Suicides among Children and Adolescents in Paraguay: An 18-year National Exploratory Study (2004-2022)

Background: Suicide and suicide attempts are impacting events for patients and their relatives, and these behaviors are still taboo among adults and may be even more traumatic when involving children and adolescents. Aim: In this study we aimed to describe suicide rates among children and adolescents in Paraguay over the last decades as well as associated factors such as sociodemographic characteristics and methods used for suicide. Methods: This was an observational and exploratory study describing the frequency and characteristics of suicide among children and adolescents in Paraguay between 2004 and 2022. Official records of all deaths by suicide were reviewed, and statistical analyses were performed. In addition, an attempt was made to predict the number of suicides in the next 5 years using a mathematical model based on simple linear regression. Results: In the 18-year period observed, 940 suicides among children and adolescents were recorded. The mean age was 15.05 +/- 1.8 years old. Of these, 51.17% were male, 74.6% were from urban areas, and 22.2% were from the Greater Asuncion and Central Department of Paraguay. The most frequently used method of suicide was intentional self-inflicted injury by hanging, strangulation, or suffocation, which all represented 75.3% of the cases. Our mathematical modeling based on simple linear regression determined that the expected yearly number of national suicides in the pediatric population for the following years, from 2023 to 2027, will range between 72 and 81. Conclusion: This study is the first large national epidemiological report on the emerging issue of suicide among children and adolescents in Paraguay. It may be a relevant source of information for mental health professionals, health authorities, and decision makers to develop national prevention strategies and actions against suicide among youths.