PROFILE OF SELF-HARM NOTIFICATIONS AMONG ADOLESCENTS IN THE 10TH HEALTH REGION OF PARANÁ, BRAZIL: SELECTIVE DECLINE DURING THE COVID-19 PANDEMIC (2014-2024)

Abstract

This study analyzed the profile of self-harm notifications among adolescents aged 10 to 19 years in the 10th Health Region of Paraná, Brazil, from 2014 to 2024, and assessed whether the decrease observed during the COVID-19 pandemic affected all groups equally. This is an ecological time-series study using data from the Notifiable Diseases Information System, grouped into pre-pandemic (2017-2019), pandemic (2020-2021), and post-pandemic (2022-2024) periods and compared using the chi-square test. A total of 2,506 notifications were recorded, 75.2% among females and 70.0% in the 15-to-19 age group, with poisoning as the predominant method. In 2022, the rate was 415.0 per 100,000 adolescents. Between 2019 and 2020, records decreased by 56.0% among those aged 10 to 14 and by 23.3% among those aged 15 to 19, as well as by 41.4% in the regional hub municipality and by 11.8% in the other municipalities. The share of younger adolescents fell from 33.2% to 25.2% (p = 0.010) and that of Cascavel from 73.1% to 66.5% (p = 0.034), whereas the proportion of females remained stable (p = 0.77). From 2022 onward, notifications exceeded previous levels. The decrease concentrated in the groups most dependent on schools and specialized services suggests a loss of detection rather than a true decline in occurrence and reinforces the importance of active case-finding in pediatric care for adolescents.