Characteristics of deaths by suicide in postmortem studies in Brazil: A systematic review and meta‐analysis.

Introduction: Suicide is one of the leading causes of death, with a trend for its increase in Brazil in past decades. This study aimed to review the characteristics of suicides in Brazilian postmortem studies. Methods: Studies investigating suicide deaths in Brazil, and based on autopsy or psychological autopsy were included. Proportions were pooled across studies with the use of random and fixed effects models. Results: 6777 references were retrieved from six databases (searches up to January, 2023), and 45 studies included. In autopsy studies (k = 37, n = 16,231), substance use at toxicological analysis was found in 36.42% of cases (95% CI: 30.05–43.32), previous suicide attempts in 23.92% (95% CI: 6.73–57.78). In psychological autopsy studies (k = 8, n = 139), previous suicide attempts were reported in 28.09% (95% CI: 19.74–38.28), psychiatric conditions/symptoms in 90.67% (95% CI: 67.79–97.82), family history of suicidality in 21.33% (95% CI: 13.5–32.03). Most suicide deaths were reported in males and took place at the victim's home, hanging was the most frequent suicide method. Included studies presented significant limitations in quality assessment. Conclusion: Future studies should present more robust methodology, including bigger samples, the use of controls, and validated methodology. [ABSTRACT FROM AUTHOR]