TY - JOUR

T1 - Suicide numbers during the first 9-15 months of the COVID-19 pandemic compared with pre-existing trends

T2 - An interrupted time series analysis in 33 countries

AU - Pirkis, Jane

AU - Gunnell, David

AU - Shin, Sangsoo

AU - Del Pozo-Banos, Marcos

AU - Arya, Vikas

AU - Aguilar, Pablo Analuisa

AU - Appleby, Louis

AU - Arafat, S. M. Yasir

AU - Arensman, Ella

AU - Ayuso-Mateos, Jose Luis

AU - Balhara, Yatan Pal Singh

AU - Bantjes, Jason

AU - Baran, Anna

AU - Behera, Chittaranjan

AU - Bertolote, Jose

AU - Borges, Guilherme

AU - Bray, Michael

AU - Brečić, Petrana

AU - Caine, Eric

AU - Calati, Raffaella

AU - Carli, Vladimir

AU - Castelpietra, Giulio

AU - Chan, Lai Fong

AU - Chang, Shu-Sen

AU - Colchester, David

AU - Coss-Guzmán, Maria

AU - Crompton, David

AU - Ćurković, Marko

AU - Dandona, Rakhi

AU - De Jaegere, Eva

AU - De Leo, Diego

AU - Deisenhammer, Eberhard A.

AU - Dwyer, Jeremy

AU - Erlangsen, Annette

AU - Faust, Jeremy S.

AU - Fornaro, Michele

AU - Fortune, Sarah

AU - Garrett, Andrew

AU - Gentile, Guendalina

AU - Gerstner, Rebekka

AU - Gilissen, Renske

AU - Gould, Madelyn

AU - Gupta, Sudhir Kumar

AU - Hawton, Keith

AU - Holz, Franziska

AU - Kamenshchikov, Iurii

AU - Kapur, Navneet

AU - Kasal, Alexandr

AU - Khan, Murad

AU - Kirtley, Olivia J.

AU - Knipe, Duleeka

AU - Kõlves, Kairi

AU - Kölzer, Sarah C.

AU - Krivda, Hryhorii

AU - Leske, Stuart

AU - Madeddu, Fabio

AU - Marshall, Andrew

AU - Memon, Anjum

AU - Mittendorfer-Rutz, Ellenor

AU - Nestadt, Paul

AU - Neznanov, Nikolay

AU - Niederkrotenthaler, Thomas

AU - Nielsen, Emma

AU - Nordentoft, Merete

AU - Oberlerchner, Herwig

AU - O'Connor, Rory C.

AU - Papsdorf, Rainer

AU - Partonen, Timo

AU - Phillips, Michael R

AU - Platt, Steve

AU - Portzky, Gwendolyn

AU - Psota, Georg

AU - Qin, Ping

AU - Radeloff, Daniel

AU - Reif, Andreas

AU - Reif-Leonhard, Christine

AU - Rezaeian, Mohsen

AU - Román-Vázquez, Nayda

AU - Roskar, Saska

AU - Rozanov, Vsevolod

AU - Sara, Grant

AU - Scavacini, Karen

AU - Schneider, Barbara

AU - Semenova, Natalia

AU - Sinyor, Mark

AU - Tambuzzi, Stefano

AU - Townsend, Ellen

AU - Ueda, Michiko

AU - Wasserman, Danuta

AU - Webb, Roger T

AU - Winkler, Petr

AU - Yip, Paul S. F.

AU - Zalsman, Gil

AU - Zoja, Riccardo

AU - John, Ann

AU - Spittal, Matthew J.

N1 - Publisher Copyright: © 2022 The Authors

PY - 2022

Y1 - 2022

N2 - Background: Predicted increases in suicide were not generally observed in the early months of the COVID-19 pandemic. However, the picture may be changing and patterns might vary across demographic groups. We aimed to provide a timely, granular picture of the pandemic's impact on suicides globally. Methods: We identified suicide data from official public-sector sources for countries/areas-within-countries, searching websites and academic literature and contacting data custodians and authors as necessary. We sent our first data request on 22nd June 2021 and stopped collecting data on 31st October 2021. We used interrupted time series (ITS) analyses to model the association between the pandemic's emergence and total suicides and suicides by sex-, age- and sex-by-age in each country/area-within-country. We compared the observed and expected numbers of suicides in the pandemic's first nine and first 10-15 months and used meta-regression to explore sources of variation. Findings: We sourced data from 33 countries (24 high-income, six upper-middle-income, three lower-middle-income; 25 with whole-country data, 12 with data for area(s)-within-the-country, four with both). There was no evidence of greater-than-expected numbers of suicides in the majority of countries/areas-within-countries in any analysis; more commonly, there was evidence of lower-than-expected numbers. Certain sex, age and sex-by-age groups stood out as potentially concerning, but these were not consistent across countries/areas-within-countries. In the meta-regression, different patterns were not explained by countries’ COVID-19 mortality rate, stringency of public health response, economic support level, or presence of a national suicide prevention strategy. Nor were they explained by countries’ income level, although the meta-regression only included data from high-income and upper-middle-income countries, and there were suggestions from the ITS analyses that lower-middle-income countries fared less well. Interpretation: Although there are some countries/areas-within-countries where overall suicide numbers and numbers for certain sex- and age-based groups are greater-than-expected, these countries/areas-within-countries are in the minority. Any upward movement in suicide numbers in any place or group is concerning, and we need to remain alert to and respond to changes as the pandemic and its mental health and economic consequences continue. Funding: None.

AB - Background: Predicted increases in suicide were not generally observed in the early months of the COVID-19 pandemic. However, the picture may be changing and patterns might vary across demographic groups. We aimed to provide a timely, granular picture of the pandemic's impact on suicides globally. Methods: We identified suicide data from official public-sector sources for countries/areas-within-countries, searching websites and academic literature and contacting data custodians and authors as necessary. We sent our first data request on 22nd June 2021 and stopped collecting data on 31st October 2021. We used interrupted time series (ITS) analyses to model the association between the pandemic's emergence and total suicides and suicides by sex-, age- and sex-by-age in each country/area-within-country. We compared the observed and expected numbers of suicides in the pandemic's first nine and first 10-15 months and used meta-regression to explore sources of variation. Findings: We sourced data from 33 countries (24 high-income, six upper-middle-income, three lower-middle-income; 25 with whole-country data, 12 with data for area(s)-within-the-country, four with both). There was no evidence of greater-than-expected numbers of suicides in the majority of countries/areas-within-countries in any analysis; more commonly, there was evidence of lower-than-expected numbers. Certain sex, age and sex-by-age groups stood out as potentially concerning, but these were not consistent across countries/areas-within-countries. In the meta-regression, different patterns were not explained by countries’ COVID-19 mortality rate, stringency of public health response, economic support level, or presence of a national suicide prevention strategy. Nor were they explained by countries’ income level, although the meta-regression only included data from high-income and upper-middle-income countries, and there were suggestions from the ITS analyses that lower-middle-income countries fared less well. Interpretation: Although there are some countries/areas-within-countries where overall suicide numbers and numbers for certain sex- and age-based groups are greater-than-expected, these countries/areas-within-countries are in the minority. Any upward movement in suicide numbers in any place or group is concerning, and we need to remain alert to and respond to changes as the pandemic and its mental health and economic consequences continue. Funding: None.

KW - COVID-19

KW - Monitoring

KW - Pandemic

KW - Suicide

U2 - 10.1016/j.eclinm.2022.101573

DO - 10.1016/j.eclinm.2022.101573

M3 - Journal article

C2 - 35935344

AN - SCOPUS:85135354142

VL - 51

JO - EClinicalMedicine

JF - EClinicalMedicine

SN - 2589-5370

M1 - 101573

ER -