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Lantos T, Nyári TA. The impact of the first year of COVID-19 pandemic on suicides in a collection of 27 EU-related countries. Sci Rep 2024; 14:17671. [PMID: 39085389 PMCID: PMC11291984 DOI: 10.1038/s41598-024-68604-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/24/2024] [Accepted: 07/25/2024] [Indexed: 08/02/2024] Open
Abstract
Disasters, including epidemics, have a characteristic course, both in terms of the specific events and the human reactions to them. However, it is difficult to predict whether the COVID-19 pandemic will eventually lead to an increase in suicide rates. We aimed to provide a general pattern of the change in suicide rates in the countries linked to the European Union by direct comparison of the years 2019 and 2020 by gender and age group, grouped according to the predominant religions. Overall, 27 countries were included in the analysis. Incidence rate ratios and their 95% confidence intervals were calculated to characterise annual changes in the incidence of suicide deaths. In almost two-thirds of the countries studied, suicide rates did not increase. The largest increases were observed in Catholic-majority and 'mixed' Catholic-Protestant countries, but this was significant only for the oldest age group (over 65 years). This increase was even more marked within some Catholic-majority countries (Hungary, Ireland, and Spain) during the first months of the pandemic. There was no statistically significant increase overall in the suicide death rates in Europe. However, the pattern of suicide rates has changed significantly in some countries, and by age group and religion, respectively.
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Affiliation(s)
- Tamás Lantos
- Department of Medical Physics and Informatics, Albert Szent-Györgyi Medical School, University of Szeged, 9 Korányi Alley, Szeged, 6720, Hungary.
| | - Tibor András Nyári
- Department of Medical Physics and Informatics, Albert Szent-Györgyi Medical School, University of Szeged, 9 Korányi Alley, Szeged, 6720, Hungary
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Jeremic JV, Mihaljevic JM, Radosavljevic ILJ, Jurisic MM, Suđecki BJ, Stojicic MT, Jovanović MD, Pavlovic Z, Radenovic KG, Milic NV, Pavlovic V, Milic NM, Jovic MS. Trend of suicide by self-immolation in a 13-year timeline: was the COVID-19 pandemic a potentially important stressor? Front Public Health 2024; 12:1234584. [PMID: 38450141 PMCID: PMC10914977 DOI: 10.3389/fpubh.2024.1234584] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/04/2023] [Accepted: 01/31/2024] [Indexed: 03/08/2024] Open
Abstract
Introduction Self-immolation is an uncommon way of attempting and committing a suicide, with a fatality rate of 80%. The risk factors in self-immolation victims vary depending on demographic characteristics, socio-economic and cultural factors as well as religious beliefs. Whether the COVID-19 pandemic was a potentially important stressor for self-immolation is still unknown, with insufficient studies examining this issue. Therefore, in this study, we aimed to examine the trend of self-immolation in a 13-year timeline, and the potential association of COVID-19 pandemic with the increase in the incidence and severity of self-immolation injuries in Serbia in 2021. Materials and methods The study included hospitalized patients due to intentional burns caused by self-immolation in the period from January 1, 2008 to December 31, 2021. Joinpoint regression analysis was used for the analysis of continuous linear trends of self-immolation cases with change points. Results While a rising trend was observed in the 2008-2013 time segment, followed by a decline in the upcoming 2013-2016 time segment, a significant increase reached its maximum during COVID-19 pandemic (2021), with annual percent change of 37.1% (p = 0.001). A significant increase in the median number of cases per year was observed during 2021 compared to the previous periods (7.5 vs. 2). Frequency of patients with a psychiatric diagnosis vs. those without a psychiatric diagnosis was significantly higher during than before the COVID-19 period (66.7 vs. 36.1%, p = 0.046). Conclusion In our study, a significant increase in the frequency of suicide attempts by self-immolation during COVID-19 pandemic was noticed. There was also an increased frequency of pre-existing psychiatric illness among patients during the pandemic period. With limited high-quality data available, the study adds to a rising body of evidence for assessment of outcomes of the pandemic on mental health and recognition of stressors for self-immolation.
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Affiliation(s)
- Jelena V. Jeremic
- Faculty of Medicine, University of Belgrade, Belgrade, Serbia
- Clinic for Burns, Plastic and Reconstructive Surgery, University Clinical Center of Serbia, Belgrade, Serbia
| | - Jovan M. Mihaljevic
- Clinic for Burns, Plastic and Reconstructive Surgery, University Clinical Center of Serbia, Belgrade, Serbia
| | - Ivan L. J. Radosavljevic
- Clinic for Burns, Plastic and Reconstructive Surgery, University Clinical Center of Serbia, Belgrade, Serbia
| | - Milana M. Jurisic
- Clinic for Burns, Plastic and Reconstructive Surgery, University Clinical Center of Serbia, Belgrade, Serbia
| | - Branko J. Suđecki
- Clinic for Burns, Plastic and Reconstructive Surgery, University Clinical Center of Serbia, Belgrade, Serbia
| | - Milan T. Stojicic
- Faculty of Medicine, University of Belgrade, Belgrade, Serbia
- Clinic for Burns, Plastic and Reconstructive Surgery, University Clinical Center of Serbia, Belgrade, Serbia
| | - Milan D. Jovanović
- Faculty of Medicine, University of Belgrade, Belgrade, Serbia
- Clinic for Burns, Plastic and Reconstructive Surgery, University Clinical Center of Serbia, Belgrade, Serbia
| | - Zorana Pavlovic
- Faculty of Medicine, University of Belgrade, Belgrade, Serbia
- Clinic for Psychiatry, University Clinical Center of Serbia, Belgrade, Serbia
| | - Kristina G. Radenovic
- Clinic for Burns, Plastic and Reconstructive Surgery, University Clinical Center of Serbia, Belgrade, Serbia
| | - Nikola V. Milic
- Department of Medical Statistics and Informatics, Faculty of Medicine, University of Belgrade, Belgrade, Serbia
| | - Vedrana Pavlovic
- Department of Medical Statistics and Informatics, Faculty of Medicine, University of Belgrade, Belgrade, Serbia
| | - Natasa M. Milic
- Department of Medical Statistics and Informatics, Faculty of Medicine, University of Belgrade, Belgrade, Serbia
| | - Marko S. Jovic
- Faculty of Medicine, University of Belgrade, Belgrade, Serbia
- Clinic for Burns, Plastic and Reconstructive Surgery, University Clinical Center of Serbia, Belgrade, Serbia
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Sánchez-Carro Y, de la Torre-Luque A, Díaz-Marsá M, Aguayo-Estremera R, Andreo-Jover J, Ayad-Ahmed W, Bobes J, Bobes-Bascarán T, Bravo-Ortiz MF, Canal-Rivero M, Cebrià AI, Crespo-Facorro B, Elices M, Fernández-Rodrigues V, Lopez-Peña P, Grande I, Palao-Tarrero Á, Pemau A, Roberto N, Ruiz-Veguilla M, Pérez-Solà V. Psychiatric profiles in suicidal attempters: Relationships with suicide behaviour features. SPANISH JOURNAL OF PSYCHIATRY AND MENTAL HEALTH 2024:S2950-2853(24)00011-5. [PMID: 38331321 DOI: 10.1016/j.sjpmh.2024.01.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/13/2023] [Revised: 01/17/2024] [Accepted: 01/22/2024] [Indexed: 02/10/2024]
Abstract
BACKGROUND Suicide constitutes a major health concern worldwide, being a significant contributor of death, globally. The diagnosis of a mental disorder has been extensively linked to the varying forms of suicidal ideation and behaviour. The aim of our study was to identify the varying diagnostic profiles in a sample of suicide attempters. METHODS A sample of 683 adults (71.3% females, 40.10±15.74 years) admitted at a hospital emergency department due to a suicide attempt was recruited. Latent class analysis was used to identify diagnostic profiles and logistic regression to study the relationship between comorbidity profile membership and sociodemographic and clinical variables. RESULTS Two comorbidity profiles were identified (Class I: low comorbidity class, 71.3% of attempters; Class II: high comorbidity class, 28.7% of attempters). Class I members were featured by the diagnosis of depression and general anxiety disorder, and low comorbidity; by contrast, the high comorbidity profile was characterized by a higher probability of presenting two or more coexisting psychiatric disorders. Class II included more females, younger, with more depressive symptoms and with higher impulsivity levels. Moreover, Class II members showed more severe suicidal ideation, higher number of suicide behaviours and a greater number of previous suicide attempts (p<.01, for all the outcomes), compared to Class I members. CONCLUSIONS Psychiatric profiles may be considered for treatment provision and personalized psychiatric treatment in suicidal attempters as well as tackle suicide risk.
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Affiliation(s)
- Yolanda Sánchez-Carro
- Department of Psychiatry, Universidad Autónoma de Madrid, Madrid, Spain; CIBERSAM ISCIII, Madrid, Spain
| | | | - Marina Díaz-Marsá
- CIBERSAM ISCIII, Madrid, Spain; Universidad Complutense de Madrid, Madrid, Spain; Hospital Clinico San Carlos, Madrid, Spain.
| | | | - Jorge Andreo-Jover
- Department of Psychiatry, Universidad Autónoma de Madrid, Madrid, Spain; Hospital La Paz Institute for Health Research (IdiPAZ), Madrid, Spain
| | | | | | - Teresa Bobes-Bascarán
- CIBERSAM ISCIII, Madrid, Spain; Universidad de Oviedo, Spain; Instituto de Investigación Sanitaria del Principado de Asturias, Spain; Instituto de Neurocias del Principado de Asturias, Spain
| | - María Fé Bravo-Ortiz
- Department of Psychiatry, Universidad Autónoma de Madrid, Madrid, Spain; Hospital La Paz Institute for Health Research (IdiPAZ), Madrid, Spain; Department of Psychiatry, Clinical Psychology and Mental Health, La Paz University Hospital, Madrid, Spain
| | - Manuel Canal-Rivero
- CIBERSAM ISCIII, Madrid, Spain; UGC-Salud Mental de Hospital Virgen del Rocío/IBIS Sevilla, Spain; Universidad de Sevilla, Spain
| | | | - Benedicto Crespo-Facorro
- CIBERSAM ISCIII, Madrid, Spain; UGC-Salud Mental de Hospital Virgen del Rocío/IBIS Sevilla, Spain; Universidad de Sevilla, Spain
| | - Matilde Elices
- Institut Hospital del Mar d'Investigacions Mediques (IMIM), Barcelona, Spain
| | | | - Purificacion Lopez-Peña
- CIBERSAM ISCIII, Madrid, Spain; Department Psychiatry, Hospital Universitario Alava, Bioaraba, UPV/EHU, Osakidetza, Spain
| | - Iría Grande
- CIBERSAM ISCIII, Madrid, Spain; Departament de Medicina, Facultat de Medicina i Ciències de la Salut, Universitat de Barcelona (UB), Barcelona, Spain; Bipolar and Depressive Disorders Unit, Hospìtal Clinic de Barcelona, Barcelona, Spain; Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Barcelona, Spain; Institute of Neurosciences (UBNeuro), Spain
| | - Ángela Palao-Tarrero
- Department of Psychiatry, Universidad Autónoma de Madrid, Madrid, Spain; Hospital La Paz Institute for Health Research (IdiPAZ), Madrid, Spain; Department of Psychiatry, Clinical Psychology and Mental Health, La Paz University Hospital, Madrid, Spain
| | - Andrés Pemau
- Universidad Complutense de Madrid, Madrid, Spain
| | - Natalia Roberto
- CIBERSAM ISCIII, Madrid, Spain; Departament de Medicina, Facultat de Medicina i Ciències de la Salut, Universitat de Barcelona (UB), Barcelona, Spain; Bipolar and Depressive Disorders Unit, Hospìtal Clinic de Barcelona, Barcelona, Spain; Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Barcelona, Spain; Institute of Neurosciences (UBNeuro), Spain
| | - Miguel Ruiz-Veguilla
- CIBERSAM ISCIII, Madrid, Spain; UGC-Salud Mental de Hospital Virgen del Rocío/IBIS Sevilla, Spain; Universidad de Sevilla, Spain
| | - Víctor Pérez-Solà
- CIBERSAM ISCIII, Madrid, Spain; Institut Hospital del Mar d'Investigacions Mediques (IMIM), Barcelona, Spain
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Orellana JDY, de Souza MLP, Horta BL. Excess suicides in Brazil during the first 2 years of the COVID-19 pandemic: Gender, regional and age group inequalities. Int J Soc Psychiatry 2024; 70:99-112. [PMID: 37753792 DOI: 10.1177/00207640231196743] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 09/28/2023]
Abstract
BACKGROUND While the COVID-19 pandemic's total impact on global mortality is uncertain, an estimated 15 million excess deaths occurred during the first two pandemic years, suggesting that a broad impact, since several causes of death showed a substantial rise. AIMS To estimate excess suicides in Brazil and evaluate differences within and between subgroups during the first 2 years of the COVID-19 pandemic. METHOD Based on suicide data from the mortality information system of the Brazilian Ministry of Health, the expected number of suicides was estimated by age group, gender, 4-month periods and regions through quasi-Poisson generalized additive models. Analyses were performed in R software and RStudio. RESULTS Between March 2020 and February 2022, 29,295 suicides were reported in Brazil, close to what would be expected (30,116; 95% Confidence Interval (95% CI): [28,009, 32,224]), albeit in males and females aged 30 to 59 years and 60 years and over, there were excess suicides in at least one of the six 4-month periods evaluated, especially in the second pandemic year. In the Southeast region, a 28% increase was observed in women 60 years and older during the second year. In the North region, suicide increased 23% and 32% among women aged 30 to 59 years during the first and second pandemic years, respectively. The Northeast region had a 16% excess in suicides among men aged 30 to 59 years and 61% among women 60 years old and older during the second pandemic year, reaching 83% in July to October 2021. CONCLUSIONS During the first 2 pandemic years, the pattern of suicides was not homogeneous in Brazil. There were substantial excess suicides in women aged 30 to 59 years from the North and Northeast, while among the elderly and men there was a consistent pattern in several four-month periods throughout Brazil.
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Affiliation(s)
| | | | - Bernardo Lessa Horta
- Postgraduate Program in Epidemiology, Federal University of Pelotas, Pelotas, Brazil
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Paterson EN, Kent L, O'Reilly D, O'Hagan D, O'Neill SM, Maguire A. Impact of the COVID-19 pandemic on self-harm and self-harm/suicide ideation: population-wide data linkage study and time series analysis. Br J Psychiatry 2023; 223:509-517. [PMID: 37730688 PMCID: PMC10895516 DOI: 10.1192/bjp.2023.76] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/02/2023] [Revised: 05/09/2023] [Accepted: 05/10/2023] [Indexed: 09/22/2023]
Abstract
BACKGROUND The COVID-19 pandemic and associated lockdowns were predicted to have a major impact on suicidal behaviour, including self-harm. However, current studies have produced contradictory findings with limited trend data. AIMS Nine years of linked individual-level administrative data were utilised to examine changes in hospital-presenting self-harm and ideation (thoughts of self-harm or suicide) before and during the pandemic. METHOD National self-harm registry data were linked to demographic and socioeconomic indicators from healthcare registration records (n = 1 899 437). Monthly presentations of self-harm or ideation were split (pre-COVID-19 restrictions: April 2012 to February 2020; and during restrictions: March to September 2020). Auto-regressive integrated moving average (ARIMA) models were trained in R taking into consideration trends and seasonal effects. Forecast ('expected') monthly values were compared with 'actual' values, stratified by demographic factors and method of harm. RESULTS The number of individuals presenting with self-harm or ideation dropped significantly at the beginning of the pandemic (March-May 2020), before returning mostly to expected trends from June 2020. Stratified analysis showed similar presentation trends across most demographic subgroups except for those aged over 65 years, living alone or in affluent areas, where presentations remained unaffected, and those aged under 16 years, where numbers presenting with self-harm or ideation increased above expected levels. CONCLUSIONS Although population trends show an overall drop in presentations before a return to 'normal' from June 2020, the demographic profile of those presenting with self-harm or ideation varied significantly, with increases in children under the age of 16 years. This highlights important potential target groups who may have been most negatively affected by the pandemic.
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Affiliation(s)
- Euan Neil Paterson
- Centre for Public Health, Queen's University Belfast, Belfast, Northern Ireland
| | - Lisa Kent
- Centre for Public Health, Queen's University Belfast, Belfast, Northern Ireland
| | - Dermot O'Reilly
- Administrative Data Research Centre Northern Ireland (ADRC-NI), Queen's University, Belfast, Northern Ireland
| | | | | | - Aideen Maguire
- Centre for Public Health, Queen's University Belfast, Belfast, Northern Ireland
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Rees H, Hallett N. Reducing the risk of suicide among healthcare staff. Nurs Stand 2023; 38:26-33. [PMID: 37779322 DOI: 10.7748/ns.2023.e12178] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/16/2023] [Indexed: 10/03/2023]
Abstract
Reducing the number of deaths by suicide is an important area in public health. Several factors, including excessive workload demands and burnout, mean that healthcare staff such as nurses are at higher risk of death by suicide compared with people working in other occupations. This article explores the contributory factors involved in suicide among healthcare professionals and outlines some of the methods that nurses can use to enquire about suicide risk with their colleagues. It also details appropriate interventions that nurses can use to reduce the risk of suicide among their colleagues. The authors aim to increase nurses' understanding of their role in suicide prevention in the healthcare workforce.
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Affiliation(s)
- Helen Rees
- Nottingham Trent University, Nottingham, England
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Benson R, Rigby J, Brunsdon C, Corcoran P, Dodd P, Ryan M, Cassidy E, Colchester D, Hawton K, Lascelles K, de Leo D, Crompton D, Kõlves K, Leske S, Dwyer J, Pirkis J, Shave R, Fortune S, Arensman E. Real-Time Suicide Surveillance: Comparison of International Surveillance Systems and Recommended Best Practice. Arch Suicide Res 2023; 27:1312-1338. [PMID: 36237124 DOI: 10.1080/13811118.2022.2131489] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/02/2022]
Abstract
OBJECTIVE Some countries have implemented systems to monitor suicides in real-time. These systems differ because of the various ways in which suicides are identified and recorded. The main objective of this study was to conduct an international comparison of major real-time suicide mortality surveillance systems to identify joint strengths, challenges, and differences, and thereby inform best-practice criteria at local, national, and international levels. METHODS Five major real-time suicide mortality surveillance systems of various coverage levels were identified and selected for review via an internet-based scoping exercise and prior knowledge of existing systems. Key information including the system components and practices was collated from those organizations that developed and operate each system using a structured template. The information was narratively and critically synthesized to determine similarities and differences between the systems. RESULTS The comparative review of the five established real-time suicide surveillance systems revealed more commonalities than differences overall. Commonalities included rapid, routine surveillance based on minimal, provisional data to facilitate timely intervention and postvention efforts. Identified differences include the timeliness of case submission and system infrastructure. CONCLUSION The recommended criteria could promote replicable components and practices in real-time suicide surveillance while offering flexibility in adapting to regional/local circumstances and resource availability.HIGHLIGHTSEvidence-informed recommendations for current best practice in real-time suicide surveillance.Proposed comprehensive framework can be adapted based on available resources and capacity.Real-time suicide mortality data facilitates rapid data-driven decision-making in suicide prevention.
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Pell R, Suvarna SK, Cooper N, Rutty G, Green A, Osborn M, Johnson P, Hayward A, Durno J, Estrin-Serlui T, Mafham M, Roberts ISD. Coronial postmortem reports and indirect COVID-19 pandemic-related mortality. J Clin Pathol 2023; 76:457-462. [PMID: 35039447 PMCID: PMC8783968 DOI: 10.1136/jclinpath-2021-208003] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/11/2021] [Accepted: 12/23/2021] [Indexed: 02/04/2023]
Abstract
AIMS Widespread disruption of healthcare services and excess mortality not directly attributed to COVID-19 occurred between March and May 2020. We undertook the first UK multicentre study of coroners' autopsies before and during this period using postmortem reports. METHODS We reviewed reports of non-forensic coroners' autopsies performed during the first COVID-19 lockdown (23 March to 8 May 2020), and the same period in 2018. Deaths were categorised as natural non-COVID-19, COVID-19-related, non-natural (suicide, drug and alcohol-related, traumatic, other). We provided opinion regarding whether delayed access to medical care or changes in behaviour due to lockdown were a potential factor in deaths. RESULTS Seven centres covering nine coronial jurisdictions submitted a total of 1100 coroners' autopsies (498 in 2018, 602 in 2020). In only 54 autopsies was death attributed to COVID-19 (9%). We identified a significant increase in cases where delays in accessing medical care potentially contributed to death (10 in 2018, 44 in 2020). Lockdown was a contributing factor in a proportion of suicides (24%) and drug and alcohol-related deaths (12%). CONCLUSIONS Postmortem reports have considerable utility in evaluating excess mortality due to healthcare and wider societal disruption during a pandemic. They provide information at an individual case level that is not available from assessment of death certification data. Detailed evaluation of coroners' autopsy reports, supported by appropriate regulatory oversight, is recommended to mitigate disruption and indirect causes of mortality in future pandemics. Maintaining access to healthcare, including substance misuse and mental health services, is an important consideration.
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Affiliation(s)
- Robert Pell
- Department of Cellular Pathology, Oxford University Hospitals NHS Foundation Trust, Oxford, UK
| | - S Kim Suvarna
- Department of Histopathology, Northern General Hospital, The University of Sheffield, Sheffield, UK
| | - Nigel Cooper
- School of Medical Education, Newcastle University School of Clinical Medical Sciences, Newcastle upon Tyne, UK
| | - Guy Rutty
- East Midlands Forensic Pathology Unit, University of Leicester, Leicester, UK
| | - Anna Green
- Department of Cellular Pathology, Guy's and St Thomas' NHS Foundation Trust, London, UK
| | - Michael Osborn
- Department of Cellular Pathology, Imperial College Healthcare NHS Foundation Trust, London, UK
| | - Peter Johnson
- Department of Cellular Pathology, Buckinghamshire Healthcare NHS Trust, High Wycombe, UK
| | - Alison Hayward
- Department of Cellular Pathology, Milton Keynes University Hospital NHS Foundation Trust, Milton Keynes, UK
| | - Justine Durno
- Department of Cellular Pathology, Imperial College Healthcare NHS Foundation Trust, London, UK
| | | | - Marion Mafham
- Nuffield Department of Population Health, University of Oxford, Oxford, UK
| | - Ian S D Roberts
- Department of Cellular Pathology, Oxford University Hospitals NHS Foundation Trust, Oxford, UK
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de la Torre-Luque A, Pemau A, Perez-Sola V, Ayuso-Mateos JL. Suicide mortality in Spain in 2020: The impact of the COVID-19 pandemic. SPANISH JOURNAL OF PSYCHIATRY AND MENTAL HEALTH 2023; 16:116-118. [PMID: 35132342 PMCID: PMC8809655 DOI: 10.1016/j.rpsm.2022.01.003] [Citation(s) in RCA: 6] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 12/08/2021] [Revised: 01/24/2022] [Accepted: 01/25/2022] [Indexed: 10/31/2022]
Abstract
INTRODUCTION Suicide constitutes a major concern with evident contribution to global mortality worldwide. Evidence on suicide trends is mixed in the COVID-19 pandemic era. Spain may be an at-risk country for increased suicide risk in the time of COVID-19 pandemic due to prolonged restrictions and lockdown, elevated COVID-19 wave recurrence and related mental health impact. This brief report aims to provide some insight into the suicide mortality trends in the first COVID-19 pandemic year in Spain, using national data. MATERIAL AND METHODS Data from the National Death Index were used. Annual mortality rate was calculated at a province level under random-effects models for the 2019 and 2020 years. Poisson timeseries regression was used to study the relationship between monthly suicide mortality and COVID-19 pandemic outbreak and lockdown, and second COVID-19 wave peak covariates. RESULTS 3671 people died by suicide in 2019 in Spain and 3941 people died by suicide in 2020. The random-effects mortality rate in 2019 was 8.3 (CI95=7.6, 9.0) per 100,000 inhabitants, and mortality rate in 2020 was 8.9 (CI95=8.3, 9.6). No significant differences between mortality rates were found (p=.18). The Poisson regression showed a significant relationship between the COVID-19 outbreak and suicide mortality trend, with OR=1.07 (CI95=1.02, 1.12). CONCLUSIONS Although annual mortality rates were not significantly different, an increased suicide risk was found from May, 2020 onwards. Our results claim for action to tackle suicide in the post-pandemic era taking into account the discouraging upcoming scenario.
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Affiliation(s)
- Alejandro de la Torre-Luque
- Universidad Complutense de Madrid, Spain; Centre for Biomedical Research in Mental Health (CIBERSAM), Spain.
| | | | - Victor Perez-Sola
- Autonomous University of Barcelona, Spain; Institut Hospital del Mar d'Investigacions Mèdiques (IMIM), Parc de Salut Mar, Spain
| | - Jose Luis Ayuso-Mateos
- Centre for Biomedical Research in Mental Health (CIBERSAM), Spain; Autonomous University of Madrid, Spain
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Reinke M, Falke C, Cohen K, Anderson D, Cullen KR, Nielson JL. Increased suicidal ideation and suicide attempts in COVID-19 patients in the United States: Statistics from a large national insurance billing database. Psychiatry Res 2023; 323:115164. [PMID: 36948017 PMCID: PMC10008142 DOI: 10.1016/j.psychres.2023.115164] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/14/2022] [Revised: 01/27/2023] [Accepted: 03/09/2023] [Indexed: 03/14/2023]
Abstract
Emerging research suggests suicidality may have increased during the COVID-19 pandemic. This cross-sectional study aimed to advance understanding of suicide risk during the pandemic through novel use of a large insurance database. Using logistic regression across time-points, we estimated the effect of exposure to SARS-CoV-2 infection on rates of suicidal ideation and suicide attempts in infected individuals versus uninfected controls during the pandemic (March 2020 - September 2021). In uninfected individuals, we estimated the effect of exposure to the pandemic period versus the pre-pandemic control period (January 2017 to February 2020) on suicidality rates. We also investigated within-pandemic temporal patterns of suicidality. All patients with data in the UnitedHealth Group claims during those intervals were included. ICD-10 codes defined suicidality measures. There were 525,312,717 (62.3% over age 45, 57.7% female) included encounters. From the pandemic subsample (32.8%), 1.7% were COVID+. Adjusted odds ratios showed that COVID+ patients were significantly more likely to have suicidal ideation and suicide attempts than COVID- patients. Among COVID- patients, adjusted odds of suicidality were significantly lower during versus prior to the pandemic. Results were unfortunately limited by the absence of data on deaths by suicide. Further research should examine how SARS-CoV-2 infection may influence suicidality.
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Affiliation(s)
- Michael Reinke
- Department of Psychiatry & Behavioral Sciences, University of Minnesota, Minneapolis, Minnesota, United States.
| | - Chloe Falke
- Department of Psychiatry & Behavioral Sciences, University of Minnesota, Minneapolis, Minnesota, United States.
| | - Ken Cohen
- UnitedHealth Group, Minnetonka, Minnesota, United States.
| | - David Anderson
- UnitedHealth Group, Minnetonka, Minnesota, United States.
| | - Kathryn R Cullen
- Department of Psychiatry & Behavioral Sciences, University of Minnesota, Minneapolis, Minnesota, United States.
| | - Jessica L Nielson
- Department of Psychiatry & Behavioral Sciences, University of Minnesota, Minneapolis, Minnesota, United States; Institute for Health Informatics, University of Minnesota, Minneapolis, Minnesota, United States.
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Xiao Y, Junus A, Li T, Yip P. Temporal and spatial trends in suicide-related visits before and during the COVID-19 pandemic in the US, 2018-2021. J Affect Disord 2023; 324:24-35. [PMID: 36566936 PMCID: PMC9773784 DOI: 10.1016/j.jad.2022.12.062] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/10/2022] [Revised: 10/13/2022] [Accepted: 12/16/2022] [Indexed: 12/24/2022]
Abstract
BACKGROUND COVID-19 disproportionately impacted mental health in disadvantaged populations and areas. However, disparities in long-term changes in suicide-related visits across the US are unclear. This retrospective study aims to characterize temporal and spatial changes in suicide-related visits in healthcare settings from 2018 to 2021 in the U.S. METHODS We use electronic health records for 21,860,370 patients from Healthjump through the COVID-19 Research Database Consortium. Healthjump harmonizes EHR data from over 55 national databases across the US. Suicide ideation and suicide attempts between January 1, 2018 and December 12, 2021 were identified by the diagnosis codes in 6 periods in 2021 compared with the same periods in 2018-2020. RESULTS There was 30,019 suicidal ideation, and 7392 suicide attempt visits from January 2018 to November 2021. 15-20-year-olds were the most represented age group at 6302 suicide ideation visits (21.0 % of suicide ideation visits) and 1326 suicide attempt visits (17.9 % of suicide attempt visits), followed by suicide-related visits among 60+ years old. Compared with pre-pandemic periods, youth aged 15-20, females, White, non-Hispanic, and English speakers had increased suicide-related visits, especially suicidal ideation (P < 0.05). Suicide attempts with non-medical substances increased to 28.0 % in the first 6 months of the pandemic in 2020, compared with the prior year (21.5 %). COVID-19 patients had increased suicidal ideation in 2020. LIMITATIONS The EHR data is not nationally representative. CONCLUSIONS This study found significant and disproportionate increases in suicide related visits over the COVID-19 stages. To prevent the next storms of suicides, future interventions shall accommodate needs among vulnerable groups during and after periods of crisis.
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Affiliation(s)
- Yunyu Xiao
- Department of Population Health Sciences, Weill Cornell Medicine, NewYork-Presbyterian, New York, United States.
| | - Alvin Junus
- Department of Social Work and Social Administration, The University of Hong Kong, Hong Kong
| | - Tianzi Li
- Department of Population Health Sciences, Weill Cornell Medicine, NewYork-Presbyterian, New York, United States
| | - Paul Yip
- Department of Social Work and Social Administration, The University of Hong Kong, Hong Kong; HKJC Centre for Suicide Research and Prevention, The University of Hong Kong, Hong Kong
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12
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Marzano L, Hawley M, Fraser L, Lainez Y, Marsh J, Hawton K. Media coverage and speculation about the impact of the COVID-19 pandemic on suicide: a content analysis of UK news. BMJ Open 2023; 13:e065456. [PMID: 36854584 PMCID: PMC9979592 DOI: 10.1136/bmjopen-2022-065456] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 03/02/2023] Open
Abstract
OBJECTIVES Since the start of the COVID-19 pandemic, there has been much concern and speculation about rises in suicide rates, despite evidence that suicides did not in fact increase in the first year of the pandemic in most countries with real-time suicide data. This public narrative is potentially harmful, as well as misleading, and is likely to be perpetuated by sensational news coverage. METHOD Using a bespoke database, we analysed the quality and content of print and online UK news (including opinion pieces) on the impact of COVID-19 on suicidality, based on adherence to international recommendations. χ2 tests were conducted to examine variability in relation to key characteristics (eg, type of publication) and to four 'restriction phases' (based on UK government official lockdown measures) over the first 14 months of the pandemic. RESULTS We identified 372 stories about COVID-19 and suicidality in online and print news between the first UK lockdown (March 2020) and May 2021 (when restrictions were significantly eased in the UK). Throughout this period, over a third of articles (39.2%) and headlines (41.4%) claimed or predicted a rise in suicide, often attributed to feelings of entrapment and poor mental health (especially among young people) and fueled by expert commentary and speculation. Almost a third of reports were rated as being of negative quality (116, 31.2%), and at least half included no signposting to help and support. However, reporting improved in phases of less stringent COVID-19 restrictions and over time, with later articles and headlines including fewer negative statements and predictions about rises in suicides, and greater reliance on academic evidence. CONCLUSIONS As the longer-term consequences of the pandemic develop, and other national and global events unfold, it is increasingly important that the media, and the wider community of experts shaping its narratives, strive for a positive and evidence-informed approach to news coverage of suicide.
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Affiliation(s)
| | | | | | | | - James Marsh
- University of Oxford, Oxford, Oxfordshire, UK
| | - Keith Hawton
- Psychiatry, Centre for Suicide Research, Oxford University, Oxford, UK
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13
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Yan Y, Hou J, Li Q, Yu NX. Suicide before and during the COVID-19 Pandemic: A Systematic Review with Meta-Analysis. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2023; 20:3346. [PMID: 36834037 PMCID: PMC9960664 DOI: 10.3390/ijerph20043346] [Citation(s) in RCA: 23] [Impact Index Per Article: 23.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/28/2022] [Revised: 02/09/2023] [Accepted: 02/11/2023] [Indexed: 06/01/2023]
Abstract
Synthesizing evidence to examine changes in suicide-related outcomes before and during the pandemic can inform suicide management during the COVID-19 crisis. We searched 13 databases as of December 2022 for studies reporting both the pre- and peri-pandemic prevalence of suicidal ideation, suicide attempts, or rate of death by suicide. A random-effects model was used to pool the ratio of peri- and pre-pandemic prevalence of suicidal ideation and attempt (Prevalence Ratio-PR) and rate of death by suicide (Rate Ratio; RR). We identified 51, 55, and 25 samples for suicidal ideation, attempt, and death by suicide. The prevalence of suicidal ideation increased significantly among non-clinical (PR = 1.142; 95% CI: 1.018-1.282; p = 0.024; k = 28) and clinical (PR = 1.134; 95% CI: 1.048-1.227; p = 0.002; k = 23) samples, and pooled estimates differed by population and study design. Suicide attempts were more prevalent during the pandemic among non-clinical (PR = 1.14; 95% CI: 1.053-1.233; p = 0.001; k = 30) and clinical (PR = 1.32; 95% CI: 1.17-1.489; p = 0.000; k = 25) participants. The pooled RR for death by suicide was 0.923 (95% CI: 0.84-1.01; p = 0.092; k = 25), indicating a nonsignificant downward trend. An upward trend of suicidal ideation and suicide attempts was observed during the COVID-19 pandemic, despite suicide rate remaining stable. Our findings suggest that timely prevention and intervention programs are highly needed for non-clinical adult population and clinical patients. Monitoring the real-time and long-run suicide risk as the pandemic evolves is warranted.
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Affiliation(s)
- Yifei Yan
- Department of Social and Behavioural Sciences, City University of Hong Kong, Tat Chee Avenue, Kowloon, Hong Kong SAR, China
| | - Jianhua Hou
- Department of Social and Behavioural Sciences, City University of Hong Kong, Tat Chee Avenue, Kowloon, Hong Kong SAR, China
| | - Qing Li
- Department of Computing, The Hong Kong Polytechnic University, Hong Kong SAR, China
| | - Nancy Xiaonan Yu
- Department of Social and Behavioural Sciences, City University of Hong Kong, Tat Chee Avenue, Kowloon, Hong Kong SAR, China
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14
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Marzano L, Norman H, Sohal B, Hawton K, Mann R. Police-led real-time surveillance system for suspected suicides in Great Britain. BMJ MENTAL HEALTH 2023; 26:e300643. [PMID: 37085285 PMCID: PMC10124228 DOI: 10.1136/bmjment-2022-300643] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/07/2022] [Accepted: 03/21/2023] [Indexed: 04/23/2023]
Abstract
It has become increasingly apparent that rapidly available information about the occurrence of suicides is needed, particularly to support suicide prevention efforts. Concerns about the potential impact of the COVID-19 pandemic on vulnerability to suicide highlighted the need for such early data internationally. Here, we set out the nature, current status and content of a real-time suicide monitoring system in Great Britain (England, Scotland and Wales), and explore its potential to contribute to timely and targeted suicide prevention initiatives. We also discuss the challenges to successful implementation.
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Affiliation(s)
- Lisa Marzano
- Psychology Department, Middlesex University, London, UK
| | - Hilary Norman
- Psychology Department, Middlesex University, London, UK
| | - Baljit Sohal
- Public Protection and Vulnerability, British Transport Police, London, UK
| | - Keith Hawton
- Department of Psychiatry, University of Oxford, Oxford, UK
| | - Richard Mann
- Public Protection and Vulnerability, British Transport Police, London, UK
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15
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Pouquet M, Launay T, Rivière M, Chan-Chee C, Urbain F, Coulombel N, Bardoulat I, Pons R, Guerrisi C, Blanchon T, Hanslik T, Younes N. Trends and characteristics of attempted and completed suicides reported to general practitioners before vs during the COVID-19 pandemic in France: Data from a nationwide monitoring system, 2010-2022. PLoS One 2022; 17:e0278266. [PMID: 36520827 PMCID: PMC9754243 DOI: 10.1371/journal.pone.0278266] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/01/2022] [Accepted: 11/12/2022] [Indexed: 12/23/2022] Open
Abstract
BACKGROUND Most studies published to date have investigated the impact of the COVID-19 pandemic on suicidal acts using hospital data. Trends from primary care in a country such as France are crucial, as individuals may not consult hospital services after suicide attempts (SAs) but rather see their general practitioner (GP). OBJECTIVES We aimed to evaluate whether the incidence and characteristics of SAs and completed suicides (CSs) reported to French GPs were different during the COVID-19 pandemic than those of before. METHODS AND FINDINGS We conducted a retrospective observational study using data from a nationwide monitoring system, the French Sentinel Network (FSN). All SAs and CSs reported by GPs to the FSN from January 1, 2010, to March 10, 2022 were included. The annual incidence rates (IRs) and the characteristics of SAs and CSs during the pandemic (March 11, 2020, to March 10, 2022) were compared to those of before. In total, 687 SAs and 169 CSs were included. The IRs remained stable for SAs and CSs before and during the pandemic (overlap in confidence intervals). The mean IRs were 52 (95%CI = 44; 57) per 100,000 inhabitants for SAs during the pandemic versus 47 [36; 57] during the pre-pandemic period (p = 0.49), and 5 (95%CI = 2; 9) for CSs versus 11 [6; 16] (p = 0.30). During the pandemic, SA were slightly different from those before in terms of age and occupational status (young/students and older/retirees over-represented), history of consultation and expression of suicidal ideas to GP (more frequent), and CS in terms of occupational status (students over-represented) (p<0.05). CONCLUSION The COVID-19 pandemic had no major effect on the overall incidence of SAs and CSs reported to French GPs. However, more suicidal acts were reported among younger and older individuals. Suicidal patients and GPs have adapted by improving the expression of suicidal ideas.
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Affiliation(s)
- Marie Pouquet
- INSERM, Institut Pierre Louis d’Epidémiologie et de Santé Publique, Sorbonne Université, Paris, France
- * E-mail:
| | - Titouan Launay
- INSERM, Institut Pierre Louis d’Epidémiologie et de Santé Publique, Sorbonne Université, Paris, France
| | - Mathieu Rivière
- INSERM, Institut Pierre Louis d’Epidémiologie et de Santé Publique, Sorbonne Université, Paris, France
| | | | - Frédéric Urbain
- Unité de Formation et de Recherche des Sciences de la Santé Simone-Veil, Université de Versailles Saint-Quentin-en-Yvelines, Versailles, France
| | | | | | - Romain Pons
- INSERM, Institut Pierre Louis d’Epidémiologie et de Santé Publique, Sorbonne Université, Paris, France
| | - Caroline Guerrisi
- INSERM, Institut Pierre Louis d’Epidémiologie et de Santé Publique, Sorbonne Université, Paris, France
| | - Thierry Blanchon
- INSERM, Institut Pierre Louis d’Epidémiologie et de Santé Publique, Sorbonne Université, Paris, France
| | - Thomas Hanslik
- INSERM, Institut Pierre Louis d’Epidémiologie et de Santé Publique, Sorbonne Université, Paris, France
- Unité de Formation et de Recherche des Sciences de la Santé Simone-Veil, Université de Versailles Saint-Quentin-en-Yvelines, Versailles, France
- Service de Médecine Interne, Hôpital Ambroise-Paré, Assistance Publique - Hôpitaux de Paris, Boulogne-Billancourt, France
| | - Nadia Younes
- Unité de Formation et de Recherche des Sciences de la Santé Simone-Veil, Université de Versailles Saint-Quentin-en-Yvelines, Versailles, France
- Université Versailles Saint Quentin, Université Paris Saclay, Team DevPsy, Villejuif, France
- Centre Hospitalier Versailles, Service Hospitalo-Universitaire de Psychiatrie de l’Adulte et d’Addictologie, Le Chesnay, France
- Université Versailles-Saint-Quentin-en-Yvelines, Versailles, France
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16
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Matsumoto R, Kawano Y, Motomura E, Shiroyama T, Okada M. Analyzing the changing relationship between personal consumption and suicide mortality during COVID-19 pandemic in Japan, using governmental and personal consumption transaction databases. Front Public Health 2022; 10:982341. [PMID: 36159241 PMCID: PMC9489934 DOI: 10.3389/fpubh.2022.982341] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/30/2022] [Accepted: 08/15/2022] [Indexed: 01/25/2023] Open
Abstract
During the early stages of the ongoing COVID-19 pandemic, suicides did not increase in most countries/regions. Japan, however, was an exception to this, reporting increased numbers of female suicides with no changes in male suicide. To explore the trends of increasing suicides, the fluctuations of personal consumption (as an indicator of lifestyle) and standardized suicide death rate (SDR) disaggregated by age, sex, and prefecture, were determined using a linear mixed-effect model. Additionally, fixed effects of personal consumption on SDR during the pandemic were also analyzed using hierarchical linear regression models with robust standard errors. During the first wave of the pandemic, SDR for both sexes decreased slightly but increased during the second half of 2020. SDR of females younger than 70 years old and males younger than 40 years old continued to increase throughout 2021, whereas SDR for other ages of both sexes did not increase. Personal consumption expenditures on out-of-home recreations (travel agencies, pubs, and hotels) and internet/mobile communication expenses decreased, but expenditures on home-based recreations (contents distribution) increased during the pandemic. Increased expenditures on internet/mobile communication were related to increasing SDR of both sexes. Increasing expenditures on content distributions were related to increasing females' SDR without affecting that of males. Decreasing expenditures on pubs were related to increasing SDR of both sexes in the non-metropolitan region. These findings suggest that transformed individual lifestyles, extended time at home with a decreased outing for contact with others, contributed to the progression of isolation as a risk of suicide. Unexpectedly, increasing compensatory contact with others using internet/mobile communication enhanced isolation resulting in increased suicide risk.
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17
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Doyle M, Ainsworth P, Boul S, Lee D. Evaluation of a System for Real-Time Surveillance of Suicide in England. CRISIS 2022. [PMID: 35984087 DOI: 10.1027/0227-5910/a000874] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/15/2023]
Abstract
Background: Access to timely data on suicide is crucial to support suicide prevention. A real-time suicide surveillance (RTSS) system enables public health teams and allied agencies to review information following suicides promptly and take action quickly. Aims: The aim of this paper was to report on an evaluation of an RTSS system in South Yorkshire, England. Method: The system was reviewed, and outcome data were analyzed for 2019 and 2020 based on recorded suspected suicides, a stakeholder focus group, evaluation of postvention bereavement service outcomes, and lessons learned. Results: The benefits of RTSS included rapid response to emerging trends, identifying clusters, effective bereavement support, information to inform measures to mitigate risk, and supporting evaluation of interventions. The challenges faced included limited resources, data quality, consistency across places, and linkages with coronial processes. Limitations: This was an evaluation of one RTSS system based on routinely collected data covering one area, South Yorkshire, and hence some data limitations, and direct comparison with other services or against a control group was not possible. Conclusion: The RTSS system has led to better support for suicidal people and a responsive, timely, and effective service for those bereaved by suicide, all of which are likely to lead to enhanced well-being and community resilience.
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Affiliation(s)
- Michael Doyle
- Department of Nursing, School of Human and Health Sciences, University of Huddersfield, UK
| | | | - Sarah Boul
- NHS England and Improvement in South Yorkshire and Bassetlaw, Sheffield, UK
| | - Diane Lee
- Barnsley Metropolitan Borough Council, Barnsley, UK
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18
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Briggs S. The Impact of the COVID-19 Pandemic on the Suicidal and Self-Harming Behavior of Young People. Psychiatr Ann 2022. [DOI: 10.3928/00485713-20220718-01] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
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19
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Orellana JDY, de Souza MLP. Excess suicides in Brazil: Inequalities according to age groups and regions during the COVID-19 pandemic. Int J Soc Psychiatry 2022; 68:997-1009. [PMID: 35621004 DOI: 10.1177/00207640221097826] [Citation(s) in RCA: 11] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/29/2022]
Abstract
BACKGROUND The COVID-19 pandemic has already claimed more than six million direct deaths. Low-and middle-income countries, such Brazil, were severely hit, not only due to direct effects on mortality, but also for its indirect effects on other causes of deaths. AIMS The objective of this study was to estimate the excess suicides in Brazil and evaluate patterns within and between its regions during the COVID-19 pandemic in 2020. METHOD The observed suicides are gathered from the mortality information system of the Brazilian Ministry of Health. The estimates of expected suicides, according to sex, age group, bimonthly period and region, were reached through quasi-Poisson generalized additive models, with adjustment for overdispersion. The analyses were performed in R software, version 3.6.1 and RStudio, version 1.2.1335. RESULTS From March 2020 to December 2020, 10,409 suicides were observed in Brazil, resulting in an overall decrease of 13%, in comparison to the expected rate for the period. There were excess suicides of 26% in men from the Northern region in the 60 years and more age group, as well as in women from the Northern region in the 30 to 59 years age group in two consecutive bimonthly periods. Excess suicides of 40% was also observed in women in the 60 years and more age group from the Northeastern region. CONCLUSIONS Despite the overall decrease in suicides in Brazil over the period assessed, substantial excess suicides were observed in different age groups and sexes from the Northern and Northeastern regions of the country, which are regions that are historically more prone to health and socioeconomic inequalities.
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20
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Village A, Francis LJ. How Did the Psychological Well-Being of Church of England Clergy and Laity Change From the First to the Third National COVID-19 Lockdowns? PASTORAL PSYCHOLOGY 2022; 71:653-666. [PMID: 35821736 PMCID: PMC9261886 DOI: 10.1007/s11089-022-01017-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Accepted: 06/07/2022] [Indexed: 06/15/2023]
Abstract
The balanced affect model of psychological well-being conceptualises positive and negative affect as two separate continua and well-being as the function of these two entities. The COVID-19 pandemic lasted over two years in the United Kingdom and initially caused widespread declines in mental health and well-being. This paper tests whether such declines continued or stabilised as the pandemic lockdowns persisted. The psychological well-being of a religiously committed sample was assessed by perceived changes in affect balance (a function of negative and positive affect) using The Index of Affect Balance Change (TIBACh) from the first to the third COVID-19 lockdowns in the Church of England. The 2020 sample in the first lockdown comprised 792 stipendiary parochial clergy and 2,815 laity who were not in licensed ministry in the Church of England. A repeat survey in the third lockdown in England in 2021 collected responses from 401 equivalent clergy and 1027 equivalent laity. Both clergy and lay people showed increased proportions reporting lower positive affect and increased proportions reporting higher negative affect in the second survey, suggesting psychological well-being had continued to deteriorate as lockdowns persisted.
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Affiliation(s)
- Andrew Village
- School of Humanities, York St John University, Lord Mayor’s Walk, York, YO31 7EX UK
| | - Leslie J. Francis
- Centre for Educational Development, Appraisal and Research, The University of Warwick, Coventry, CV4 7AL UK
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21
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Haeffel GJ. Psychology needs to get tired of winning. ROYAL SOCIETY OPEN SCIENCE 2022; 9:220099. [PMID: 35754994 PMCID: PMC9214288 DOI: 10.1098/rsos.220099] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/28/2022] [Accepted: 06/06/2022] [Indexed: 05/03/2023]
Abstract
Psychological science is on an extraordinary winning streak. A review of the published literature shows that nearly all study hypotheses are supported. This means that either all the theories are correct, or the literature is biased towards positive findings. Results from large-scale replication projects and the prevalence of questionable research practices indicate the latter. This is a problem because science progresses from being wrong. For decades, there have been calls for better theories and the adoption of a strong inference approach to science. However, there is little reason to believe that psychological science is ready to change. Although recent developments like the open science movement have improved transparency and replicability, they have not addressed psychological science's method-oriented (rather than problem-oriented) mindset. Psychological science still does not embrace the scientific method of developing theories, conducting critical tests of those theories, detecting contradictory results, and revising (or disposing of) the theories accordingly. In this article, I review why psychologists must embrace being wrong and how the Registered Report format might be one strategy for stopping psychology's winning streak.
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Affiliation(s)
- Gerald J. Haeffel
- Department of Psychology, University of Notre Dame, Notre Dame, IN 46556, USA
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22
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Haddad M, Young N. Self-harm and suicide: occurrence, risk assessment and management for general nurses. Nurs Stand 2022; 37:71-76. [PMID: 35502573 DOI: 10.7748/ns.2022.e11911] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/09/2022] [Indexed: 11/09/2022]
Abstract
Suicide is a tragic event that has traumatic and far-reaching effects on families, friends and healthcare professionals, for whom feelings of guilt, blame and regret are common. Although there have been reductions in suicide rates globally and in the UK over past decades, it remains one of the leading causes of death. Assessing and supporting people who present with self-harm and risk of suicide are essential aspects of all nurses' clinical practice. This article explains the relationship between suicide, self-harm and other risk factors. It also provides guidance for general nurses on evidence-based approaches to managing self-harm and assessing suicide risk collaboratively with service users.
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Affiliation(s)
- Mark Haddad
- Centre for Health Services Research, City University of London School of Health Sciences, London, England
| | - Norman Young
- Early Intervention in Psychosis, Cardiff and Vale University Health Board, Hafan Y Coed, Llandough, Wales
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23
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Stene-Larsen K, Raknes G, Engdahl B, Qin P, Mehlum L, Strøm MS, Reneflot A. Suicide trends in Norway during the first year of the Covid-19 pandemic. A register-based cohort study. Eur Psychiatry 2022; 65:1-24. [PMID: 35437137 PMCID: PMC9058441 DOI: 10.1192/j.eurpsy.2022.17] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/07/2021] [Revised: 03/27/2022] [Accepted: 03/29/2022] [Indexed: 11/26/2022] Open
Abstract
Background There is a concern that the COVID-19 pandemic will lead to an increase in suicides. Several reports from the first months of the pandemic showed no increase in suicide rates while studies with longer observation times report contrasting results. In this study, we explore the suicide rates in Norway during the first year of the pandemic for the total population as well as for relevant subgroups such as sex, age, geographical areas, and pandemic phases. Methods This is a cohort study covering the entire Norwegian population between 2010 and 2020. The main outcome was age-standardized suicide rates (per 100,000 inhabitants) in 2020 according to the Norwegian Cause of Death Registry. This was compared with 95% prediction intervals (95% PI) based on the suicide rates between 2010 and 2019. Results In 2020, there were 639 suicides in Norway corresponding to a rate of 12.1 per 100,000 (95% PI 10.2–14.4). There were no significant deviations from the predicted values for suicides in 2020 when analyzing age, sex, pandemic phase, or geographical area separately. We observed a trend toward a lower than predicted suicide rate among females (6.5, 95% PI 6.0–9.2), and during the two COVID-19 outbreak phases in 2020 (2.8, 95% PI 2.3–4.3 and 2.8, 95% CI 2.3–4.3). Conclusion There is no indication that the COVID-19 pandemic led to an increase in suicide rates in Norway in 2020.
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Affiliation(s)
- K. Stene-Larsen
- Department of Mental Health and Suicide, National Institute of Public Health, Oslo, Norway
| | | | - B. Engdahl
- Department of Physical Health and Ageing, National Institute of Public Health, Oslo, Norway
| | - P. Qin
- National Centre for Suicide Research and Prevention, Institute of Clinical Medicine, University of Oslo, Oslo, Norway
| | - L. Mehlum
- National Centre for Suicide Research and Prevention, Institute of Clinical Medicine, University of Oslo, Oslo, Norway
| | - M. S. Strøm
- Department of Health Registry Research and Development, National Institute of Public Health, Bergen, Norway
| | - A. Reneflot
- Department of Mental Health and Suicide, National Institute of Public Health, Oslo, Norway
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Barberis N, Cannavò M, Cuzzocrea F, Verrastro V. Suicidal Behaviours During Covid-19 Pandemic: A Review. CLINICAL NEUROPSYCHIATRY 2022; 19:84-96. [PMID: 35601250 PMCID: PMC9112993 DOI: 10.36131/cnfioritieditore20220202] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 01/23/2023]
Abstract
Objective Novel COVID-19 disease has become a major concern worldwide, and a recent line of research warned that the context of the COVID-19 pandemic may be a major risk factor for developing severe suicidal behaviors. A broad systematic review is needed to cover the studies that have already assessed the potential underlying factors for suicidal behaviors in the context of the COVID-19 outbreak. Method A total of 52 studies met the inclusion criteria, and data were then described according to the subsequent categories: (1) countries where the studies were carried out; (2) factors impacting suicidal behaviors during the COVID-19 outbreak; and (3) examination of the observed populations. Results Findings of the current systematic review suggest that there is a certain amount of heterogeneity in factors impacting suicidal behaviors during the COVID-19 outbreak, with economic downturn, psychiatric vulnerability, isolation and quarantine, health concerns, and relational difficulties being the most prominent reasons for developing suicidal behaviors during the COVID-19 outbreak. Conclusions Timely interventions are needed to prevent suicidal behaviors in both the clinical and general populations, and in this regard, the creation of standard procedures may speed up the process.
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Marshall C, Lanyi K, Green R, Wilkins GC, Pearson F, Craig D. Using Natural Language Processing to Explore Mental Health Insights From UK Tweets During the COVID-19 Pandemic: Infodemiology Study. JMIR INFODEMIOLOGY 2022; 2:e32449. [PMID: 36406146 PMCID: PMC9642841 DOI: 10.2196/32449] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 07/28/2021] [Revised: 10/15/2021] [Accepted: 01/12/2022] [Indexed: 12/02/2022]
Abstract
Background There is need to consider the value of soft intelligence, leveraged using accessible natural language processing (NLP) tools, as a source of analyzed evidence to support public health research outputs and decision-making. Objective The aim of this study was to explore the value of soft intelligence analyzed using NLP. As a case study, we selected and used a commercially available NLP platform to identify, collect, and interrogate a large collection of UK tweets relating to mental health during the COVID-19 pandemic. Methods A search strategy comprised of a list of terms related to mental health, COVID-19, and lockdown restrictions was developed to prospectively collate relevant tweets via Twitter’s advanced search application programming interface over a 24-week period. We deployed a readily and commercially available NLP platform to explore tweet frequency and sentiment across the United Kingdom and identify key topics of discussion. A series of keyword filters were used to clean the initial data retrieved and also set up to track specific mental health problems. All collated tweets were anonymized. Results We identified and analyzed 286,902 tweets posted from UK user accounts from July 23, 2020 to January 6, 2021. The average sentiment score was 50%, suggesting overall neutral sentiment across all tweets over the study period. Major fluctuations in volume (between 12,622 and 51,340) and sentiment (between 25% and 49%) appeared to coincide with key changes to any local and/or national social distancing measures. Tweets around mental health were polarizing, discussed with both positive and negative sentiment. Key topics of consistent discussion over the study period included the impact of the pandemic on people’s mental health (both positively and negatively), fear and anxiety over lockdowns, and anger and mistrust toward the government. Conclusions Using an NLP platform, we were able to rapidly mine and analyze emerging health-related insights from UK tweets into how the pandemic may be impacting people’s mental health and well-being. This type of real-time analyzed evidence could act as a useful intelligence source that agencies, local leaders, and health care decision makers can potentially draw from, particularly during a health crisis.
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Affiliation(s)
- Christopher Marshall
- National Institute for Health Research Innovation Observatory Newcastle University Newcastle United Kingdom
| | - Kate Lanyi
- National Institute for Health Research Innovation Observatory Newcastle University Newcastle United Kingdom
| | - Rhiannon Green
- National Institute for Health Research Innovation Observatory Newcastle University Newcastle United Kingdom
| | - Georgina C Wilkins
- National Institute for Health Research Innovation Observatory Newcastle University Newcastle United Kingdom
| | - Fiona Pearson
- National Institute for Health Research Innovation Observatory Newcastle University Newcastle United Kingdom
| | - Dawn Craig
- National Institute for Health Research Innovation Observatory Newcastle University Newcastle United Kingdom
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Dmetrichuk JM, Rosenthal JS, Man J, Cullip M, Wells RA. Retrospective study of non-natural manners of death in Ontario: Effects of the COVID-19 pandemic and related public health measures. LANCET REGIONAL HEALTH. AMERICAS 2022; 7:100130. [PMID: 34927128 PMCID: PMC8671724 DOI: 10.1016/j.lana.2021.100130] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 11/02/2022]
Abstract
BACKGROUND The effects of the COVID-19 pandemic on non-natural manners of death in Ontario is not known. Understanding the indirect consequences of the pandemic and related public health measures (i.e. lockdown) fills a vital need to inform best practice in public health and guide policy decisions. METHODS The Office of the Chief Coroner and the Ontario Forensic Pathology Service (OCC-OFPS) investigate sudden and unexpected deaths in the province of Ontario. The number of homicides, suicides, and accidental deaths (non-natural deaths=77,655) were extracted from the centralized Coroner's Information System database (total deaths=197,966), across four provincially defined stages of lockdown related to the COVID-19 pandemic (March 17 to December 31, 2020), and crude rates (per 100,000 people) were compared to the previous eleven years. FINDINGS There was no major change to the rate of homicides during 2020 compared to 2009-2019 (RR 1⋅1, 95% CI 0⋅95-1⋅2; p=0⋅19; estimated annual effect=21 more deaths in 2020). The rate of suicides also did not show an overall major change in 2020 (RR 1⋅02, 95% CI 0⋅96-1⋅1; p=0⋅50; estimated annual effect=27 more deaths in 2020). However, during the first stage of lockdown (Stage 0), there was a decrease in the rate of suicides compared to all combinations of recent years from 2013 onwards (RRs 0⋅82-0⋅86, combined 95% CI 0⋅69-0⋅99; max p=0⋅039; estimated effect of 30 less deaths in Stage 0). There was an excess of over 1,500 accidental drug-related deaths that occurred during 2020 (RR 2⋅5, 95% CI 2⋅4-2⋅7; p<0⋅001). This finding held up to 'interrupted time series' robustness testing, indicating that 2020 had substantially more drug-related deaths, even when accounting for the linear increasing trend over time. Although motor vehicle collision associated fatalities appeared to decrease slightly in 2020 (RR 0⋅89, 95% CI 0⋅81-0⋅96; p=0⋅0039; estimated annual effect of 78 less deaths), we could not conclude any lockdown-associated effect, particularly when compared to 2019 (RR 0⋅26, 95% CI 0⋅75-1⋅1; p=0⋅26). INTERPRETATION In Ontario, the short-term effects of the COVID-19 pandemic did not greatly increase homicide or suicide rates, nor decrease motor vehicle collision fatality rates; however, the longer-term impact of the pandemic remains to be elucidated and ongoing vigilance is warranted in the event that other trends emerge. Accidental drug-related fatalities substantially increased during all stages of the lockdown, marking an urgent need for consideration in policy. These results highlight the vital role of death investigation systems in providing high quality and timely data to inform public health recommendations.
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Affiliation(s)
- Jennifer M Dmetrichuk
- Provincial Forensic Pathology Unit, Ontario Forensic Pathology Service, Forensic Services and Coroner's Complex, Toronto, Ontario, Canada.,Department of Laboratory Medicine and Pathobiology, University of Toronto, Toronto, Ontario, Canada
| | - Jeffrey S Rosenthal
- Department of Statistical Sciences, University of Toronto, Toronto, Ontario, Canada
| | - Julia Man
- Office of the Chief Coroner, Forensic Services and Coroner's Complex, Toronto, Ontario, Canada
| | - Mackenzie Cullip
- Provincial Forensic Pathology Unit, Ontario Forensic Pathology Service, Forensic Services and Coroner's Complex, Toronto, Ontario, Canada
| | - Richard A Wells
- Office of the Chief Coroner, Forensic Services and Coroner's Complex, Toronto, Ontario, Canada
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Guest editorial. JOURNAL OF PUBLIC MENTAL HEALTH 2022. [DOI: 10.1108/jpmh-03-2022-155] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
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Maleitzke T, Zocholl D, Topp T, Dimitrov-Discher A, Daus E, Reaux G, Zocholl M, Conze RN, Kolster M, Weber P, Fleckenstein FN, Scheutz Henriksen L, Stöckle U, Fuchs T, Gümbel D, Spranger N, Ringk A, Märdian S. Quality and quantity of serious violent suicide attempts during the COVID-19 pandemic. Front Psychiatry 2022; 13:927696. [PMID: 35928775 PMCID: PMC9343723 DOI: 10.3389/fpsyt.2022.927696] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/24/2022] [Accepted: 06/27/2022] [Indexed: 11/16/2022] Open
Abstract
BACKGROUND While repeated shutdown and lockdown measures helped contain the spread of SARS-CoV-2 during the COVID-19 pandemic, social distancing and self-isolation negatively impacted global mental health in 2020 and 2021. Although suicide rates did reportedly not increase during the first months of the pandemic, long-term data, and data on the quality of serious violent suicide attempts (SVSAs) are not available to date. MATERIALS AND METHODS Orthopaedic trauma patient visits to the emergency department (ED), ED trauma team activations, and SVSAs were retrospectively evaluated from January 2019 until May 2021 in four Level-I Trauma Centers in Berlin, Germany. SVSAs were assessed for suicide method, injury pattern and severity, type of treatment, and length of hospital stay. RESULTS Significantly fewer orthopaedic trauma patients presented to EDs during the pandemic (n = 70,271) compared to the control (n = 84,864) period (p = 0.0017). ED trauma team activation numbers remained unchanged. SVSAs (corrected for seasonality) also remained unchanged during control (n = 138) and pandemic (n = 129) periods, and no differences were observed for suicide methods, injury patterns, or length of hospital stay. CONCLUSION Our data emphasize that a previously reported rise in psychological stress during the COVID-19 pandemic does not coincide with increased SVSA rates or changes in quality of SVSAs.
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Affiliation(s)
- Tazio Maleitzke
- Charité - Universitätsmedizin Berlin, corporate member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Center for Musculoskeletal Surgery, Berlin, Germany.,Berlin Institute of Health at Charité - Universitätsmedizin Berlin, Julius Wolff Institute, Berlin, Germany.,Berlin Institute of Health at Charité - Universitätsmedizin Berlin, BIH Biomedical Innovation Academy, BIH Charité Clinician Scientist Program, Berlin, Germany
| | - Dario Zocholl
- Charité - Universitätsmedizin Berlin, corporate member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Institute of Biometry and Clinical Epidemiology, Berlin, Germany
| | - Tobias Topp
- Charité - Universitätsmedizin Berlin, corporate member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Department of Orthopaedic, Trauma, Hand and Reconstructive Surgery, Berlin, Germany
| | - Annika Dimitrov-Discher
- Charité - Universitätsmedizin Berlin, corporate member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Center for Musculoskeletal Surgery, Berlin, Germany
| | - Elly Daus
- Charité - Universitätsmedizin Berlin, corporate member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Center for Musculoskeletal Surgery, Berlin, Germany
| | - Gabriel Reaux
- Charité - Universitätsmedizin Berlin, corporate member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Center for Musculoskeletal Surgery, Berlin, Germany
| | - Malin Zocholl
- Department of Orthopaedic, Trauma, Hand and Reconstructive Surgery, Vivantes Hospital Friedrichshain, Berlin, Germany
| | - Rolf Nicolas Conze
- Department of Orthopaedic, Trauma, Hand and Reconstructive Surgery, Vivantes Hospital Friedrichshain, Berlin, Germany
| | - Moritz Kolster
- Department of Trauma and Orthopaedic Surgery, BG Klinikum Unfallkrankenhaus Berlin gGmbH, Berlin, Germany
| | - Philipp Weber
- Center for Orthopaedics and Trauma Surgery, Helios Klinikum Berlin-Buch, Berlin, Germany
| | - Florian Nima Fleckenstein
- Berlin Institute of Health at Charité - Universitätsmedizin Berlin, BIH Biomedical Innovation Academy, BIH Charité Clinician Scientist Program, Berlin, Germany.,Department of Growth and Reproduction, Copenhagen University Hospital - Rigshospitalet, Copenhagen, Denmark
| | - Louise Scheutz Henriksen
- International Centre for Research and Training in Endocrine Disruption of Male Reproduction and Child Health (EDMaRC), Copenhagen University Hospital - Rigshospitalet, Copenhagen, Denmark.,Department of Growth and Reproduction, Rigshospitalet, University of Copenhagen, Copenhagen, Denmark
| | - Ulrich Stöckle
- Charité - Universitätsmedizin Berlin, corporate member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Center for Musculoskeletal Surgery, Berlin, Germany
| | - Thomas Fuchs
- Department of Orthopaedic, Trauma, Hand and Reconstructive Surgery, Vivantes Hospital Friedrichshain, Berlin, Germany
| | - Denis Gümbel
- Department of Trauma and Orthopaedic Surgery, BG Klinikum Unfallkrankenhaus Berlin gGmbH, Berlin, Germany
| | - Nikolai Spranger
- Department of Trauma and Orthopaedic Surgery, BG Klinikum Unfallkrankenhaus Berlin gGmbH, Berlin, Germany
| | - Alexander Ringk
- Center for Orthopaedics and Trauma Surgery, Helios Klinikum Berlin-Buch, Berlin, Germany
| | - Sven Märdian
- Charité - Universitätsmedizin Berlin, corporate member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Center for Musculoskeletal Surgery, Berlin, Germany
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Eden CM, Zhu R, Khedr S, Khariton K. Effect of the Coronavirus Disease 2019 Pandemic on Suicide-Related Trauma Burden at a Level 1 Trauma Center. J Emerg Trauma Shock 2022; 15:88-92. [PMID: 35910318 PMCID: PMC9336639 DOI: 10.4103/jets.jets_142_21] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/17/2021] [Accepted: 01/14/2022] [Indexed: 12/03/2022] Open
Abstract
INTRODUCTION In March 2020, the first coronavirus disease 2019 (COVID-19) cases were reported in New York and a stay-at-home order was enacted soon after. Social isolation combined with pandemic-related stressors profoundly affected mental health. We hypothesize that there was an increase in violent suicide attempt during the COVID-19 pandemic lockdown compared to previous years. METHODS We queried our institutional trauma registry for total number of trauma activations and identified adult patients with International Classification of Diseases-10 diagnosis of intentional self-harm. We compared incidence during the lockdown to corresponding time periods from previous years. Demographic and injury characteristics were compared, as were outcomes such as mortality. RESULTS We observe a significant uptrend in patients requiring trauma intervention after suicide attempts from July 2019 through July 2020 (r = 0.8, P < 0.001) despite a significant downtrend in trauma volume at our institution during the same period (r = ‒0.7, P = 0.003). Although not statistically significant, patients attempting violent suicide during lockdown were more likely to have preexisting psychiatric diagnoses, to live alone, to have injury severity score >9, and to require surgical intervention. Three COVID-period patients died in the emergency room compared to zero in the comparison group. CONCLUSION Our data show a rise in violent suicide attempts during the pandemic lockdown despite an overall decrease in trauma volume. The ramifications of a stay-at-home order seem to have the most profound impact on individuals with preexisting mental health disease. Early establishment of mental health outreach programs may mitigate the reverberating psychosocial consequences of a pandemic.
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Affiliation(s)
- Claire M. Eden
- Department of Surgery, New York-Presbyterian/Queens, Queens, New York, USA,Address for correspondence: Dr. Claire M. Eden, Department of Surgery, New York-Presbyterian/Queens, No. 56-45 Main St, Queens, New York 11355, USA. E-mail:
| | - Roger Zhu
- Department of Surgery, New York-Presbyterian/Queens, Queens, New York, USA
| | - Shahenda Khedr
- Department of Surgery, New York-Presbyterian/Queens, Queens, New York, USA
| | - Konstantin Khariton
- Department of Surgery, Weill Cornell Medicine, New York-Presbyterian, New York, USA
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Winter R, Lavis A. The Impact of COVID-19 on Young People's Mental Health in the UK: Key Insights from Social Media Using Online Ethnography. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 19:352. [PMID: 35010612 PMCID: PMC8744667 DOI: 10.3390/ijerph19010352] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 11/03/2021] [Revised: 12/13/2021] [Accepted: 12/19/2021] [Indexed: 12/14/2022]
Abstract
There is increasing evidence of the psychological impact of COVID-19 on various population groups, with concern particularly focused on young people's mental health. However, few papers have engaged with the views of young people themselves. We present findings from a study into young people's discussions on social media about the impact of COVID-19 on their mental health. Real-time, multi-platform online ethnography was used to collect social media posts by young people in the United Kingdom (UK), March 2020-March 2021, 1033 original posts and 13,860 associated comments were analysed thematically. Mental health difficulties that were described as arising from, or exacerbated by, school closures, lost opportunities or fraught family environments included depression, anxiety and suicidality. Yet, some also described improvements to their mental health, away from prior stressors, such as school. Young people also recounted anxiety at the ramifications of the virus on others. The complexities of the psychological impact of COVID-19 on young people, and how this impact is situated in their pre-existing social worlds, need recognising. Forging appropriate support necessitates looking beyond an individualised conceptualisation of young people's mental health that sets this apart from broader societal concerns. Instead, both research and practice need to take a systemic approach, recognising young people's societal belonging and social contexts.
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Affiliation(s)
| | - Anna Lavis
- Institute of Applied Health Research, University of Birmingham, Birmingham B15 2TT, UK;
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Chen S, Jones PB, Underwood BR, Fernandez‐Egea E, Qin P, Lewis JR, Cardinal RN. Risk factors for excess deaths during lockdown among older users of secondary care mental health services without confirmed COVID-19: A retrospective cohort study. Int J Geriatr Psychiatry 2021; 36:1899-1907. [PMID: 34382242 PMCID: PMC8420159 DOI: 10.1002/gps.5610] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/15/2021] [Accepted: 08/05/2021] [Indexed: 01/18/2023]
Abstract
OBJECTIVE To investigate factors contributing to excess deaths of older patients during the initial 2020 lockdown beyond those attributable to confirmed COVID-19. METHODS Retrospective cohort study comparing patients treated between 23 March 2020 and 14 June 2020, deemed exposed to the pandemic/lockdown, to patients treated between 18 December 2019 and 10 March 2020, deemed to be unexposed. Data came from electronic clinical records from secondary care mental health services in Cambridgeshire and Peterborough NHS Foundation Trust (CPFT), UK (catchment area population ∼0.86 million). Eligible patients were aged 65 years or over at baseline with at least 14 days' follow-up, excluding patients diagnosed with confirmed or suspected SARS-CoV-2 infection. The primary outcome was all-cause mortality. FINDINGS In the two cohorts, 3,073 subjects were exposed to lockdown and 4,372 subjects were unexposed; the cohorts were followed up for an average of 74 and 78 days, respectively. After controlling for confounding by sociodemographic factors, smoking status, mental comorbidities, and physical comorbidities, patients with dementia suffered an additional 53% risk of death (HR = 1.53, 95% CI = 1.02-2.31), and patients with severe mental illness suffered an additional 123% risk of death (HR = 2.23, 95% CI = 1.42-3.49). No significant additional mortality risks were identified from physical comorbidities, potentially due to low statistical power in that respect. CONCLUSION During lockdown people with dementia or severe mental illness had a higher risk of death without confirmed COVID-19. These data could inform future health service responses and policymaking to help prevent avoidable excess death during future outbreaks of this or a similar infectious disease.
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Affiliation(s)
- Shanquan Chen
- Department of PsychiatryUniversity of CambridgeCambridgeUK
| | - Peter B. Jones
- Department of PsychiatryUniversity of CambridgeCambridgeUK,NIHR Applied Research CollaborationEast of EnglandUK,Cambridgeshire and Peterborough NHS Foundation TrustFulbournUK
| | - Benjamin R. Underwood
- Department of PsychiatryUniversity of CambridgeCambridgeUK,Cambridgeshire and Peterborough NHS Foundation TrustFulbournUK
| | - Emilio Fernandez‐Egea
- Department of PsychiatryUniversity of CambridgeCambridgeUK,Cambridgeshire and Peterborough NHS Foundation TrustFulbournUK
| | - Pei Qin
- Department of Biostatistics and EpidemiologyShenzhen University Health Science CentreShenzhenChina
| | | | - Rudolf N. Cardinal
- Department of PsychiatryUniversity of CambridgeCambridgeUK,Cambridgeshire and Peterborough NHS Foundation TrustFulbournUK
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Knipe D, Gunnell D, Evans H, John A, Fancourt D. Is Google Trends a useful tool for tracking mental and social distress during a public health emergency? A time-series analysis. J Affect Disord 2021; 294:737-744. [PMID: 34348169 PMCID: PMC8411666 DOI: 10.1016/j.jad.2021.06.086] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/17/2021] [Revised: 06/26/2021] [Accepted: 06/30/2021] [Indexed: 11/18/2022]
Abstract
BACKGROUND Google Trends data are increasingly used by researchers as an indicator of population mental health, but few studies have investigated the validity of this approach during a public health emergency. METHODS Relative search volumes (RSV) for the topics depression, anxiety, self-harm, suicide, suicidal ideation, loneliness, and abuse were obtained from Google Trends. We used graphical and time-series approaches to compare daily trends in searches for these topics against population measures of these outcomes recorded using validated self-report scales (PHQ-9; GAD-7; UCLA-3) in a weekly survey (n = ~70,000) of the impact COVID-19 on psychological and social experiences in the UK population (21/03/2020 to 21/08/ 2020). RESULTS Self-reported levels of depression, anxiety, self-harm/suicidal ideation, self-harm, loneliness and abuse decreased during the period studied. There was no evidence of an association between self-reported anxiety, self-harm, abuse and RSV on Google Trends. Trends in Google topic RSV for depression and suicidal ideation were inversely associated with self-reports of these outcomes (p = 0.03 and p = 0.04, respectively). However, there was statistical and graphical evidence that self-report and Google searches for loneliness (p < 0.001) tracked one another. LIMITATIONS No age/sex breakdown of Google Trends data available. Survey respondents were not representative of the UK population and no pre-pandemic data were available. CONCLUSION Google Trends data do not appear to be a useful indicator of changing levels of population mental health during a public health emergency, but may have some value as an indicator of loneliness.
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Affiliation(s)
- Duleeka Knipe
- Population Health Sciences, Bristol Medical School, University of Bristol, Bristol, UK
| | - David Gunnell
- Population Health Sciences, Bristol Medical School, University of Bristol, Bristol, UK.; National Institute of Health Research Biomedical Research Centre, University Hospitals Bristol and Weston NHS Foundation Trust, UK.
| | - Hannah Evans
- Population Data Science, Swansea University Medical School, Swansea, UK
| | - Ann John
- Population Data Science, Swansea University Medical School, Swansea, UK
| | - Daisy Fancourt
- Department of Behavioural Science and Health, University College London, London, UK
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Kontopantelis E, Mamas MA, Webb RT, Castro A, Rutter MK, Gale CP, Ashcroft DM, Pierce M, Abel KM, Price G, Faivre-Finn C, Van Spall HG, Graham MM, Morciano M, Martin GP, Doran T. Excess deaths from COVID-19 and other causes by region, neighbourhood deprivation level and place of death during the first 30 weeks of the pandemic in England and Wales: A retrospective registry study. THE LANCET REGIONAL HEALTH. EUROPE 2021; 7:100144. [PMID: 34557845 PMCID: PMC8454637 DOI: 10.1016/j.lanepe.2021.100144] [Citation(s) in RCA: 27] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Abstract
BACKGROUND Excess deaths during the COVID-19 pandemic compared with those expected from historical trends have been unequally distributed, both geographically and socioeconomically. Not all excess deaths have been directly related to COVID-19 infection. We investigated geographical and socioeconomic patterns in excess deaths for major groups of underlying causes during the pandemic. METHODS Weekly mortality data from 27/12/2014 to 2/10/2020 for England and Wales were obtained from the Office of National Statistics. Negative binomial regressions were used to model death counts based on pre-pandemic trends for deaths caused directly by COVID-19 (and other respiratory causes) and those caused indirectly by it (cardiovascular disease or diabetes, cancers, and all other indirect causes) over the first 30 weeks of the pandemic (7/3/2020-2/10/2020). FINDINGS There were 62,321 (95% CI: 58,849 to 65,793) excess deaths in England and Wales in the first 30 weeks of the pandemic. Of these, 46,221 (95% CI: 45,439 to 47,003) were attributable to respiratory causes, including COVID-19, and 16,100 (95% CI: 13,410 to 18,790) to other causes. Rates of all-cause excess mortality ranged from 78 per 100,000 in the South West of England and in Wales to 130 per 100,000 in the West Midlands; and from 93 per 100,000 in the most affluent fifth of areas to 124 per 100,000 in the most deprived. The most deprived areas had the highest rates of death attributable to COVID-19 and other indirect deaths, but there was no socioeconomic gradient for excess deaths from cardiovascular disease/diabetes and cancer. INTERPRETATION During the first 30 weeks of the COVID-19 pandemic there was significant geographic and socioeconomic variation in excess deaths for respiratory causes, but not for cardiovascular disease, diabetes and cancer. Pandemic recovery plans, including vaccination programmes, should take account of individual characteristics including health, socioeconomic status and place of residence. FUNDING None.
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Affiliation(s)
- Evangelos Kontopantelis
- Division of Informatics, Imaging and Data Sciences, University of Manchester, Oxford Road, M13 9PL Manchester, England, United Kingdom
- NIHR School for Primary Care Research, University of Oxford, Oxford, England, United Kingdom
- Health Organisation, Policy and Economics (HOPE) research group, University of Manchester, Manchester, England, United Kingdom
| | - Mamas A. Mamas
- Division of Informatics, Imaging and Data Sciences, University of Manchester, Oxford Road, M13 9PL Manchester, England, United Kingdom
- Keele Cardiovascular Research Group, Centre for Prognosis Research, Keele University, Keele, England, United Kingdom
- Department of Cardiology, Jefferson University, Philadelphia, United States
| | - Roger T. Webb
- Centre for Mental Health & Safety, Division of Psychology & Mental Health, University of Manchester and Manchester Academic Health Sciences Centre (MAHSC), England, United Kingdom
- NIHR Greater Manchester Patient Safety Translational Research Centre, Manchester, England, United Kingdom
| | - Ana Castro
- Department of Health Sciences, University of York, England, United Kingdom
| | - Martin K. Rutter
- Division of Diabetes, Endocrinology and Gastroenterology, School of Medical Sciences, University of Manchester, Manchester, England, United Kingdom
- Diabetes, Endocrinology and Metabolism Centre, Manchester University NHS Foundation Trust, Manchester Academic Health Sciences Centre, Manchester, England, United Kingdom
| | - Chris P. Gale
- Leeds Institute of Cardiovascular and Metabolic Medicine, University of Leeds, Leeds, England, United Kingdom
- Leeds Institute for Data Analytics, University of Leeds, Leeds, England, United Kingdom
- Department of Cardiology, Leeds Teaching Hospitals NHS Trust, Leeds, England, United Kingdom
| | - Darren M. Ashcroft
- NIHR School for Primary Care Research, University of Oxford, Oxford, England, United Kingdom
- NIHR Greater Manchester Patient Safety Translational Research Centre, Manchester, England, United Kingdom
- Division of Pharmacy & Optometry, University of Manchester, Manchester, England, United Kingdom
| | - Matthias Pierce
- Centre for Women's Mental Health, Division of Psychology and Mental Health, University of Manchester, Manchester, England, United Kingdom
| | - Kathryn M. Abel
- Centre for Women's Mental Health, Division of Psychology and Mental Health, University of Manchester, Manchester, England, United Kingdom
| | - Gareth Price
- Manchester Cancer Research Centre, The Christie NHS Foundation Trust, University of Manchester, Manchester, England, United Kingdom
| | - Corinne Faivre-Finn
- Manchester Cancer Research Centre, The Christie NHS Foundation Trust, University of Manchester, Manchester, England, United Kingdom
| | - Harriette G.C. Van Spall
- Department of Medicine and Department of Health Research Methods, Evidence, and Impact, McMaster University, Hamilton, Canada
| | - Michelle M. Graham
- Division of Cardiology, University of Alberta and Mazankowski Alberta Heart Institute, Edmonton, Alberta, Canada
| | - Marcello Morciano
- NIHR School for Primary Care Research, University of Oxford, Oxford, England, United Kingdom
- Health Organisation, Policy and Economics (HOPE) research group, University of Manchester, Manchester, England, United Kingdom
| | - Glen P. Martin
- Division of Informatics, Imaging and Data Sciences, University of Manchester, Oxford Road, M13 9PL Manchester, England, United Kingdom
| | - Tim Doran
- Department of Health Sciences, University of York, England, United Kingdom
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Rück C, Mataix-Cols D, Malki K, Adler M, Flygare O, Runeson B, Sidorchuk A. Swedish nationwide time series analysis of influenza and suicide deaths from 1910 to 1978. BMJ Open 2021; 11:e049302. [PMID: 34233997 PMCID: PMC8266430 DOI: 10.1136/bmjopen-2021-049302] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/31/2022] Open
Abstract
OBJECTIVES There is concern that the COVID-19 pandemic will be associated with an increase in suicides, but evidence supporting a link between pandemics and suicide is limited. Using data from the three influenza pandemics of the 20th century, we aimed to investigate whether an association exists between influenza deaths and suicide deaths. DESIGN Time series analysis. SETTING Sweden. PARTICIPANTS Deaths from influenza and suicides extracted from the Statistical Yearbook of Sweden for 1910-1978, covering three pandemics (the Spanish influenza, the Asian influenza and the Hong Kong influenza). MAIN OUTCOME MEASURES Annual suicide rates in Sweden among the whole population, men and women. Non-linear autoregressive distributed lag models was implemented to explore if there is a short-term and/or long-term relationship of increases and decreases in influenza death rates with suicide rates during 1910-1978. RESULTS Between 1910 and 1978, there was no evidence of either short-term or long-term significant associations between influenza death rates and changes in suicides (β coefficients of 0.00002, p=0.931 and β=0.00103, p=0.764 for short-term relationship of increases and decreases in influenza death rates, respectively, with suicide rates, and β=-0.0002, p=0.998 and β=0.00211, p=0.962 for long-term relationship of increases and decreases in influenza death rates, respectively, with suicide rates). The same pattern emerged in separate analyses for men and women. CONCLUSIONS We found no evidence of short-term or long-term association between influenza death rates and suicide death rates across three 20th century pandemics.
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Affiliation(s)
- Christian Rück
- Centre for Psychiatry Research, Department of Clinical Neuroscience, Karolinska Institutet & Stockholm Health Care Services, Region Stockholm, Stockholm, Sweden
| | - David Mataix-Cols
- Centre for Psychiatry Research, Department of Clinical Neuroscience, Karolinska Institutet & Stockholm Health Care Services, Region Stockholm, Stockholm, Sweden
| | - Kinda Malki
- Centre for Psychiatry Research, Department of Clinical Neuroscience, Karolinska Institutet & Stockholm Health Care Services, Region Stockholm, Stockholm, Sweden
| | - Mats Adler
- Centre for Psychiatry Research, Department of Clinical Neuroscience, Karolinska Institutet & Stockholm Health Care Services, Region Stockholm, Stockholm, Sweden
| | - Oskar Flygare
- Centre for Psychiatry Research, Department of Clinical Neuroscience, Karolinska Institutet & Stockholm Health Care Services, Region Stockholm, Stockholm, Sweden
| | - Bo Runeson
- Centre for Psychiatry Research, Department of Clinical Neuroscience, Karolinska Institutet & Stockholm Health Care Services, Region Stockholm, Stockholm, Sweden
| | - Anna Sidorchuk
- Centre for Psychiatry Research, Department of Clinical Neuroscience, Karolinska Institutet & Stockholm Health Care Services, Region Stockholm, Stockholm, Sweden
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Sacco DF, Brown M, Macchione AL, Young SG. No Evidence for Social Surrogacy in Fostering Intentions to Follow Social Distancing Guidelines. SOCIAL PSYCHOLOGY 2021. [DOI: 10.1027/1864-9335/a000450] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Abstract
Abstract. We tested whether temporary social needs satisfaction through social surrogacy would ensure greater willingness to adhere to social distancing recommendations elicited by the COVID-19 pandemic. Participants were randomly assigned to social exclusion or inclusion via Cyberball ( n = 534) followed by either a social surrogacy manipulation (imagine favorite TV show), or one of two control states. No restorative effects emerged following a social surrogacy prime. An exploratory analysis considering age as a moderator ( MAge = 36.89 years, SD = 10.88, range = 19–70 years) found that excluded adults (i.e., middle and older ages) reported more intentions to deviate following surrogacy experiences relative to control experiences; no effects emerged for younger adults in this analysis. We discuss the limitations of social surrogacy in fostering compliance with social distancing initiatives.
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Affiliation(s)
- Donald F. Sacco
- School of Psychology, The University of Southern Mississippi, Hattiesburg, MS, USA
| | - Mitch Brown
- Department of Psychological Science, University of Arkansas, Fayetteville, AR, USA
| | - Alicia L. Macchione
- School of Psychology, The University of Southern Mississippi, Hattiesburg, MS, USA
| | - Steven G. Young
- Baruch College and The Graduate Center, CUNY, New York, NY, USA
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Pirkis J, John A, Shin S, DelPozo-Banos M, Arya V, Analuisa-Aguilar P, Appleby L, Arensman E, Bantjes J, Baran A, Bertolote JM, Borges G, Brečić P, Caine E, Castelpietra G, Chang SS, Colchester D, Crompton D, Curkovic M, Deisenhammer EA, Du C, Dwyer J, Erlangsen A, Faust JS, Fortune S, Garrett A, George D, Gerstner R, Gilissen R, Gould M, Hawton K, Kanter J, Kapur N, Khan M, Kirtley OJ, Knipe D, Kolves K, Leske S, Marahatta K, Mittendorfer-Rutz E, Neznanov N, Niederkrotenthaler T, Nielsen E, Nordentoft M, Oberlerchner H, O'Connor RC, Pearson M, Phillips MR, Platt S, Plener PL, Psota G, Qin P, Radeloff D, Rados C, Reif A, Reif-Leonhard C, Rozanov V, Schlang C, Schneider B, Semenova N, Sinyor M, Townsend E, Ueda M, Vijayakumar L, Webb RT, Weerasinghe M, Zalsman G, Gunnell D, Spittal MJ. Suicide trends in the early months of the COVID-19 pandemic: an interrupted time-series analysis of preliminary data from 21 countries. Lancet Psychiatry 2021; 8:579-588. [PMID: 33862016 PMCID: PMC9188435 DOI: 10.1016/s2215-0366(21)00091-2] [Citation(s) in RCA: 389] [Impact Index Per Article: 129.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/22/2020] [Revised: 02/12/2021] [Accepted: 02/24/2021] [Indexed: 01/04/2023]
Abstract
BACKGROUND The COVID-19 pandemic is having profound mental health consequences for many people. Concerns have been expressed that, at their most extreme, these consequences could manifest as increased suicide rates. We aimed to assess the early effect of the COVID-19 pandemic on suicide rates around the world. METHODS We sourced real-time suicide data from countries or areas within countries through a systematic internet search and recourse to our networks and the published literature. Between Sept 1 and Nov 1, 2020, we searched the official websites of these countries' ministries of health, police agencies, and government-run statistics agencies or equivalents, using the translated search terms "suicide" and "cause of death", before broadening the search in an attempt to identify data through other public sources. Data were included from a given country or area if they came from an official government source and were available at a monthly level from at least Jan 1, 2019, to July 31, 2020. Our internet searches were restricted to countries with more than 3 million residents for pragmatic reasons, but we relaxed this rule for countries identified through the literature and our networks. Areas within countries could also be included with populations of less than 3 million. We used an interrupted time-series analysis to model the trend in monthly suicides before COVID-19 (from at least Jan 1, 2019, to March 31, 2020) in each country or area within a country, comparing the expected number of suicides derived from the model with the observed number of suicides in the early months of the pandemic (from April 1 to July 31, 2020, in the primary analysis). FINDINGS We sourced data from 21 countries (16 high-income and five upper-middle-income countries), including whole-country data in ten countries and data for various areas in 11 countries). Rate ratios (RRs) and 95% CIs based on the observed versus expected numbers of suicides showed no evidence of a significant increase in risk of suicide since the pandemic began in any country or area. There was statistical evidence of a decrease in suicide compared with the expected number in 12 countries or areas: New South Wales, Australia (RR 0·81 [95% CI 0·72-0·91]); Alberta, Canada (0·80 [0·68-0·93]); British Columbia, Canada (0·76 [0·66-0·87]); Chile (0·85 [0·78-0·94]); Leipzig, Germany (0·49 [0·32-0·74]); Japan (0·94 [0·91-0·96]); New Zealand (0·79 [0·68-0·91]); South Korea (0·94 [0·92-0·97]); California, USA (0·90 [0·85-0·95]); Illinois (Cook County), USA (0·79 [0·67-0·93]); Texas (four counties), USA (0·82 [0·68-0·98]); and Ecuador (0·74 [0·67-0·82]). INTERPRETATION This is the first study to examine suicides occurring in the context of the COVID-19 pandemic in multiple countries. In high-income and upper-middle-income countries, suicide numbers have remained largely unchanged or declined in the early months of the pandemic compared with the expected levels based on the pre-pandemic period. We need to remain vigilant and be poised to respond if the situation changes as the longer-term mental health and economic effects of the pandemic unfold. FUNDING None.
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Affiliation(s)
- Jane Pirkis
- Centre for Mental Health, Melbourne School of Population and Global Health, University of Melbourne, Melbourne, VIC, Australia.
| | - Ann John
- Swansea University Medical School, Swansea, UK
| | - Sangsoo Shin
- Centre for Mental Health, Melbourne School of Population and Global Health, University of Melbourne, Melbourne, VIC, Australia
| | | | - Vikas Arya
- Centre for Mental Health, Melbourne School of Population and Global Health, University of Melbourne, Melbourne, VIC, Australia; Translational Health Research Institute, Western Sydney University, Campbelltown, NSW, Australia
| | | | - Louis Appleby
- National Confidential Inquiry into Suicide and Safety in Mental Health, University of Manchester, Manchester, UK
| | - Ella Arensman
- School of Public Health, National Suicide Research Foundation, University College Cork, Cork, Ireland; Australian Institute for Suicide Research and Prevention, School of Applied Psychology, Griffith University, Brisbane, QLD, Australia
| | - Jason Bantjes
- Institute for Life Course Health Research, Department of Global Health, Stellenbosch University, Stellenbosch, South Africa
| | - Anna Baran
- Working Group on Prevention of Suicide and Depression at Public Health Council, Warsaw, Poland; Department of Psychiatry, Blekinge Hospital, Karlshamn, Sweden
| | - Jose M Bertolote
- Botucatu Medical School, Universidade Estadual Paulista, São Paulo, Brazil
| | - Guilherme Borges
- Instituto Nacional de Psiquiatría Ramon de la Fuente Muñiz, Mexico City, Mexico
| | - Petrana Brečić
- Department for Medical Ethics, University Psychiatric Hospital Vrapče, School of Medicine, University of Zagreb, Zagreb, Croatia; Department for Psychiatry, University Psychiatric Hospital Vrapče, School of Medicine, University of Zagreb, Zagreb, Croatia
| | - Eric Caine
- University of Rochester Medical Center, Rochester, NY, USA
| | - Giulio Castelpietra
- Region Friuli Venezia Giulia, Central Health Directorate, Outpatient and Inpatient Care Service, Trieste, Italy; Department of Medicine, University of Udine, Trieste, Italy
| | - Shu-Sen Chang
- Institute of Health Behaviors and Community Sciences, College of Public Health, National Taiwan University, Taipei, Taiwan
| | | | - David Crompton
- Australian Institute for Suicide Research and Prevention, School of Applied Psychology, Griffith University, Brisbane, QLD, Australia
| | - Marko Curkovic
- Department for Medical Ethics, University Psychiatric Hospital Vrapče, School of Medicine, University of Zagreb, Zagreb, Croatia
| | - Eberhard A Deisenhammer
- Department of Psychiatry, Psychotherapy and Psychosomatics, Medical University of Innsbruck, Innsbruck, Austria
| | - Chengan Du
- Center for Outcomes Research and Evaluation, Yale School of Medicine, New Haven, CT, USA
| | - Jeremy Dwyer
- Centre for Mental Health, Melbourne School of Population and Global Health, University of Melbourne, Melbourne, VIC, Australia; Coroners Court of Victoria, Melbourne, VIC, Australia
| | - Annette Erlangsen
- Danish Research Institute for Suicide Prevention, Copenhagen, Denmark; Department of Mental Health, Johns Hopkins School of Public Health, Baltimore, MD, USA; Centre for Mental Health Research, Australian National University, Canberra, ACT, Australia
| | - Jeremy S Faust
- Brigham and Women's Hospital Department of Emergency Medicine, Boston, MA, USA
| | - Sarah Fortune
- School of Population Health, University of Auckland, Auckland, New Zealand
| | - Andrew Garrett
- Magistrates Court of Tasmania (Coronial Division), Hobart, TAS, Australia
| | - Devin George
- Bureau of Vital Records and Statistics, Louisiana Office of Public Health, Baton Rouge, LA, USA
| | - Rebekka Gerstner
- Ministry of Public Health, Undersecretary of Health Services, Quito, Ecuador
| | - Renske Gilissen
- Research Department, 113 Suicide Prevention, Amsterdam, Netherlands
| | - Madelyn Gould
- Departments of Psychiatry and Epidemiology, Columbia University Medical Center/New York State Psychiatric Institute, New York, NY, USA
| | - Keith Hawton
- Centre for Suicide Research, University of Oxford, Oxford, UK
| | - Joseph Kanter
- Louisiana Department of Health, Baton Rouge, LA, USA
| | - Navneet Kapur
- Centre for Mental Health and Safety and National Institute for Health Research Patient Safety Translational Research Centre, University of Manchester, Manchester, UK; Greater Manchester Mental Health NHS Foundation Trust, Manchester, UK
| | - Murad Khan
- Department of Psychiatry, Aga Khan University, Karachi, Pakistan
| | | | - Duleeka Knipe
- Population Health Sciences, Bristol Medical School, University of Bristol, Bristol, UK; South Asian Clinical Toxicology Research Collaboration, Faculty of Medicine, University of Peradeniya, Peradeniya, Sri Lanka
| | - Kairi Kolves
- Australian Institute for Suicide Research and Prevention, School of Applied Psychology, Griffith University, Brisbane, QLD, Australia
| | - Stuart Leske
- Australian Institute for Suicide Research and Prevention, School of Applied Psychology, Griffith University, Brisbane, QLD, Australia
| | - Kedar Marahatta
- World Health Organization, Country Office for Nepal, Kathmandu, Nepal
| | | | - Nikolay Neznanov
- Bekhterev National Medical Research Center of Psychiatry and Neurology, Pavlov First Saint Petersburg State Medical University, Saint Petersburg, Russia
| | - Thomas Niederkrotenthaler
- Unit Suicide Research and Mental Health Promotion, Department of Social and Preventive Medicine, Center for Public Health, Medical University of Vienna, Vienna, Austria
| | - Emma Nielsen
- School of Psychology, University of Nottingham, Nottingham, UK
| | | | - Herwig Oberlerchner
- Department of Psychiatry and Psychotherapy, Klinikum Klagenfurt am Wörthersee, Klagenfurt, Austria
| | - Rory C O'Connor
- Suicidal Behaviour Research Lab, University of Glasgow, Glasgow, UK
| | - Melissa Pearson
- Preventing Deaths from Poisoning Research Group, University of Edinburgh, Edinburgh, UK
| | - Michael R Phillips
- Suicide Research and Prevention Center, Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, Shanghai, China; Departments of Psychiatry and Epidemiology, Columbia University, New York, NY, USA
| | - Steve Platt
- Usher Institute, University of Edinburgh, Edinburgh, UK
| | - Paul L Plener
- Department of Child and Adolescent Psychiatry, Medical University of Vienna, Vienna, Austria; Department of Child and Adolescent Psychiatry and Psychotherapy, University of Ulm, Ulm, Germany
| | - Georg Psota
- Psychosocial Services in Vienna, Vienna, Austria
| | - Ping Qin
- National Centre for Suicide Research and Prevention, Institute of Clinical Medicine, University of Oslo, Oslo, Norway
| | - Daniel Radeloff
- Department of Child and Adolescent Psychiatry, Psychotherapy and Psychosomatics, University Hospital Leipzig, Leipzig, Germany
| | - Christa Rados
- Department of Psychiatry and Psychotherapeutic Medicine, Landeskrankenhaus Villach, Villach, Austria
| | - Andreas Reif
- Department of Psychiatry, Psychosomatic Medicine and Psychotherapy, University Hospital Frankfurt, Frankfurt am Main, Germany
| | - Christine Reif-Leonhard
- Department of Psychiatry, Psychosomatic Medicine and Psychotherapy, University Hospital Frankfurt, Frankfurt am Main, Germany
| | - Vsevolod Rozanov
- Department of Borderline Disorders and Psychotherapy, Bekhterev National Medical Research Center of Psychiatry and Neurology, Saint Petersburg State University, Saint Petersburg, Russia
| | - Christiane Schlang
- Department of Psychiatry, Health Authority Frankfurt am Main, Frankfurt, Germany
| | - Barbara Schneider
- Department of Addictive Disorders, Psychiatry and Psychotherapy, LVR-Klinik Köln, Cologne, Germany; Department of Psychiatry, Psychosomatic Medicine and Psychotherapy, Goethe-University, Frankfurt am Main, Germany
| | - Natalia Semenova
- Organizational-Scientific Department, Bekhterev National Medical Research Center of Psychiatry and Neurology, Saint Petersburg, Russia
| | - Mark Sinyor
- Department of Psychiatry, University of Toronto, Toronto, ON, Canada; Department of Psychiatry, Sunnybrook Health Sciences Centre, Toronto, ON, Canada
| | - Ellen Townsend
- Self-Harm Research Group, School of Psychology, University of Nottingham, Nottingham, UK
| | - Michiko Ueda
- Waseda University, Faculty of Political Science and Economics, Tokyo, Japan
| | | | - Roger T Webb
- Centre for Mental Health and Safety and National Institute for Health Research Patient Safety Translational Research Centre, University of Manchester, Manchester, UK
| | - Manjula Weerasinghe
- Department of Community Medicine, Faculty of Medicine and Allied Sciences, Rajarata University of Sri Lanka, Anuradhapura, Sri Lanka
| | - Gil Zalsman
- Department of Psychiatry, Sackler School of Medicine, Tel Aviv University and Geha Mental Health Center, Tel Aviv, Israel; Division of Molecular Imaging and Neuropathology, New York State Psychiatric Institute and Department of Psychiatry, Columbia University, New York, USA
| | - David Gunnell
- National Institute of Health Research Biomedical Research Centre, University Hospitals Bristol and Weston NHS Foundation Trust, University of Bristol, Bristol, UK
| | - Matthew J Spittal
- Centre for Mental Health, Melbourne School of Population and Global Health, University of Melbourne, Melbourne, VIC, Australia
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