), adolescents aged 13–18 years (38.6%), students (46.3%), individuals of mixed race (pardo) (81.9%), single individuals (71.6%), and urban residents (94.3%). During the pre-pandemic period, self-inflicted cutting was the most frequent method, whereas medication poisoning and hanging became the predominant methods during and after the pandemic, both associated with higher lethality. The mean severity of suicide attempts increased significantly, with SALSA scores rising from 1.92 ± 0.3 in the pre-pandemic period to 2.94 ± 0.2 during and after the pandemic (p = 0.001). Conclusion: A substantial increase in both the frequency and severity of suicide attempts was observed following the onset of the COVID-19 pandemic, suggesting an important shift in the epidemiological profile of this condition in the municipality. These findings highlight the need to strengthen epidemiological surveillance, expand the Psychosocial Care Network, and enhance Primary Health Care for the early identification and longitudinal follow-up of individuals at risk, particularly in municipalities within the Brazilian Amazon.