Transtornos mentais prevalentes em homens idosos que tentaram suicídio: uma revisão sistemática e metanálise

Abstract

INTRODUCTION: Brazil, like most countries, is in the process of an aging society. Concurrently, the worldwide rate of consummate suicide and suicide attempts grows. Today, suicide is already the second leading cause of death among older people in the world, and in men, this number is four times higher than in women. In addition, it was observed a strong association between suicide in this age group and some comorbidities, such as mental disorders. OBJECTIVE: To verify the prevalence of different mental disorders in elderly men with mental disorders who attempted suicide. METHODOLOGY: The research was done in January of 2019 using five electronic databases (SciELO, LILACS, PubMed, Web of Science, Scopus), as well as the "gray literature", in the OpenThesis, OpenGrey and OATD databases to minimize bias of selection and publication. Observational studies were considered eligible with men over 60 years of age who attempted suicide. The risk of bias and the individual methodological quality of the selected studies were evaluated by the tool "The Joanna Briggs Institute Critical Appraisal tools for use in JBI Systematic Reviews" for prevalence studies. The GRADE tool was used to evaluate the quality of evidence from this study. RESULTS: The research resulted in 12,894 records, of which two met the eligibility criteria. Among the included studies, the total number of elderly people with a mental disorder who attempted suicide was 359 events. The highest prevalence was for those suffering from mood disorders (42.0%, 95% CI: 31.0-74.0%, I2: 0.0% p = 0.763), followed by substance use disorders (41.0%, 95% CI: 8.0-74.0%, I2: 96.4 p <0.001) and, finally, schizophrenic disorders (5.0%, 95% CI:0.0% -14.0%, I2: 80.3% p = 0.024). CONCLUSION: Mood disorders and substance use disorders have a higher prevalence in elderly men with mental disorders who attempt suicide.The number of suicide attempts may even be greater than the estimates show, as it is usually underestimated, considering the possibilities of failure in the records or the suicide outcome being undervalued due to other diagnoses. It is important to consider the role of health services in the early diagnosis of mental disorders in elderly men in order to propose a timely and adequate treatment.