@article{Pirkis_J-2022_92501,
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},
author = {Pirkis, J. and Gunnell, D. and Shin, S. and Del Pozo-Banos, M. and Arya, V. and Aguilar, P. and Appleby, L. and Arafat, S. and Arensman, E. and Ayuso-Mateos, J. and Balhara, Y. and Bantjes, J. and Baran, A. and Behera, C. and Bertolote, J. and Borges, G. and Bray, M. and Brečić, P. and Caine, E. and Calati, R. and Carli, V. and Castelpietra, G. and Chan, L. and Chang, S. and Colchester, D. and Coss-Guzmán, M. and Crompton, D. and Ćurković, M. and Dandona, R. and De Jaegere, E. and De Leo, D. and Deisenhammer, E. and Dwyer, J. and Erlangsen, A. and Faust, J. and Fornaro, M. and Fortune, S. and Garrett, A. and Gentile, G. and Gerstner, R. and Gilissen, R. and Gould, M. and Gupta, S. and Hawton, K. and Holz, F. and Kamenshchikov, I. and Kapur, N. and Kasal, A. and Khan, M. and Kirtley, O. and Knipe, D. and Kõlves, K. and Kölzer, S. and Krivda, H. and Leske, S. and Madeddu, F. and Marshall, A. and Memon, A. and Mittendorfer-Rutz, E. and Nestadt, P. and Neznanov, N. and Niederkrotenthaler, T. and Nielsen, E. and Nordentoft, M. and Oberlerchner, H. and O'Connor, R. and Papsdorf, R. and Partonen, T. and Phillips, M. and Platt, S. and Portzky, G. and Psota, G. and Qin, P. and Radeloff, D. and Reif, A. and Reif-Leonhard, C. and Rezaeian, M. and Román-Vázquez, N. and Roskar, S. and Rozanov, V. and Sara, G. and Scavacini, K. and Schneider, B. and Semenova, N. and Sinyor, M. and Tambuzzi, S. and Townsend, E. and Ueda, M. and Wasserman, D. and Webb, R. and Winkler, P. and Yip, P. and Zalsman, G. and Zoja, R. and John, A. and Spittal, M.},
month = {sep},
year = {2022},
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.},
volume = {51},
journal = {EClinicalMedicine},
publisher = {Elsevier},
url = {http://dx.doi.org/10.1016/j.eclinm.2022.101573},
}
