TY - JOUR PY - 2021// TI - Suicide trends in the early months of the COVID-19 pandemic: an interrupted time-series analysis of preliminary data from 21 countries JO - Lancet psychiatry A1 - Pirkis, Jane A1 - John, Ann A1 - Shin, Sangsoo A1 - DelPozo-Banos, Marcos A1 - Arya, Vikas A1 - Analuisa-Aguilar, Pablo A1 - Appleby, Louis A1 - Arensman, Ella A1 - Bantjes, Jason A1 - Baran, Anna A1 - Bertolote, Jose M. A1 - Borges, Guilherme L. G. A1 - Brecić, Petrana A1 - Caine, Eric A1 - Castelpietra, Giulio A1 - Chang, Shu-Sen A1 - Colchester, David A1 - Crompton, David A1 - Curkovic, Marko A1 - Deisenhammer, Eberhard A. A1 - Du, Chengan A1 - Dwyer, Jeremy A1 - Erlangsen, Annette A1 - Faust, Jeremy S. A1 - Fortune, Sarah A1 - Garrett, Andrew A1 - George, Devin A1 - Gerstner, Rebekka A1 - Gilissen, Renske A1 - Gould, Madelyn A1 - Hawton, Keith A1 - Kanter, Joseph A1 - Kapur, Navneet A1 - Khan, Murad A1 - Kirtley, Olivia J. A1 - Knipe, Duleeka A1 - Kolves, Kairi A1 - Leske, Stuart A1 - Marahatta, Kedar A1 - Mittendorfer-Rutz, Ellenor A1 - Neznanov, Nikolay A1 - Niederkrotenthaler, Thomas A1 - Nielsen, Emma A1 - Nordentoft, Merete A1 - Oberlerchner, Herwig A1 - O'Connor, Rory C. A1 - Pearson, Melissa A1 - Phillips, Michael R. A1 - Platt, Steve A1 - Plener, Paul L. A1 - Psota, Georg A1 - Qin, Ping A1 - Radeloff, Daniel A1 - Rados, Christa A1 - Reif, Andreas A1 - Reif-Leonhard, Christine A1 - Rozanov, Vsevolod A. A1 - Schlang, Christiane A1 - Schneider, Barbara A1 - Semenova, Natalia A1 - Sinyor, Mark A1 - Townsend, Ellen A1 - Ueda, Michiko A1 - Vijayakumar, Lakshmi A1 - Webb, Roger T. A1 - Weerasinghe, Manjula A1 - Zalsman, Gil A1 - Gunnell, David A1 - Spittal, Matthew J. SP - ePub EP - ePub VL - ePub IS - ePub N2 - 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.

Language: en

LA - en SN - 2215-0374 UR - http://dx.doi.org/10.1016/S2215-0366(21)00091-2 ID - ref1 ER -