Citation

Courtet P, Olié E. Eur. Neuropsychopharmacol. 2021; 50: 118-120.

Copyright

(Copyright © 2021, Elsevier Publishing)

DOI

10.1016/j.euroneuro.2021.06.005

PMID

unavailable

Abstract

Since the emergence of the COVID-19 pandemic and the national lockdowns, the scientific community has feared an increase in suicides, mainly due to the psychological impact of such a sudden and important stress and of the social and neurobiological consequences of social distancing (Courtet et al., 2020; Zalsman, 2020). Population-based surveys rapidly reported high levels of depression, anxiety, insomnia, and suicidal ideation (Xiong et al., 2020). They also highlighted a higher risk for psychiatric patients because they already experience loneliness and because of possible breakdowns of the care systems. However, admissions for suicide attempts decreased in many countries at the beginning of the pandemic, especially during national lockdowns, compared with the preceding months and the previous year (2019) (Olie et al., 2021). According to national and local data from 21 countries, suicide death rates decreased in 12 countries and did not significantly increase in the others from April to July 2020 (Pirkis et al., 2021). This observation raises the question of whether the available data are reliable because they seem in contradiction with the higher psychological distress. It may be too early to have robust data or to measure the consequences of the mental health deterioration in terms of suicidal risk. Moreover, the use of self-report questionnaires to assess psychological conditions in online surveys may not fully reflect the psychopathology.

Nevertheless, all these data open perspectives to improve suicide prevention by pinpointing what could have contributed to reduce the suicide risk during the pandemic. First, the lockdowns and the war rhetoric used by governments may have strengthened social cohesion. The daily expression of gratitude towards healthcare workers in 2020 illustrates the positive state of mind and solidarity, which may have not disappeared. Second, loneliness and social isolation were major enemies leading to strengthen social ties. The use of communication tools widely increased and were adopted almost by everybody. Social networks, usually criticised for disseminating false information, became a tool to voice complaints and to share resentment, but also to keep in touch with family and friends. Third, staying at home may have helped to take care of loved ones and to decrease work stress by teleworking. Fourth, growing evidence concerning the deterioration of mental health during lockdown increased the governments' awareness of this issue and was covered by the media. Consequently people may have adopted protective measures for themselves and their family, while institutions were encouraged to develop support programmes and hotlines. Psychiatrists were immediately concerned about the consequences of the pandemic and might have been particularly active in adapting the care system to continue to help patients. For instance, telemedicine, which had been slowly developing for several decades, was deployed in all hospitals, breaking down all remaining obstacles within few weeks. As a result, all these measures at the level of individuals, society and health system might have promoted social connections and played a beneficial role in mitigating the pandemic negative impact in terms of suicidal behaviour...

Language: en