ABSTRACT Objective: Suicide is the culmination of a process or continuum known as suicidal behavior that proceeds from ideation and planning to attempt. The objective was to estimate the prevalence of suicide attempts in the adult Mexican population and to analyze their main associated factors. Methods: We conducted an observational, cross-sectional, and descriptive study with information from the National Health and Nutrition Survey (2018). Self-reported lifetime suicide attempt was used in the analysis. We analyzed depression, obesity, tobacco smoking, and alcohol consumption as suicide attempt-associated factors using a multivariate logistic regression model. Results: The prevalence of adult suicide attempt was 2.0% (95%CI 1.8–2.2) and it was higher among women (2.4%; 95%CI 2.2–2.8) and young people (2.9%; 95%CI 2.4–3.4). Low education (OR=1.6; 95%CI 1.2–2.2), being single (OR=1.3; 95%CI 1.0–1.6), having obesity (OR=1.4; 95%CI 1.1–1.8), consumption of alcohol (OR=2.4; 95%CI 1.7–3.4) or tobacco smoking (OR=1.8; 95%CI 1.4–2.4), and having strong symptoms of depression (OR=10.1; 95%CI 6.2–16.3) were associated with a higher prevalence of suicide attempts. Conclusion: These results help better understand suicidal behavior in Mexico and identify the factors that increase the likelihood of suicide attempts, which is essential to help reduce suicide mortality. This research is crucial for developing early interventions and prevention programs aimed at reducing suicide's public health burden.

RESUMO Objetivo: O suicídio é o resultado de um processo ou continuidade conhecido como comportamento suicida, que parte da ideação e planejamento até a tentativa. O objetivo foi estimar a prevalência de tentativa de suicídio na população adulta mexicana e analisar seus principais fatores associados. Métodos: Realizamos um estudo observacional, transversal e descritivo com informações da Pesquisa Nacional de Saúde e Nutrição (2018). Na análise, foi utilizado o relato de tentativa de suicídio ao longo da vida. Analisamos a depressão, a obesidade, o tabagismo e o consumo de álcool como fatores associados à tentativa de suicídio, usando um modelo de regressão logística multivariada. Resultados: A prevalência de tentativas de suicídio em adultos foi de 2,0% (intervalo de confiança de 95% — IC95% 1,8-2,2); foi mais alta entre as mulheres (2,4%; IC95% 2,2–2,8) e entre os jovens (2,9%; IC95% 2,4–3,4). Baixa educação (odds ratio — OR=1.6; IC95% 1.2–2.2), estado civil solteiro (OR=1.3; IC95% 1.0–1.6), obesidade (OR=1.4; IC95% 1.1–1.8), consumo de álcool (OR=2.4; IC95% 1.7–3.4) ou tabaco (OR=1.8; IC95% 1.4–2.4) e sintomas fortes de depressão (OR=10.1; IC95% 6.2–16.3) estão associados a uma maior prevalência de tentativas de suicídio. Conclusão: Esses resultados ajudam a entender melhor o comportamento suicida no México e a identificar os fatores que aumentam a probabilidade de tentativas de suicídio, o que é essencial para ajudar a reduzir a mortalidade por essa causa. Esta pesquisa é crucial para o desenvolvimento de intervenções precoces e programas de prevenção com o objetivo de reduzir o ônus de saúde pública do suicídio.

Abstract: Suicide behavior has increased in Mexican adolescents and young adults. The objective was to analyze the effect of self-esteem and depression on suicide ideation in Mexico City’s junior high and high school teenager students in 2012. We analyzed Mexico City’s Student Drug Consumption Survey of 2012 using a confirmatory factor analysis and a structural equation model. Female students had a higher prevalence of suicide ideation, depression and low self-esteem. Self-esteem and depression had a direct effect on suicide ideation. Self-esteem had a negative effect on suicide ideation when it is mediated by depression. Suicide ideation studies help to generate evidence for the planning, design and evaluation of strategies, policies and programs aimed at suicide prevention.

Resumen: La conducta suicida se ha incrementado en jóvenes y adolescentes mexicanos. El objetivo fue estudiar el efecto de la autoestima y la depresión en la ideación suicida en adolescentes estudiantes de secundaria y bachillerato de la Ciudad de México (CDMX) en 2012. Se analizó la Encuesta de Consumo de Drogas en Estudiantes en CDMX utilizando análisis de factores confirmatorio y un modelo de ecuaciones estructurales. Las estudiantes tuvieron mayor prevalencia de ideación suicida, depresión y baja autoestima. La autoestima y la depresión tuvieron un efecto directo en la ideación suicida. La autoestima tuvo un efecto negativo sobre la ideación suicida, cuando está mediada por la depresión. Los estudios sobre ideación suicida ayudan a generar evidencia para la planeación, diseño y evaluación de estrategias, políticas y programas de prevención del suicidio.

Abstract: Introduction: Attempted suicide is the main risk factor for completed suicides. Objective: To analyze the prevalen ce of attempted suicide in junior high school and high school students in Mexico City, and its asso ciated factors. Subjects and Method: Observational, cross-sectional and descriptive study conducted with data from the Mexico National Survey on Drug Use Among Students (ENCODE) 2012. The validated survey was anonymous, structured and self-applied, and contains seven sections: Sociode mographic; Tobacco, alcohol and drug use; Problems related to drug use; Antisocial behavior; Social sphere; Interpersonal sphere and Personal sphere. Family atmosphere, communication with parents, and self-esteem indexes were created using principal component analysis. A binomial logistic regres sion model was adjusted, and the odds ratio (OR) were analyzed. Results: The estimated prevalence of attempted suicide was 6.8%. The factors that increased the attempted suicide possibility were: being a woman (OR 3.1), be under 16 years old (OR 1.6), living in an unfavorable family atmosphere (OR 1.5) or having a poor communication with parents (OR 1.8), having low self-esteem (OR 1.9), behavioral or learning problems (OR 1.4) or suffering a mental illness (OR 3.6); having been forced into sexual contact (OR 2.6); or drugs use, smoking or alcohol consumption (OR 1.7, 1.2 and 1.7). Conclusions: The attempted suicide prevention should be focused on women younger than 16 years, with any psychiatric disorder, behavioral problem or low self-esteem, who live in an unfavorable family atmosphere, with risky behavior such as smoking, or alcohol or drugs consumption, or who have been forced into sexual contact.

Resumen: Introducción: El intento de suicidio es el principal factor de riesgo del suicidio consumado. Objetivo: Analizar la prevalencia de intento de suicidio en adolescentes estudiantes de secundaria y bachillerato de la Ciudad de México, y sus factores asociados. Sujetos y Método: Estudio observacional, transversal y descriptivo con la Encuesta de Consumo de Drogas en Estudiantes de la Ciudad de México en 2012. El cuestionario validado, fue anónimo, estructurado y autoaplicado, contiene siete secciones: Sociodemográfica; Consumo de tabaco, alcohol y drogas; Problemas relacionados con el consumo de drogas; Conducta antisocial; Ámbito social; Ámbito interpersonal y Ámbito personal. Se crearon índices de clima familiar, comunicación con los padres y autoestima utilizando análisis de compo nentes principales. Se ajustó un modelo de regresión logística binomial y se analizaron las razones de momios (OR). Resultados: La prevalencia estimada de intento de suicidio fue 6,8%. Los factores que incrementan la posibilidad de intento de suicido fueron: ser mujer (OR 3,1), tener menos de 16 años (OR 1,6), vivir en un clima familiar malo (OR 1,5) o con mala comunicación con los padres (OR 1,8), tener baja autoestima (OR 1,9), problemas de conducta o aprendizaje (OR 1,4) o tener una enfermedad mental (OR 3,6); haber sido forzados a tener contacto sexual (OR 2,6); o consumir drogas, tabaco o alcohol (OR 1,7, 1,2 y 1,7). Conclusiones: La prevención del intento de suicidio se debe dirigir a mujeres menores de 16 años; con un desorden psiquiátrico, problema de conducta o baja autoestima; que convivan en un ambiente familiar desfavorable; con comportamientos de riesgo como consumo de tabaco, alcohol o drogas; o que hayan sido forzados a tener contacto sexual.

Resumen En México el suicidio ha aumentado desde hace más de cuarenta años. El objetivo fue analizar los factores asociados con el intento de suicidio en adolescentes mexicanos en tres momentos: los doce meses previos a la encuesta, antes de doce meses y en algún momento de la vida. Se ajustaron modelos de regresión logística binomial y se exploró el método del intento con un análisis de correspondencias múltiples. Las mujeres reportaron mayor prevalencia de intento de suicidio, y esta fue menor para los más jóvenes. Si sufrió una agresión o tenía rezago educativo aumentó la propensión a intentar suicidarse, al igual que en aquellos adolescentes que consumen alcohol o tabaco. La prevención del suicidio se debe enfocar en el intento, que es su principal factor de riesgo, y se debe dirigir hacia las mujeres más jóvenes, adolescentes con rezago educativo, que fumen o consuman alcohol o que sufrieron recientemente violencia.

Abstract In Mexico, suicides have increased for more than forty years ago. This article aims to analyze the factors associated to the suicide attempts by Mexican teenagers in three different time points: at twelve month before the survey; any time between the survey and the 12-month point; and any time in the teenager’s life. Binomial logistic regression models were adjusted in order to explore the suicide attempt types under a multiple correspondence analysis. Women showed a higher suicide attempt prevalence, but it was lower among the younger ones. Having been assaulted or being in educational backwardness led to an increase in the suicidal intent; it was also an increase thereof among tobacco- or alcohol-consuming teenagers. Suicide prevention should be focused on the attempts, which is the main risk factor and prevention efforts should target the youngest women, those teenagers in educational backwardness who, either smoke or consume alcohol, or who underwent a violence event recently.

Resumo No México o suicídio vem se acrescentando por mais de quarenta anos. O objetivo foi analisar os fatores associados à tentativa de suicídio em adolescentes mexicanos em três momentos: os doze meses prévios ao inquérito, antes de doze meses e em algum momento da vida. Modelos de regressão logística binomial foram ajustados e explorou-se o método da tentativa com uma análise de correspondências múltiplas. As mulheres mostraram maior prevalência de tentativa de suicídio, e ela foi menor para os mais jovens. Quando tiver sofrido agressão ou atraso educativo, a propensão a tentar se suicidar aumentou, bem como em aqueles adolescentes que consomem álcool ou tabaco. A prevenção do suicídio deve se enfocar na tentativa, que é o principal fator de risco, e deve se direcionar para as mulheres mais jovens, adolescentes com atraso educativo, que fumem ou consumam álcool ou que sofreram recentemente violência.