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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

Jane Pirkis Orcid Logo, David Gunnell, Sangsoo Shin, Marcos del Pozo Banos Orcid Logo, Vikas Arya, Pablo Analuisa Aguilar, Louis Appleby, S. M. Yasir Arafat Orcid Logo, Ella Arensman, Jose Luis Ayuso-Mateos, Yatan Pal Singh Balhara, Jason Bantjes, Anna Baran, Chittaranjan Behera Orcid Logo, 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 Orcid Logo, 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 Orcid Logo, Ellenor Mittendorfer-Rutz, Paul Nestadt, Nikolay Neznanov, Thomas Niederkrotenthaler Orcid Logo, Emma Nielsen, Merete Nordentoft, Herwig Oberlerchner, Rory C. O'Connor, Rainer Papsdorf, Timo Partonen Orcid Logo, Michael R. Phillips, Steve Platt, Gwendolyn Portzky, Georg Psota, Ping Qin, Daniel Radeloff Orcid Logo, 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 Orcid Logo, Ellen Townsend, Michiko Ueda, Danuta Wasserman, Roger T. Webb, Petr Winkler, Paul S.F. Yip, Gil Zalsman, Riccardo Zoja, Ann John Orcid Logo, Matthew J. Spittal Orcid Logo

eClinicalMedicine, Volume: 51, Start page: 101573

Swansea University Authors: Marcos del Pozo Banos Orcid Logo, Ann John Orcid Logo

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DOI (Published version): 10.1016/j.eclinm.2022.101573

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 global...

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Published in: eClinicalMedicine
ISSN: 2589-5370
Published: Elsevier BV 2022
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URI: https://cronfa.swan.ac.uk/Record/cronfa60489
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fullrecord <?xml version="1.0"?><rfc1807><datestamp>2022-11-17T10:15:01.7212936</datestamp><bib-version>v2</bib-version><id>60489</id><entry>2022-07-13</entry><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</title><swanseaauthors><author><sid>f141785b1c0ab9efe45665d35c081b84</sid><ORCID>0000-0003-1502-389X</ORCID><firstname>Marcos</firstname><surname>del Pozo Banos</surname><name>Marcos del Pozo Banos</name><active>true</active><ethesisStudent>false</ethesisStudent></author><author><sid>ed8a9c37bd7b7235b762d941ef18ee55</sid><ORCID>0000-0002-5657-6995</ORCID><firstname>Ann</firstname><surname>John</surname><name>Ann John</name><active>true</active><ethesisStudent>false</ethesisStudent></author></swanseaauthors><date>2022-07-13</date><deptcode>MEDS</deptcode><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.</abstract><type>Journal Article</type><journal>eClinicalMedicine</journal><volume>51</volume><journalNumber/><paginationStart>101573</paginationStart><paginationEnd/><publisher>Elsevier BV</publisher><placeOfPublication/><isbnPrint/><isbnElectronic/><issnPrint>2589-5370</issnPrint><issnElectronic/><keywords>Suicide; COVID-19; Pandemic; Monitoring</keywords><publishedDay>1</publishedDay><publishedMonth>9</publishedMonth><publishedYear>2022</publishedYear><publishedDate>2022-09-01</publishedDate><doi>10.1016/j.eclinm.2022.101573</doi><url/><notes/><college>COLLEGE NANME</college><department>Medical School</department><CollegeCode>COLLEGE CODE</CollegeCode><DepartmentCode>MEDS</DepartmentCode><institution>Swansea University</institution><apcterm/><funders>We acknowledge the help that the International COVID-19 Suicide Prevention Research Collaboration (ICSPRC) has received from the International Association for Suicide Prevention (IASP) in establishing and supporting its activities. This study was supported by the ADP, which is funded by MQ Mental Health Research Charity (grant reference MQBF/3 ADP). ADP and the authors acknowledge the data providers who supplied the datasets enabling this study. The views expressed are entirely those of the authors and should not be assumed to be the same as those of ADP or MQ Mental Health Research Charity. The authors would also like to thank the team working on the living systematic review of COVID-19 and suicidal behaviour: Emily Eyles, Luke McGuinness, Babatunde K Olorisade, Lena Schmidt, Catherine MacLeod Hall, and Julian Higgins (University of Bristol); Chukwudi Okolie, Dana Dekel, and Amanda Marchant (University of Swansea); Faraz Mughal (University of Keele); Lana Bojanic (University of Manchester). JP is funded by a National Health and Medical Research Council Investigator Grant (GNT1173126). AJ is funded by MQ (MQBF/3) and the Medical Research Council (MC_PC_17211). MDPB is funded by Health and Care Research Wales (CA04). VA is supported by Australian Government Research Training Program Scholarship. AB is supported by the European Union's Erasmus+ Strategic Partnership Programme (2019-1-SE01-KA203-060571). OJK is supported by a Senior Postdoctoral Fellowship from Research Foundation Flanders (FWO 1257821N). MRP funded in part by a Global Alliance for Chronic Diseases &#x2013; National Natural Science Foundation of China grant (NSFC. No. 81761128031). AK is supported by the project &#x201C;Sustainability for the National Institute of Mental Health&#x201D;, LO1611, Ministry of Education, Youth and Sports of the Czech Republic under the NPU I programme and by the Charles University, Prague (SVV 260 596 and GA UK 552119). MS is supported by Academic Scholar Awards from the Departments of Psychiatry at Sunnybrook Health Sciences Centre and the University of Toronto. RTW is supported by the NIHR Greater Manchester Patient Safety Translational Research Centre, University of Manchester, UK. DGu is supported by the NIHR Biomedical Research Centre at University Hospitals Bristol NHS Foundation Trust and the University of Bristol. 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spelling 2022-11-17T10:15:01.7212936 v2 60489 2022-07-13 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 f141785b1c0ab9efe45665d35c081b84 0000-0003-1502-389X Marcos del Pozo Banos Marcos del Pozo Banos true false ed8a9c37bd7b7235b762d941ef18ee55 0000-0002-5657-6995 Ann John Ann John true false 2022-07-13 MEDS 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. Journal Article eClinicalMedicine 51 101573 Elsevier BV 2589-5370 Suicide; COVID-19; Pandemic; Monitoring 1 9 2022 2022-09-01 10.1016/j.eclinm.2022.101573 COLLEGE NANME Medical School COLLEGE CODE MEDS Swansea University We acknowledge the help that the International COVID-19 Suicide Prevention Research Collaboration (ICSPRC) has received from the International Association for Suicide Prevention (IASP) in establishing and supporting its activities. This study was supported by the ADP, which is funded by MQ Mental Health Research Charity (grant reference MQBF/3 ADP). ADP and the authors acknowledge the data providers who supplied the datasets enabling this study. The views expressed are entirely those of the authors and should not be assumed to be the same as those of ADP or MQ Mental Health Research Charity. The authors would also like to thank the team working on the living systematic review of COVID-19 and suicidal behaviour: Emily Eyles, Luke McGuinness, Babatunde K Olorisade, Lena Schmidt, Catherine MacLeod Hall, and Julian Higgins (University of Bristol); Chukwudi Okolie, Dana Dekel, and Amanda Marchant (University of Swansea); Faraz Mughal (University of Keele); Lana Bojanic (University of Manchester). JP is funded by a National Health and Medical Research Council Investigator Grant (GNT1173126). AJ is funded by MQ (MQBF/3) and the Medical Research Council (MC_PC_17211). MDPB is funded by Health and Care Research Wales (CA04). VA is supported by Australian Government Research Training Program Scholarship. AB is supported by the European Union's Erasmus+ Strategic Partnership Programme (2019-1-SE01-KA203-060571). OJK is supported by a Senior Postdoctoral Fellowship from Research Foundation Flanders (FWO 1257821N). MRP funded in part by a Global Alliance for Chronic Diseases – National Natural Science Foundation of China grant (NSFC. No. 81761128031). AK is supported by the project “Sustainability for the National Institute of Mental Health”, LO1611, Ministry of Education, Youth and Sports of the Czech Republic under the NPU I programme and by the Charles University, Prague (SVV 260 596 and GA UK 552119). MS is supported by Academic Scholar Awards from the Departments of Psychiatry at Sunnybrook Health Sciences Centre and the University of Toronto. RTW is supported by the NIHR Greater Manchester Patient Safety Translational Research Centre, University of Manchester, UK. DGu is supported by the NIHR Biomedical Research Centre at University Hospitals Bristol NHS Foundation Trust and the University of Bristol. MJS is a recipient of an Australian Research Council Future Fellowship (FT180100075). 2022-11-17T10:15:01.7212936 2022-07-13T15:58:07.0984091 Faculty of Medicine, Health and Life Sciences Swansea University Medical School - Medicine Jane Pirkis 0000-0002-2538-4472 1 David Gunnell 2 Sangsoo Shin 3 Marcos del Pozo Banos 0000-0003-1502-389X 4 Vikas Arya 5 Pablo Analuisa Aguilar 6 Louis Appleby 7 S. M. Yasir Arafat 0000-0003-0521-5708 8 Ella Arensman 9 Jose Luis Ayuso-Mateos 10 Yatan Pal Singh Balhara 11 Jason Bantjes 12 Anna Baran 13 Chittaranjan Behera 0000-0003-3280-4778 14 Jose Bertolote 15 Guilherme Borges 16 Michael Bray 17 Petrana Brečić 18 Eric Caine 19 Raffaella Calati 20 Vladimir Carli 21 Giulio Castelpietra 22 Lai Fong Chan 23 Shu-Sen Chang 24 David Colchester 25 Maria Coss-Guzmán 26 David Crompton 27 Marko Ćurković 28 Rakhi Dandona 29 Eva De Jaegere 30 Diego De Leo 31 Eberhard A. Deisenhammer 32 Jeremy Dwyer 33 Annette Erlangsen 34 Jeremy S. Faust 35 Michele Fornaro 36 Sarah Fortune 37 Andrew Garrett 38 Guendalina Gentile 39 Rebekka Gerstner 0000-0003-4084-5182 40 Renske Gilissen 41 Madelyn Gould 42 Sudhir Kumar Gupta 43 Keith Hawton 44 Franziska Holz 45 Iurii Kamenshchikov 46 Navneet Kapur 47 Alexandr Kasal 48 Murad Khan 49 Olivia J. Kirtley 50 Duleeka Knipe 51 Kairi Kõlves 52 Sarah C. Kölzer 53 Hryhorii Krivda 54 Stuart Leske 55 Fabio Madeddu 56 Andrew Marshall 57 Anjum Memon 0000-0001-8256-3015 58 Ellenor Mittendorfer-Rutz 59 Paul Nestadt 60 Nikolay Neznanov 61 Thomas Niederkrotenthaler 0000-0001-9550-628x 62 Emma Nielsen 63 Merete Nordentoft 64 Herwig Oberlerchner 65 Rory C. O'Connor 66 Rainer Papsdorf 67 Timo Partonen 0000-0003-1951-2455 68 Michael R. Phillips 69 Steve Platt 70 Gwendolyn Portzky 71 Georg Psota 72 Ping Qin 73 Daniel Radeloff 0000-0002-8430-8306 74 Andreas Reif 75 Christine Reif-Leonhard 76 Mohsen Rezaeian 77 Nayda Román-Vázquez 78 Saska Roskar 79 Vsevolod Rozanov 80 Grant Sara 81 Karen Scavacini 82 Barbara Schneider 83 Natalia Semenova 84 Mark Sinyor 85 Stefano Tambuzzi 0000-0003-4711-5545 86 Ellen Townsend 87 Michiko Ueda 88 Danuta Wasserman 89 Roger T. Webb 90 Petr Winkler 91 Paul S.F. Yip 92 Gil Zalsman 93 Riccardo Zoja 94 Ann John 0000-0002-5657-6995 95 Matthew J. Spittal 0000-0002-2841-1536 96 60489__25811__708fce0074dc42f0a69879a83ee45509.pdf 60489.pdf 2022-11-16T18:13:12.5910148 Output 3611838 application/pdf Version of Record true Copyright 2022 The Authors. This is an open access article under the CC BY-NC-ND license true eng http://creativecommons.org/licenses/by-nc-nd/4.0/
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
spellingShingle 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
Marcos del Pozo Banos
Ann John
title_short 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
title_full 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
title_fullStr 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
title_full_unstemmed 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
title_sort 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_id_str_mv f141785b1c0ab9efe45665d35c081b84
ed8a9c37bd7b7235b762d941ef18ee55
author_id_fullname_str_mv f141785b1c0ab9efe45665d35c081b84_***_Marcos del Pozo Banos
ed8a9c37bd7b7235b762d941ef18ee55_***_Ann John
author Marcos del Pozo Banos
Ann John
author2 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
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
Ellen Townsend
Michiko Ueda
Danuta Wasserman
Roger T. Webb
Petr Winkler
Paul S.F. Yip
Gil Zalsman
Riccardo Zoja
Ann John
Matthew J. Spittal
format Journal article
container_title eClinicalMedicine
container_volume 51
container_start_page 101573
publishDate 2022
institution Swansea University
issn 2589-5370
doi_str_mv 10.1016/j.eclinm.2022.101573
publisher Elsevier BV
college_str Faculty of Medicine, Health and Life Sciences
hierarchytype
hierarchy_top_id facultyofmedicinehealthandlifesciences
hierarchy_top_title Faculty of Medicine, Health and Life Sciences
hierarchy_parent_id facultyofmedicinehealthandlifesciences
hierarchy_parent_title Faculty of Medicine, Health and Life Sciences
department_str Swansea University Medical School - Medicine{{{_:::_}}}Faculty of Medicine, Health and Life Sciences{{{_:::_}}}Swansea University Medical School - Medicine
document_store_str 1
active_str 0
description 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.
published_date 2022-09-01T14:16:23Z
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score 11.047588

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