Citation

Gordon M, Jayakumar N, Atzema C, Korczak DJ, Kennedy S, Schaffer A, Goldstein B, Orser BA, Yee D, Fiksenbaum L, Choi LHL, Phillips A, McFarlan A, Kreller M, Freedman C, Tanenbaum B, McDowall D, Ceniti A, Sinyor M. Psychiatry Res. 2024; 336: e115892.

Copyright

(Copyright © 2024, Elsevier Publishing)

DOI

10.1016/j.psychres.2024.115892

PMID

38642422

Abstract

The COVID-19 pandemic raised concerns regarding increased suicide-related behaviours. We compared characteristics and counts of Emergency Department (ED) presentations for self-harm, an important suicide-related outcome, during versus prior to the pandemic's first year. We included patients presenting with self-harm to the ED of two trauma centres in Toronto, Canada. Time series models compared intra-pandemic (March 2020-February 2021) presentation counts to predictions from pre-pandemic data. The self-harm proportion of ED presentations was compared between the intra-pandemic period and preceding three years. A retrospective chart review of eligible patients seen from March 2019-February 2021 compared pre- vs. intra-pandemic patient and injury characteristics. While monthly intra-pandemic self-harm counts were largely within expected ranges, the self-harm proportion of total presentations increased. Being widowed (OR=9.46; 95 %CI=1.10-81.08), employment/financial stressors (OR=1.65, 95 %CI=1.06-2.58), job loss (OR=3.83; 95 %CI=1.36-10.76), and chest-stabbing self-harm (OR=2.50; 95 %CI=1.16-5.39) were associated with intra-pandemic presentations. Intra-pandemic self-harm was also associated with Intensive Care Unit (ICU) admission (OR=2.18, 95 %CI=1.41-3.38). In summary, while the number of self-harm presentations to these trauma centres did not increase during the early pandemic, their proportion was increased. The association of intra-pandemic self-harm with variables indicating medically severe injury, economic stressors, and being widowed may inform future suicide and self-harm prevention strategies.

Language: en

Keywords

Emergency medicine; Retrospective studies; Self-injurious behavior; Suicide