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Suicide numbers during the first 9-15 months of the COVID-19 pandemic compared with pre-existing trends: An interrupted time series analysis in 33 countries

Pirkis, Jane; Gunnell, David; Shin, Sangsoo; Del Pozo-Banos, Marcos; Arya, Vikas; Aguilar, Pablo Analuisa; Appleby, Louis; Arafat, S. M.Yasir; Arensman, Ella; Ayuso-Mateos, Jose Luis; Balhara, Yatan Pal Singh; Bantjes, Jason; Baran, Anna; Behera, Chittaranjan; Bertolote, Jose; Borges, Guilherme; Bray, Michael; Brečić, Petrana; Caine, Eric; Calati, Raffaella; Carli, Vladimir; Castelpietra, Giulio; Chan, Lai Fong; Chang, Shu Sen; Colchester, David; Coss-Guzmán, Maria; Crompton, David; Ćurković, Marko; Dandona, Rakhi; De Jaegere, Eva; De Leo, Diego; Deisenhammer, Eberhard A.; Dwyer, Jeremy; Erlangsen, Annette; Faust, Jeremy S.; Fornaro, Michele; Fortune, Sarah; Garrett, Andrew; Gentile, Guendalina; Gerstner, Rebekka; Gilissen, Renske; Gould, Madelyn; Gupta, Sudhir Kumar; Hawton, Keith; Holz, Franziska; Kamenshchikov, Iurii; Kapur, Navneet; Kasal, Alexandr; Khan, Murad; Kirtley, Olivia J.; Knipe, Duleeka; Kõlves, Kairi; Kölzer, Sarah C.; Krivda, Hryhorii; Leske, Stuart; Madeddu, Fabio; Mar...

Suicide numbers during the first 9-15 months of the COVID-19 pandemic compared with pre-existing trends: An interrupted time series analysis in 33 countries Thumbnail


Authors

Jane Pirkis

David Gunnell

Sangsoo Shin

Marcos Del Pozo-Banos

Vikas Arya

Pablo Analuisa Aguilar

Louis Appleby

S. M.Yasir Arafat

Ella Arensman

Jose Luis Ayuso-Mateos

Yatan Pal Singh Balhara

Jason Bantjes

Anna Baran

Chittaranjan Behera

Jose Bertolote

Guilherme Borges

Michael Bray

Petrana Brečić

Eric Caine

Raffaella Calati

Vladimir Carli

Giulio Castelpietra

Lai Fong Chan

Shu Sen Chang

David Colchester

Maria Coss-Guzmán

David Crompton

Marko Ćurković

Rakhi Dandona

Eva De Jaegere

Diego De Leo

Eberhard A. Deisenhammer

Jeremy Dwyer

Annette Erlangsen

Jeremy S. Faust

Michele Fornaro

Sarah Fortune

Andrew Garrett

Guendalina Gentile

Rebekka Gerstner

Renske Gilissen

Madelyn Gould

Sudhir Kumar Gupta

Keith Hawton

Franziska Holz

Iurii Kamenshchikov

Navneet Kapur

Alexandr Kasal

Murad Khan

Olivia J. Kirtley

Duleeka Knipe

Kairi Kõlves

Sarah C. Kölzer

Hryhorii Krivda

Stuart Leske

Fabio Madeddu

Andrew Marshall

Anjum Memon

Ellenor Mittendorfer-Rutz

Paul Nestadt

Nikolay Neznanov

Thomas Niederkrotenthaler

EMMA NIELSEN EMMA.NIELSEN@NOTTINGHAM.AC.UK
Patient and Public Involvement and Engagement Manager: children and Young Peoples' Mental Health

Merete Nordentoft

Herwig Oberlerchner

Rory C. O'Connor

Rainer Papsdorf

Timo Partonen

Michael R. Phillips

Steve Platt

Gwendolyn Portzky

Georg Psota

Ping Qin

Daniel Radeloff

Andreas Reif

Christine Reif-Leonhard

Mohsen Rezaeian

Nayda Román-Vázquez

Saska Roskar

Vsevolod Rozanov

Grant Sara

Karen Scavacini

Barbara Schneider

Natalia Semenova

Mark Sinyor

Stefano Tambuzzi

Michiko Ueda

Danuta Wasserman

Roger T. Webb

Petr Winkler

Paul S.F. Yip

Gil Zalsman

Riccardo Zoja

Ann John

Matthew J. Spittal



Abstract

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.

Journal Article Type Article
Acceptance Date Jun 30, 2022
Online Publication Date Aug 2, 2022
Publication Date Sep 1, 2022
Deposit Date Aug 9, 2022
Publicly Available Date Aug 9, 2022
Journal eClinicalMedicine
Electronic ISSN 2589-5370
Publisher Elsevier BV
Peer Reviewed Peer Reviewed
Volume 51
Article Number 101573
DOI https://doi.org/10.1016/j.eclinm.2022.101573
Public URL https://nottingham-repository.worktribe.com/output/9899007
Publisher URL https://www.sciencedirect.com/science/article/pii/S2589537022003030
Additional Information This article is maintained by: Elsevier; Article Title: Suicide numbers during the first 9-15 months of the COVID-19 pandemic compared with pre-existing trends: An interrupted time series analysis in 33 countries; Journal Title: eClinicalMedicine; CrossRef DOI link to publisher maintained version: https://doi.org/10.1016/j.eclinm.2022.101573

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