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. 2021 Feb 12;16(2):e0244596.
doi: 10.1371/journal.pone.0244596. eCollection 2021.

Fluctuations in influenza-like illness epidemics and suicide mortality: A time-series regression of 13-year mortality data in South Korea

Sun Jae Jung  1   2 , Sung-Shil Lim  3 , Jin-Ha Yoon  1   3
Affiliations

Fluctuations in influenza-like illness epidemics and suicide mortality: A time-series regression of 13-year mortality data in South Korea

Sun Jae Jung et al. PLoS One. .

Abstract

Aims: We explored the association between influenza epidemic and suicide mortality rates in a large population using a time-series regression of 13-year mortality data in South Korea.

Methods: Weekly suicide mortalities and influenza-like illness (ILI) were analyzed using time series regression. Regression coefficient for suicide mortality based on percentage change of ILI was calculated using a quasi-Poisson regression. Non-linear distributed lag models with quadratic function up to 24 weeks were constructed.

Results: The association between ILI and suicide mortality increased significantly up to 8 weeks post-influenza diagnosis. A significant positive association between ILI and suicide mortality was observed from 2009, when a novel influenza A(H1N1)pdm09 virus provoked a worldwide pandemic. No meaningful association between these factors was observed before 2009.

Conclusion: There was a significant positive relationship between ILI and suicide mortality after 2009, when a novel influenza A(H1N1)pdm09 virus provoked a worldwide pandemic.

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Conflict of interest statement

The authors have declared that no competing interests exist.

Figures

Fig 1
Fig 1. Weekly numbers of suicides and influenza-like illnesses per 100 outpatients from 2004 to 2017.
β (Beta) indicates the change in weekly suicide numbers, considering the % increment in influenza-like illness cases; red dot line show weekly number of suicide after adjusting time series factors, and red shadow indicates 95% confidence interval of the estimated weekly suicide rate, which was assessed using a generalized additive model; blue line show influenza like illness per 100 outpatients without lag time, and horizontal line indicates the year 2009.
Fig 2
Fig 2. Monthly variation of weekly numbers of suicides during study period.
Fig 3
Fig 3. Association between suicide and influenza according to different lag periods.
See this image and copyright information in PMC

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