Mortalidad y Suicidio Entre Personas en Situación de Sinhogarismo: un Estudio de Seguimiento de Siete Años
PDF

Palabras clave

Homelessness
Suicide
Violence
Overdose
Mortality
Suicidal behavior Sinhogarismo
Suicidio
Violencia
Sobredosis
Mortalidad
Conducta suicida

Cómo citar

Calvo, F., Carbonell, X., Johnsen, S., Panadero, S., Vázquez, J. J., Calvet, A., McInnes, K., & Font-Mayolas, S. (2024). Mortalidad y Suicidio Entre Personas en Situación de Sinhogarismo: un Estudio de Seguimiento de Siete Años. Psicothema, 36(4), 331–340. Recuperado a partir de https://reunido.uniovi.es/index.php/PST/article/view/21942

Resumen

Antecedentes: Existe un vacío en el conocimiento científico sobre el suicidio entre las personas en situación de sinhogarismo (PSH). Método: Este estudio longitudinal de siete años, examinó una cohorte de 154 PSH. En 2015 se evaluaron el riesgo de suicidio y las causas de muerte recopiladas en los registros del servicio de salud en 2022. Resultados: En estos siete años, el 14.3% de la muestra falleció a una edad promedio de 52.6 años. Las principales causas de muerte fueron cáncer, suicidio y sobredosis accidental. Se encontró que aquellos participantes que experimentaron violencia presentaron un mayor número de intentos de suicidio, así como una puntuación más elevada en la escala de ideación suicida. Los factores más significativos relacionados con la mortalidad fueron los intentos de suicidio previos y la ideación suicida. Conclusiones: Este estudio resalta la importancia de la puntuación en la escala de riesgo de suicidio como el predictor principal de mortalidad. Así mismo, destaca la necesidad de realizar investigaciones longitudinales sobre suicidio entre PSH y de desarrollar programas específicos para prevenir el suicidio en esta población. Se sugiere un enfoque que combine perspectivas estructurales e individuales, considerando políticas de vivienda adecuadas y atención de salud mental.

PDF

Citas

Al-Halabí, S., & Fonseca-Pedrero, E. (2021). Suicidal behavior prevention: The time to act is now. Clínica y Salud, 32(2), 89-92. https://doi.org/10.5093/clysa2021a17.

Al-Halabí, S., & Fonseca-Pedrero, E. (2023). Are there common components in effective psychotherapies for suicidal behavior? Implications for professional practice. Revista de Psicoterapia, 34(124), 83-99. https://doi.org/10.5944/rdp.v34i124.37050

Aquin, J. P., Roos, L. E., Distasio, J., Katz, L. Y., Bourque, J., Bolton, J. M., Bolton, S. L., Wong, J. Y., Chateau, D., Somers, J. M., Enns, M. W., Hwang,

S. W., Frankish, J. C., & Sareen, J. (2017). Effect of housing first on suicidal behaviour: A randomised controlled trial of homeless adults with mental disorders. Canadian Journal of Psychiatry, 62(7), 473-481. https://doi.org/10.1177/0706743717694836

Ayano, G., Tsegay, L., Abraha, M., & Yohannes, K. (2019). Suicidal ideation and attempt among homeless people: A systematic review and meta-analysis. Psychiatric Quarterly, 90(4), 829–842. https://doi.org/10.1007/S11126-019-09667-8/FIGURES/6

Babidge, N. C., Buhrich, N., & Butler, T. (2001). Mortality among homeless people with schizophrenia in Sydney, Australia: A 10-year follow-up. Acta Psychiatrica Scandinavica, 103(2), 105–110. https://doi.org/10.1034/J.1600- 0447.2001.00192.X

Beautrais, A. L. (2016). Risk factors for suicide and attempted suicide among young people. Australian & New Zealand Journal of Psychiatry, 34(3), 420– 436. https://doi.org/10.1080/J.1440-1614.2000.00691.X

Busch-Geertsema, V., Culhane, D., & Fitzpatrick, S. (2016). Developing a global framework for conceptualising and measuring homelessness. Habitat International, 55, 124–132. https://doi.org/10.1016/J.HABITATINT.2016.03.004

Calvo, F., Alfranca, R., Carbonell, X., Molina, E., & Font-Mayolas, S. (2023a). The health of individuals experiencing homelessness: A 15-year retrospective cohort study. Journal of Social Distress and Homelessness, 32(2), 189-199). https://doi.org/10.1080/10530789.2022.2069404

Calvo, F., Alfranca, R., Carbonell, X., Molina, E., & Font-Mayolas, S. (2023b). Age and gender differences in mental health and addictions of individuals experiencing homelessness in Spain: A 15-year retrospective cohort study. Journal of Social Distress and Homelessness, 33(1), 112-121 https://doi.org/10.1080/10530789.2022.2086668

Calvo, F., Turró-Garriga, O., & Carbonell, X. (2020). Evaluation of the efficacy of WhatsApp through a harm reduction intervention group for injecting drug users. Adicciones, 33(3), 201–215. https://doi.org/10.20882/adicciones.1329

Calvo, F., Watts, B., Panadero, S., Giralt, C., Rived-Ocaña, M., & Carbonell, X. (2022). The prevalence and nature of violence against women experiencing homelessness: A quantitative study. Violence Against Women, 28(6-7), 1464- 1482. https://doi.org/10.1177/10778012211022780

Calvo-García, F., Giralt-Vázquez, C., Calvet-Roura, A., & Carbonell-Sánchez,X. (2016). Suicide risk among homeless population. Clínica y Salud, 27(2),89–96. https://doi.org/10.1016/j.clysa.2016.05.002

Carrasco-Garrido, P., Jiménez-Trujillo, I., Hernández-Barrera, V., García-Gómez- Heras, S., Alonso-Fernández, N., & Palacios-Ceña, D. (2018). Trends in the misuse of tranquilizers, sedatives, and sleeping pills by adolescents in Spain, 2004–2014. Journal of Adolescent Health, 63(6), 709–716. https://doi.org/10.1016/J.JADOHEALTH.2018.04.003

Castillo, I. I., Saiz, F. G., Rojas, Ó. L., Landabaso Vázquez, M. Á., & Jiménez Lerma, J. M. (2010). Estimación de un punto de corte para la Escala de Severidad de la Dependencia (SDS) para la adicción a opiáceos mediante análisis ROC [Estimation of a cut point for the Dependency Severity Scale (SDS) for opioid addiction using ROC analysis]. Actas Españolas de Psiquiatría, 38(5), 270–277.

Darke, S., Duflou, J., & Torok, M. (2009). Toxicology and circumstances of completed suicide by means other than overdose. Journal of Forensic Sciences, 54(2), 490–494. https://doi.org/10.1111/J.1556-4029.2008.00967

Desai, R. A., Liu-Mares, W., Dausey, D. J., & Rosenheck, R. A. (2003). Suicidal ideation and suicide attempts in a sample of homeless people with mental illness. Journal of Nervous and Mental Disease, 191(6), 365–371. https://doi.org/10.1097/01.NMD.0000071584.88965.E1

Fazel, S., Geddes, J. R., & Kushel, M. (2014). The health of homeless people in high-income countries: descriptive epidemiology, health consequences, and clinical and policy recommendations. The Lancet, 384(9953), 1529–1540. https://doi.org/10.1016/S0140-6736(14)61132-6

García, J., González, M., Fonseca-Pedrero, E., & Al-Halabí, S. (2023). Conceptualización de la conducta suicida [Conceptualization of suicidal behavior]. In Manual de psicología de la conducta suicida [Manual of psychology of suicidal behavior] (pp. 31–68). Pirámide. https://www.edicionespiramide.es/libro.php?id=6891901

Geulayov, G., Casey, D., Bale, L., Brand, F., Clements, C., Farooq, B., ... & Hawton, K. (2019). Suicide following presentation to hospital for non-fatal self-harm in the Multicentre Study of Self-harm: a long-term follow-up study. The Lancet Psychiatry, 6(12), 1021-1030. https://doi.org/10.1016/s2215-0366(19)30402-x

Goñi-Sarriés, A., Blanco, M., Azcárate, L., Peinado, R., & López-Goñi, J. J. (2018). Are previous suicide attempts a risk factor for completed suicide? Psicothema, 30(1), 33–38. https://doi.org/10.7334/psicothema2016.318

Gossop, M., Darke, S., Griffiths, P., Hando, J., Powis, B., Hall, W., & Strang, J. (2006). The Severity of Dependence Scale (SDS): psychometric properties of the SDS in English and Australian samples of heroin, cocaine and amphetamine users. Addiction, 90(5), 607–614. https://doi.org/10.1046/ j.1360-0443.1995.9056072.x

Guzmán, E. M., Cha, C. B., Ribeiro, J. D., & Franklin, J. C. (2019). Suicide risk around the world: A meta-analysis of longitudinal studies. Social Psychiatry and Psychiatric Epidemiology, 54(12), 1459–1470. https://doi.org/10.1007/ S00127-019-01759-X/FIGURES/3

Heerde, J. A., & Hemphill, S. A. (2016). Sexual risk behaviors, sexual offenses, and sexual victimization among homeless youth: A systematic review of associations with substance use. Trauma, Violence & Abuse, 17(5), 468–489. https://doi.org/10.1177/1524838015584371

Heerde, J. A., Scholes-Balog, K. E., & Hemphill, S. A. (2015). Associations between youth homelessness, sexual offenses, sexual victimization, and sexual risk behaviors: A systematic literature review. Archives of Sexual Behavior, 44(1), 181–212.

https://doi.org/10.1007/S10508-014-0375-2

Idescat. (2017). Territory. The municipality in figures. Girona (Gironès). https://www.idescat.cat/emex/?id=170792&lang=en

Instituto Nacional de Estadística. (2023). Defunciones por suicidios. Resultados nacionales [Suicide deaths. National results]. https://www.ine.es/dynt3/ inebase/es/index.htm?padre=5453&capsel=5454

Johnsen, S., Cuthill, F., & Blenkinsopp, J. (2021). Outreach-based clinical pharmacist prescribing input into the healthcare of people experiencing homelessness: A qualitative investigation. BMC Health Services Research, 21, Article 7.

https://doi.org/10.1186/S12913-020-06013-8

Jolley, C. J., Bell, J., Rafferty, G. F., Moxham, J., & Strang, J. (2015). Understanding heroin overdose: A study of the acute respiratory depressant effects of injected pharmaceutical heroin. PLOS ONE, 10(10), e0140995. https://doi.org/10.1371/JOURNAL.PONE.0140995

Krausz, R. M., Westenberg, J. N., & Ziafat, K. (2021). The opioid overdose crisis as a global health challenge. Current Opinion in Psychiatry, 34(4), 405–412. https://doi.org/10.1097/YCO.0000000000000712

Lee, K. H., Jun, J. S., Kim, Y. J., Roh, S., Moon, S. S., Bukonda, N., & Hines, L. (2017). Mental health, substance abuse, and suicide among homeless adults. Journal of Evidence-Informed Social Work, 14(4), 229–242. https://doi.org/10.1080/23761407.2017.1316221

López, D. J., Morell, M. F., & del Río, F. J. (2023). Colectivos vulnerables para la conducta suicida [Vulnerable groups for suicidal behavior]. In S. Al-Halabí & E. Fonseca-Pedrero (Eds.), Manual de psicología de la conducta suicida [Manual of psychology of suicidal behavior] (pp. 235–271). Pirámide.

Luchenski, S., Maguire, N., Aldridge, R. W., Hayward, A., Story, A., Perri, P., Withers, J., Clint, S., Fitzpatrick, S., & Hewett, N. (2018). What works in inclusion health: Overview of effective interventions for marginalised and excluded populations. The Lancet, 391(10117), 266–280. https://doi.org/10.1016/S0140-6736(17)31959-1

Machado, D. B., Rasella, D., & Dos Santos, D. N. (2015). Impact of income inequality and other social determinants on suicide rate in Brazil. PLOS ONE, 10(4), Article e0124934. https://doi.org/10.1371/JOURNAL.PONE.0124934

Martins, S. S., Sampson, L., Cerdá, M., & Galea, S. (2015). Worldwide prevalence and trends in unintentional drug overdose: A systematic review of the literature. American Journal of Public Health, 105(11), e29-49. https://doi.org/10.2105/AJPH.2015.302843

Murray, R. M., Conroy, E., Connolly, M., Stokes, D., Frazer, K., & Kroll, T. (2021). Scoping review: Suicide specific intervention programmes for people experiencing homelessness. International Journal of Environmental Research and Public Health, 18(13), Article 6729. https://doi.org/10.3390/ IJERPH18136729/S1

Navarrete Betancort, E. M., Herrera Rodríguez, J., & León Pérez, P. (2019). The limits of suicide prevention. Revista de La Asociación Española de Neuropsiquiatría, 39(135), 193–214. https://doi.org/10.4321/S0211-57352019000100011

Nicholas, W., Greenwell, L., Henwood, B. F., & Simon, P. (2021). Using point-in- time homeless counts to monitor mortality trends among people experiencing homelessness in Los Angeles County, California, 2015‒2019. American Journal of Public Health, 111(12), 2212-2222. https://doi.org/10.2105/ AJPH.2021.306502

Nilsson, S. F., Hjorthøj, C. R., Erlangsen,A., & Nordentoft, M. (2014). Suicide and unintentional injury mortality among homeless people: A Danish nationwide register-based cohort study. European Journal of Public Health, 24(1), 50–56. https://doi.org/10.1093/EURPUB/CKT025

Noël, F., Moniruzzaman, A., Somers, J., Frankish, J., Strehlau, V., Schütz, C., & Krausz, M. (2016). A longitudinal study of suicidal ideation among homeless, mentally ill individuals. Social Psychiatry and Psychiatric Epidemiology, 51(1), 107–114.

https://doi.org/10.1007/S00127-015-1142-Y/TABLES/3

O’Connor, R. C., & Nock, M. K. (2014). The psychology of suicidal behaviour. The lancet. Psychiatry, 1(1), 73-85. https://doi.org/10.1016/S2215-0366(14)70222-6

Panadero, S., Martín, R., & Vázquez, J. J. (2018). Suicide attempts and stressful life events among homeless people in Madrid (Spain). Journal of Community & Applied Social Psychology, 28(4), 200–212. https://doi.org/10.1002/ CASP.2351

Paykel, E. S., Myers, J. K., Lindenthal, J. J., & Tanner, J. (1974). Suicidal feelings in the general population: A prevalence study. The British Journal of Psychiatry, 124(582), 460–469. https://doi.org/10.1192/BJP.124.5.460

Pedrero-Pérez, E. J., Morales-Alonso, S., Álvarez-Crespo, B., & Benítez- Robredo, M. T. (2020). Opiate drug use in the city of Madrid: Associated health and sociodemographic factors. Adicciones, 33(3), 235–244. https://doi.org/10.20882/ADICCIONES.1335

Peltier, B., Raitt, J. M., Habazi, D., Roaten, K., Pollio, D., & North, C. S. (2021). A longitudinal study of suicidality in a homeless population sample. Archives of Suicide Research, 27(1), 1-12. https://doi.org/10.1080/13811118.2021.1950588

Plutchik, R., van Praag, H. M., Conte, H. R., & Picard, S. (1989). Correlates of suicide and violence risk 1: The suicide risk measure. Comprehensive Psychiatry, 30(4), 296–302. https://doi.org/10.1016/0010-440X(89)90053-9

Rubio, G., Montero, J., Jáuregui, J., Villanueva, R., Casado, M. A., Marin, J. J., & Santo-Domingo, J. (1998). Validacion de la escale de riesgo suicida de Plutchik en poblacion española [Validation of the Plutchik suicide risk scale in the Spanish population]. Archivos de Neurobiología, 61(2), 143–152. https://psycnet.apa.org/record/2000-02758-005

Salazar, A., Moreno, S., De Sola, H., Moral-Munoz, J. A., Dueñas, M., & Failde, I. (2020). The evolution of opioid-related mortality and potential years of life lost in Spain from 2008 to 2017: Differences between Spain and the United States. Current Medical Research and Opinion, 36(2), 285-291. https://doi.org/10.1080/03007995.2019.1684251

Saloner, B., McGinty, E. E., Beletsky, L., Bluthenthal, R., Beyrer, C., Botticelli, M., & Sherman, S. G. (2018). A public health strategy for the opioid crisis. Public Health Reports, 133, 24–34. https://doi.org/10.1177/0033354918793627

Shoib, S., Gaitán Buitrago, J. E. T., Shuja, K. H., Aqeel, M., de Filippis, R., Abbas, J., Ullah, I., & Arafat, S. M. Y. (2022). Suicidal behavior sociocultural factors in developing countries during COVID-19. L’Encéphale, 48(1), 78–82. https://doi.org/10.1016/J.ENCEP.2021.06.011

Silva, M., Loureiro, A., & Cardoso, G. (2016). Social determinants of mental health: a review of the evidence. The European Journal of Psychiatry, 30(4), 259–292.

Sinyor, M., Kozloff, N., Reis, C., & Schaffer, A. (2017). An observational study of suicide death in homeless and precariously housed people in Toronto. Canadian Journal of Psychiatry. 62(7), 501–505. https://doi. org/10.1177/0706743717705354

Sommers-Flanagan, J., & Shaw, S. L. (2017). Suicide risk assessment: What psychologists should know. Professional Psychology: Research and Practice, 48(2), 98–106. https://doi.org/10.1037/PRO0000106

Tinland, A., Boyer, L., Greacen, T., Girard, V., Boucekine, M., Fond, G., & Auquier, P. (2018). Victimization and posttraumatic stress disorder in homeless women with mental illness are associated with depression, suicide, and quality of life. Neuropsychiatric Disease and Treatment, 14, 2269–2279. https://doi.org/10.2147/NDT.S161377

Turecki, G., & Brent, D. A. (2016). Suicide and suicidal behaviour. The Lancet, 387(10024), 1227–1239.

https://doi.org/10.1016/S0140-6736(15)00234-2

Turecki, G., Brent, D. A., Gunnell, D., O’Connor, R. C., Oquendo, M. A., Pirkis, J., & Stanley, B. H. (2019). Suicide and suicide risk. Nature Reviews Disease Primers, 5(1), 1–22. https://doi.org/10.1038/s41572-019-0121-0

Vazquez, J. J., & Panadero, S. (2019). Suicidal attempts and stressful life events among women in a homeless situation in Madrid (Spain). American Journal of Orthopsychiatry, 89(2), 304–311. https://doi.org/10.1037/ORT0000387

Volkow, N. D., Jones, E. B., Einstein, E. B., & Wargo, E. M. (2019). Prevention and treatment of opioid misuse and addiction: A review. JAMA Psychiatry, 76(2), 208–216. https://doi.org/10.1001/ JAMAPSYCHIATRY.2018.3126

World Health Organization. (2023). Suicide. https://www.who.int/news-room/ fact-sheets/detail/suicide

Yamamoto, A., Needleman, J., Gelberg, L., Kominski, G., Shoptaw, S., & Tsugawa, Y. (2019). Association between homelessness and opioid overdose and opioid-related hospital admissions/emergency department visits. Social Science & Medicine, 242, 112585. https://doi.org/10.1016/j. socscimed.2019.112585

Zalsman, G. (2019). Suicide: Epidemiology, etiology, treatment and prevention. Harefuah, 158(7), 468–472.

Zalsman, G., Hawton, K., Wasserman, D., van Heeringen, K., Arensman, E., Sarchiapone, M., Carli, V., Höschl, C., Barzilay, R., Balazs, J., Purebl, G., Kahn, J. P., Sáiz, P. A., Lipsicas, C. B., Bobes, J., Cozman, D., Hegerl, U., & Zohar, J. (2016). Suicide prevention strategies revisited: 10-year systematic review. The Lancet Psychiatry, 3(7), 646–659. https://doi.org/10.1016/S2215- 0366(16)30030-X

Zhong, S., Senior, M., Yu, R., Perry, A., Hawton, K., Shaw, J., & Fazel, S. (2021). Risk factors for suicide in prisons: a systematic review and meta-analysis. The Lancet Public Health, 6(3), e164–e174. https://doi.org/10.1016/S2468- 2667(20)30233-4

Zortea, T. C., Cleare, S., Melson, A. J., Wetherall, K., & O’Connor, R. C. (2020). Understanding and managing suicide risk. British Medical Bulletin, 134(1), 73-84. https://doi.org/10.1093/bmb/ldaa013