. 2021 Jul;8(7):579-588.

doi: 10.1016/S2215-0366(21)00091-2. Epub 2021 Apr 13.

Suicide trends in the early months of the COVID-19 pandemic: an interrupted time-series analysis of preliminary data from 21 countries

Jane Pirkis¹, Ann John², Sangsoo Shin³, Marcos DelPozo-Banos², Vikas Arya⁴, Pablo Analuisa-Aguilar⁵, Louis Appleby⁶, Ella Arensman⁷, Jason Bantjes⁸, Anna Baran⁹, Jose M Bertolote¹⁰, Guilherme Borges¹¹, Petrana Brečić¹², Eric Caine¹³, Giulio Castelpietra¹⁴, Shu-Sen Chang¹⁵, David Colchester¹⁶, David Crompton¹⁷, Marko Curkovic¹⁸, Eberhard A Deisenhammer¹⁹, Chengan Du²⁰, Jeremy Dwyer²¹, Annette Erlangsen²², Jeremy S Faust²³, Sarah Fortune²⁴, Andrew Garrett²⁵, Devin George²⁶, Rebekka Gerstner²⁷, Renske Gilissen²⁸, Madelyn Gould²⁹, Keith Hawton³⁰, Joseph Kanter³¹, Navneet Kapur³², Murad Khan³³, Olivia J Kirtley³⁴, Duleeka Knipe³⁵, Kairi Kolves¹⁷, Stuart Leske¹⁷, Kedar Marahatta³⁶, Ellenor Mittendorfer-Rutz³⁷, Nikolay Neznanov³⁸, Thomas Niederkrotenthaler³⁹, Emma Nielsen⁴⁰, Merete Nordentoft⁴¹, Herwig Oberlerchner⁴², Rory C O'Connor⁴³, Melissa Pearson⁴⁴, Michael R Phillips⁴⁵, Steve Platt⁴⁶, Paul L Plener⁴⁷, Georg Psota⁴⁸, Ping Qin⁴⁹, Daniel Radeloff⁵⁰, Christa Rados⁵¹, Andreas Reif⁵², Christine Reif-Leonhard⁵², Vsevolod Rozanov⁵³, Christiane Schlang⁵⁴, Barbara Schneider⁵⁵, Natalia Semenova⁵⁶, Mark Sinyor⁵⁷, Ellen Townsend⁵⁸, Michiko Ueda⁵⁹, Lakshmi Vijayakumar⁶⁰, Roger T Webb⁶¹, Manjula Weerasinghe⁶², Gil Zalsman⁶³, David Gunnell⁶⁴, Matthew J Spittal³

Affiliations

¹ Centre for Mental Health, Melbourne School of Population and Global Health, University of Melbourne, Melbourne, VIC, Australia. Electronic address: j.pirkis@unimelb.edu.au.
² Swansea University Medical School, Swansea, UK.
³ Centre for Mental Health, Melbourne School of Population and Global Health, University of Melbourne, Melbourne, VIC, Australia.
⁴ Centre for Mental Health, Melbourne School of Population and Global Health, University of Melbourne, Melbourne, VIC, Australia; Translational Health Research Institute, Western Sydney University, Campbelltown, NSW, Australia.
⁵ Ministry of Public Health, Department of Health Promotion, Quito, Ecuador.
⁶ National Confidential Inquiry into Suicide and Safety in Mental Health, University of Manchester, Manchester, UK.
⁷ School of Public Health, National Suicide Research Foundation, University College Cork, Cork, Ireland; Australian Institute for Suicide Research and Prevention, School of Applied Psychology, Griffith University, Brisbane, QLD, Australia.
⁸ Institute for Life Course Health Research, Department of Global Health, Stellenbosch University, Stellenbosch, South Africa.
⁹ Working Group on Prevention of Suicide and Depression at Public Health Council, Warsaw, Poland; Department of Psychiatry, Blekinge Hospital, Karlshamn, Sweden.
¹⁰ Botucatu Medical School, Universidade Estadual Paulista, São Paulo, Brazil.
¹¹ Instituto Nacional de Psiquiatría Ramon de la Fuente Muñiz, Mexico City, Mexico.
¹² Department for Medical Ethics, University Psychiatric Hospital Vrapče, School of Medicine, University of Zagreb, Zagreb, Croatia; Department for Psychiatry, University Psychiatric Hospital Vrapče, School of Medicine, University of Zagreb, Zagreb, Croatia.
¹³ University of Rochester Medical Center, Rochester, NY, USA.
¹⁴ Region Friuli Venezia Giulia, Central Health Directorate, Outpatient and Inpatient Care Service, Trieste, Italy; Department of Medicine, University of Udine, Trieste, Italy.
¹⁵ Institute of Health Behaviors and Community Sciences, College of Public Health, National Taiwan University, Taipei, Taiwan.
¹⁶ Thames Valley Local Criminal Justice Board, Bicester, UK.
¹⁷ Australian Institute for Suicide Research and Prevention, School of Applied Psychology, Griffith University, Brisbane, QLD, Australia.
¹⁸ Department for Medical Ethics, University Psychiatric Hospital Vrapče, School of Medicine, University of Zagreb, Zagreb, Croatia.
¹⁹ Department of Psychiatry, Psychotherapy and Psychosomatics, Medical University of Innsbruck, Innsbruck, Austria.
²⁰ Center for Outcomes Research and Evaluation, Yale School of Medicine, New Haven, CT, USA.
²¹ Centre for Mental Health, Melbourne School of Population and Global Health, University of Melbourne, Melbourne, VIC, Australia; Coroners Court of Victoria, Melbourne, VIC, Australia.
²² Danish Research Institute for Suicide Prevention, Copenhagen, Denmark; Department of Mental Health, Johns Hopkins School of Public Health, Baltimore, MD, USA; Centre for Mental Health Research, Australian National University, Canberra, ACT, Australia.
²³ Brigham and Women's Hospital Department of Emergency Medicine, Boston, MA, USA.
²⁴ School of Population Health, University of Auckland, Auckland, New Zealand.
²⁵ Magistrates Court of Tasmania (Coronial Division), Hobart, TAS, Australia.
²⁶ Bureau of Vital Records and Statistics, Louisiana Office of Public Health, Baton Rouge, LA, USA.
²⁷ Ministry of Public Health, Undersecretary of Health Services, Quito, Ecuador.
²⁸ Research Department, 113 Suicide Prevention, Amsterdam, Netherlands.
²⁹ Departments of Psychiatry and Epidemiology, Columbia University Medical Center/New York State Psychiatric Institute, New York, NY, USA.
³⁰ Centre for Suicide Research, University of Oxford, Oxford, UK.
³¹ Louisiana Department of Health, Baton Rouge, LA, USA.
³² Centre for Mental Health and Safety and National Institute for Health Research Patient Safety Translational Research Centre, University of Manchester, Manchester, UK; Greater Manchester Mental Health NHS Foundation Trust, Manchester, UK.
³³ Department of Psychiatry, Aga Khan University, Karachi, Pakistan.
³⁴ KU Leuven, Center for Contextual Psychiatry, Leuven, Belgium.
³⁵ Population Health Sciences, Bristol Medical School, University of Bristol, Bristol, UK; South Asian Clinical Toxicology Research Collaboration, Faculty of Medicine, University of Peradeniya, Peradeniya, Sri Lanka.
³⁶ World Health Organization, Country Office for Nepal, Kathmandu, Nepal.
³⁷ Karolinska Institutet, Stockholm, Sweden.
³⁸ Bekhterev National Medical Research Center of Psychiatry and Neurology, Pavlov First Saint Petersburg State Medical University, Saint Petersburg, Russia.
³⁹ Unit Suicide Research and Mental Health Promotion, Department of Social and Preventive Medicine, Center for Public Health, Medical University of Vienna, Vienna, Austria.
⁴⁰ School of Psychology, University of Nottingham, Nottingham, UK.
⁴¹ Mental Health Centre Copenhagen, Copenhagen, Denmark.
⁴² Department of Psychiatry and Psychotherapy, Klinikum Klagenfurt am Wörthersee, Klagenfurt, Austria.
⁴³ Suicidal Behaviour Research Lab, University of Glasgow, Glasgow, UK.
⁴⁴ Preventing Deaths from Poisoning Research Group, University of Edinburgh, Edinburgh, UK.
⁴⁵ Suicide Research and Prevention Center, Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, Shanghai, China; Departments of Psychiatry and Epidemiology, Columbia University, New York, NY, USA.
⁴⁶ Usher Institute, University of Edinburgh, Edinburgh, UK.
⁴⁷ Department of Child and Adolescent Psychiatry, Medical University of Vienna, Vienna, Austria; Department of Child and Adolescent Psychiatry and Psychotherapy, University of Ulm, Ulm, Germany.
⁴⁸ Psychosocial Services in Vienna, Vienna, Austria.
⁴⁹ National Centre for Suicide Research and Prevention, Institute of Clinical Medicine, University of Oslo, Oslo, Norway.
⁵⁰ Department of Child and Adolescent Psychiatry, Psychotherapy and Psychosomatics, University Hospital Leipzig, Leipzig, Germany.
⁵¹ Department of Psychiatry and Psychotherapeutic Medicine, Landeskrankenhaus Villach, Villach, Austria.
⁵² Department of Psychiatry, Psychosomatic Medicine and Psychotherapy, University Hospital Frankfurt, Frankfurt am Main, Germany.
⁵³ Department of Borderline Disorders and Psychotherapy, Bekhterev National Medical Research Center of Psychiatry and Neurology, Saint Petersburg State University, Saint Petersburg, Russia.
⁵⁴ Department of Psychiatry, Health Authority Frankfurt am Main, Frankfurt, Germany.
⁵⁵ Department of Addictive Disorders, Psychiatry and Psychotherapy, LVR-Klinik Köln, Cologne, Germany; Department of Psychiatry, Psychosomatic Medicine and Psychotherapy, Goethe-University, Frankfurt am Main, Germany.
⁵⁶ Organizational-Scientific Department, Bekhterev National Medical Research Center of Psychiatry and Neurology, Saint Petersburg, Russia.
⁵⁷ Department of Psychiatry, University of Toronto, Toronto, ON, Canada; Department of Psychiatry, Sunnybrook Health Sciences Centre, Toronto, ON, Canada.
⁵⁸ Self-Harm Research Group, School of Psychology, University of Nottingham, Nottingham, UK.
⁵⁹ Waseda University, Faculty of Political Science and Economics, Tokyo, Japan.
⁶⁰ Sneha-Suicide Prevention Centre, Voluntary Health Services, Chennai, India.
⁶¹ Centre for Mental Health and Safety and National Institute for Health Research Patient Safety Translational Research Centre, University of Manchester, Manchester, UK.
⁶² Department of Community Medicine, Faculty of Medicine and Allied Sciences, Rajarata University of Sri Lanka, Anuradhapura, Sri Lanka.
⁶³ Department of Psychiatry, Sackler School of Medicine, Tel Aviv University and Geha Mental Health Center, Tel Aviv, Israel; Division of Molecular Imaging and Neuropathology, New York State Psychiatric Institute and Department of Psychiatry, Columbia University, New York, USA.
⁶⁴ National Institute of Health Research Biomedical Research Centre, University Hospitals Bristol and Weston NHS Foundation Trust, University of Bristol, Bristol, UK.

PMID: 33862016
PMCID: PMC9188435
DOI: 10.1016/S2215-0366(21)00091-2

Suicide trends in the early months of the COVID-19 pandemic: an interrupted time-series analysis of preliminary data from 21 countries

Jane Pirkis et al. Lancet Psychiatry. 2021 Jul.

. 2021 Jul;8(7):579-588.

doi: 10.1016/S2215-0366(21)00091-2. Epub 2021 Apr 13.

Authors

Affiliations

¹ Centre for Mental Health, Melbourne School of Population and Global Health, University of Melbourne, Melbourne, VIC, Australia. Electronic address: j.pirkis@unimelb.edu.au.
² Swansea University Medical School, Swansea, UK.
³ Centre for Mental Health, Melbourne School of Population and Global Health, University of Melbourne, Melbourne, VIC, Australia.
⁴ Centre for Mental Health, Melbourne School of Population and Global Health, University of Melbourne, Melbourne, VIC, Australia; Translational Health Research Institute, Western Sydney University, Campbelltown, NSW, Australia.
⁵ Ministry of Public Health, Department of Health Promotion, Quito, Ecuador.
⁶ National Confidential Inquiry into Suicide and Safety in Mental Health, University of Manchester, Manchester, UK.
⁷ School of Public Health, National Suicide Research Foundation, University College Cork, Cork, Ireland; Australian Institute for Suicide Research and Prevention, School of Applied Psychology, Griffith University, Brisbane, QLD, Australia.
⁸ Institute for Life Course Health Research, Department of Global Health, Stellenbosch University, Stellenbosch, South Africa.
⁹ Working Group on Prevention of Suicide and Depression at Public Health Council, Warsaw, Poland; Department of Psychiatry, Blekinge Hospital, Karlshamn, Sweden.
¹⁰ Botucatu Medical School, Universidade Estadual Paulista, São Paulo, Brazil.
¹¹ Instituto Nacional de Psiquiatría Ramon de la Fuente Muñiz, Mexico City, Mexico.
¹² Department for Medical Ethics, University Psychiatric Hospital Vrapče, School of Medicine, University of Zagreb, Zagreb, Croatia; Department for Psychiatry, University Psychiatric Hospital Vrapče, School of Medicine, University of Zagreb, Zagreb, Croatia.
¹³ University of Rochester Medical Center, Rochester, NY, USA.
¹⁴ Region Friuli Venezia Giulia, Central Health Directorate, Outpatient and Inpatient Care Service, Trieste, Italy; Department of Medicine, University of Udine, Trieste, Italy.
¹⁵ Institute of Health Behaviors and Community Sciences, College of Public Health, National Taiwan University, Taipei, Taiwan.
¹⁶ Thames Valley Local Criminal Justice Board, Bicester, UK.
¹⁷ Australian Institute for Suicide Research and Prevention, School of Applied Psychology, Griffith University, Brisbane, QLD, Australia.
¹⁸ Department for Medical Ethics, University Psychiatric Hospital Vrapče, School of Medicine, University of Zagreb, Zagreb, Croatia.
¹⁹ Department of Psychiatry, Psychotherapy and Psychosomatics, Medical University of Innsbruck, Innsbruck, Austria.
²⁰ Center for Outcomes Research and Evaluation, Yale School of Medicine, New Haven, CT, USA.
²¹ Centre for Mental Health, Melbourne School of Population and Global Health, University of Melbourne, Melbourne, VIC, Australia; Coroners Court of Victoria, Melbourne, VIC, Australia.
²² Danish Research Institute for Suicide Prevention, Copenhagen, Denmark; Department of Mental Health, Johns Hopkins School of Public Health, Baltimore, MD, USA; Centre for Mental Health Research, Australian National University, Canberra, ACT, Australia.
²³ Brigham and Women's Hospital Department of Emergency Medicine, Boston, MA, USA.
²⁴ School of Population Health, University of Auckland, Auckland, New Zealand.
²⁵ Magistrates Court of Tasmania (Coronial Division), Hobart, TAS, Australia.
²⁶ Bureau of Vital Records and Statistics, Louisiana Office of Public Health, Baton Rouge, LA, USA.
²⁷ Ministry of Public Health, Undersecretary of Health Services, Quito, Ecuador.
²⁸ Research Department, 113 Suicide Prevention, Amsterdam, Netherlands.
²⁹ Departments of Psychiatry and Epidemiology, Columbia University Medical Center/New York State Psychiatric Institute, New York, NY, USA.
³⁰ Centre for Suicide Research, University of Oxford, Oxford, UK.
³¹ Louisiana Department of Health, Baton Rouge, LA, USA.
³² Centre for Mental Health and Safety and National Institute for Health Research Patient Safety Translational Research Centre, University of Manchester, Manchester, UK; Greater Manchester Mental Health NHS Foundation Trust, Manchester, UK.
³³ Department of Psychiatry, Aga Khan University, Karachi, Pakistan.
³⁴ KU Leuven, Center for Contextual Psychiatry, Leuven, Belgium.
³⁵ Population Health Sciences, Bristol Medical School, University of Bristol, Bristol, UK; South Asian Clinical Toxicology Research Collaboration, Faculty of Medicine, University of Peradeniya, Peradeniya, Sri Lanka.
³⁶ World Health Organization, Country Office for Nepal, Kathmandu, Nepal.
³⁷ Karolinska Institutet, Stockholm, Sweden.
³⁸ Bekhterev National Medical Research Center of Psychiatry and Neurology, Pavlov First Saint Petersburg State Medical University, Saint Petersburg, Russia.
³⁹ Unit Suicide Research and Mental Health Promotion, Department of Social and Preventive Medicine, Center for Public Health, Medical University of Vienna, Vienna, Austria.
⁴⁰ School of Psychology, University of Nottingham, Nottingham, UK.
⁴¹ Mental Health Centre Copenhagen, Copenhagen, Denmark.
⁴² Department of Psychiatry and Psychotherapy, Klinikum Klagenfurt am Wörthersee, Klagenfurt, Austria.
⁴³ Suicidal Behaviour Research Lab, University of Glasgow, Glasgow, UK.
⁴⁴ Preventing Deaths from Poisoning Research Group, University of Edinburgh, Edinburgh, UK.
⁴⁵ Suicide Research and Prevention Center, Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, Shanghai, China; Departments of Psychiatry and Epidemiology, Columbia University, New York, NY, USA.
⁴⁶ Usher Institute, University of Edinburgh, Edinburgh, UK.
⁴⁷ Department of Child and Adolescent Psychiatry, Medical University of Vienna, Vienna, Austria; Department of Child and Adolescent Psychiatry and Psychotherapy, University of Ulm, Ulm, Germany.
⁴⁸ Psychosocial Services in Vienna, Vienna, Austria.
⁴⁹ National Centre for Suicide Research and Prevention, Institute of Clinical Medicine, University of Oslo, Oslo, Norway.
⁵⁰ Department of Child and Adolescent Psychiatry, Psychotherapy and Psychosomatics, University Hospital Leipzig, Leipzig, Germany.
⁵¹ Department of Psychiatry and Psychotherapeutic Medicine, Landeskrankenhaus Villach, Villach, Austria.
⁵² Department of Psychiatry, Psychosomatic Medicine and Psychotherapy, University Hospital Frankfurt, Frankfurt am Main, Germany.
⁵³ Department of Borderline Disorders and Psychotherapy, Bekhterev National Medical Research Center of Psychiatry and Neurology, Saint Petersburg State University, Saint Petersburg, Russia.
⁵⁴ Department of Psychiatry, Health Authority Frankfurt am Main, Frankfurt, Germany.
⁵⁵ Department of Addictive Disorders, Psychiatry and Psychotherapy, LVR-Klinik Köln, Cologne, Germany; Department of Psychiatry, Psychosomatic Medicine and Psychotherapy, Goethe-University, Frankfurt am Main, Germany.
⁵⁶ Organizational-Scientific Department, Bekhterev National Medical Research Center of Psychiatry and Neurology, Saint Petersburg, Russia.
⁵⁷ Department of Psychiatry, University of Toronto, Toronto, ON, Canada; Department of Psychiatry, Sunnybrook Health Sciences Centre, Toronto, ON, Canada.
⁵⁸ Self-Harm Research Group, School of Psychology, University of Nottingham, Nottingham, UK.
⁵⁹ Waseda University, Faculty of Political Science and Economics, Tokyo, Japan.
⁶⁰ Sneha-Suicide Prevention Centre, Voluntary Health Services, Chennai, India.
⁶¹ Centre for Mental Health and Safety and National Institute for Health Research Patient Safety Translational Research Centre, University of Manchester, Manchester, UK.
⁶² Department of Community Medicine, Faculty of Medicine and Allied Sciences, Rajarata University of Sri Lanka, Anuradhapura, Sri Lanka.
⁶³ Department of Psychiatry, Sackler School of Medicine, Tel Aviv University and Geha Mental Health Center, Tel Aviv, Israel; Division of Molecular Imaging and Neuropathology, New York State Psychiatric Institute and Department of Psychiatry, Columbia University, New York, USA.
⁶⁴ National Institute of Health Research Biomedical Research Centre, University Hospitals Bristol and Weston NHS Foundation Trust, University of Bristol, Bristol, UK.

PMID: 33862016
PMCID: PMC9188435
DOI: 10.1016/S2215-0366(21)00091-2

Erratum in

Correction to Lancet Psychiatry 2021; published online April 13. https://doi.org/10.1016/S2215-0366(21)00091-2.
[No authors listed] [No authors listed] Lancet Psychiatry. 2021 Aug;8(8):e18. doi: 10.1016/S2215-0366(21)00213-3. Epub 2021 Jun 4. Lancet Psychiatry. 2021. PMID: 34097871 Free PMC article. No abstract available.
Correction to Lancet Psychiatry 2021; 8: 579-88.
[No authors listed] [No authors listed] Lancet Psychiatry. 2021 Nov;8(11):e21. doi: 10.1016/S2215-0366(21)00358-8. Epub 2021 Aug 27. Lancet Psychiatry. 2021. PMID: 34461047 Free PMC article. No abstract available.

Abstract

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.

PubMed Disclaimer

Conflict of interest statement

Declaration of interests We declare no competing interests.

Figures

**Figure 1**
Pre-COVID-19 and COVID-19 periods as defined in the primary analysis and the two sensitivity analyses

**Figure 2**
Observed and expected numbers of suicides in the COVID-19 period based on trends in pre-COVID-19 period by country or area in the primary analysis The COVID-19 period was defined as April 1 to July 31, 2020, and the pre-COVID-19 period as at least Jan 1, 2019 to March 31, 2020 (with data included from Jan 1, 2016, if available). *Predictor for linear time trend only. †Predictors for linear time trends and seasonality. ‡Predictors for non-linear time trends and seasonality. §Unincorporated territory of the USA.

**Figure 3**
Observed and expected numbers of suicides in COVID-19 period based on trends in pre-COVID-19 period by country or area in the first sensitivity analysis The COVID-19 period was defined as April 1 to at least July 31, 2020 (with data included up to Oct 31, 2020, if available), and the pre-COVID-19 period as at least Jan 1, 2019, to March 31, 2020 (with data included from Jan 1, 2016 if available). *Predictor for linear time trend only. †Predictors for linear time trends and seasonality. ‡Predictors for non-linear time trends and seasonality. §Unincorporated territory of the USA.

**Figure 4**
Observed and expected numbers of suicides in COVID-19 period based on trends in pre-COVID-19 period by country or area in the second sensitivity analysis The COVID-19 period was defined as March 1 to July 31, 2020, and the pre-COVID-19 period as at least Jan 1, 2019, to Feb 29, 2020 (with data included from Jan 1, 2016, if available). *Predictor for linear time trend only. †Predictors for linear time trends and seasonality. ‡Predictors for non-linear time trends and seasonality. §Unincorporated territory of the USA.

See this image and copyright information in PMC

Comment in

Remaining vigilant about COVID-19 and suicide.
Botchway S, Fazel S. Botchway S, et al. Lancet Psychiatry. 2021 Jul;8(7):552-553. doi: 10.1016/S2215-0366(21)00117-6. Epub 2021 Apr 13. Lancet Psychiatry. 2021. PMID: 33862017 Free PMC article. No abstract available.
Reactie op: ‘Suïcidepreventie: uitdagingen en aanbevelingen’.
Gilissen R, Kavelaars M. Gilissen R, et al. Tijdschr Psychiatr. 2021;63(6):487-488. Tijdschr Psychiatr. 2021. PMID: 34231870 Dutch. No abstract available.
Spanish Flu (1918-1920) Impact on US Suicide Rates by Race: Potential Future Effects of the COVID-19 Pandemic.
Bastiampillai T, Allison S, Looi JCL. Bastiampillai T, et al. Prim Care Companion CNS Disord. 2021 Nov 18;23(6):21com03088. doi: 10.4088/PCC.21com03088. Prim Care Companion CNS Disord. 2021. PMID: 34797964 No abstract available.
Suicides in Germany During the COVID-19 Pandemic.
Radeloff D, Genuneit J, Bachmann CJ. Radeloff D, et al. Dtsch Arztebl Int. 2022 Jul 25;119(29-30):502-503. doi: 10.3238/arztebl.m2022.0198. Dtsch Arztebl Int. 2022. PMID: 36345581 Free PMC article. No abstract available.

Cited by

Exploring the relationship between suicide vulnerability, impulsivity and executive functioning during COVID-19: A longitudinal analysis.
Rogerson O, Prudenzi A, O'Connor DB. Rogerson O, et al. Psychiatry Res Commun. 2022 Dec;2(4):100088. doi: 10.1016/j.psycom.2022.100088. Epub 2022 Nov 25. Psychiatry Res Commun. 2022. PMID: 36447776 Free PMC article.
Injury mortality and morbidity changes due to the COVID-19 pandemic in the United States.
He J, Ning P, Schwebel DC, Yang Y, Li L, Cheng P, Rao Z, Hu G. He J, et al. Front Public Health. 2022 Nov 2;10:1001567. doi: 10.3389/fpubh.2022.1001567. eCollection 2022. Front Public Health. 2022. PMID: 36408028 Free PMC article.
Implication of COVID-19 Pandemic on Adolescent Mental Health: An Analysis of the Psychiatric Counseling from the Emergency Room of an Italian University Hospital in the Years 2019-2021.
Petruzzelli MG, Furente F, Colacicco G, Annecchini F, Margari A, Gabellone A, Margari L, Matera E. Petruzzelli MG, et al. J Clin Med. 2022 Oct 19;11(20):6177. doi: 10.3390/jcm11206177. J Clin Med. 2022. PMID: 36294498 Free PMC article.
The impact of the COVID-19 pandemic on suicide rates in Hungary: an interrupted time-series analysis.
Lantos T, Nyári TA. Lantos T, et al. BMC Psychiatry. 2022 Dec 9;22(1):775. doi: 10.1186/s12888-022-04322-2. BMC Psychiatry. 2022. PMID: 36494787 Free PMC article.
The impact of COVID-19 stressors on psychological distress and suicidality in a nationwide community survey in Taiwan.
Wu CY, Lee MB, Huong PTT, Chan CT, Chen CY, Liao SC. Wu CY, et al. Sci Rep. 2022 Feb 17;12(1):2696. doi: 10.1038/s41598-022-06511-1. Sci Rep. 2022. PMID: 35177670 Free PMC article.

See all "Cited by" articles

References

1. Cénat JM, Blais-Rochette C, Kokou-Kpolou CK, et al. Prevalence of symptoms of depression, anxiety, insomnia, posttraumatic stress disorder, and psychological distress among populations affected by the COVID-19 pandemic: a systematic review and meta-analysis. Psychiatry Res. 2021;295 - PMC - PubMed
1. Gunnell D, Appleby L, Arensman E, et al. Suicide risk and prevention during the COVID-19 pandemic. Lancet Psychiatry. 2020;7:468–471. - PMC - PubMed
1. Zortea TC, Brenna CTA, Joyce M, et al. The impact of infectious disease-related public health emergencies on suicide, suicidal behavior, and suicidal thoughts. Crisis. 2020 doi: 10.1027/0227-5910/a000753. published online Oct 16. - DOI - PMC - PubMed
1. Leaune E, Samuel M, Oh H, Poulet E, Brunelin J. Suicidal behaviors and ideation during emerging viral disease outbreaks before the COVID-19 pandemic: a systematic rapid review. Prev Med. 2020;141 - PMC - PubMed
1. John A, Okolie C, Eyles E, et al. The impact of the COVID-19 pandemic on self-harm and suicidal behaviour: a living systematic review [version 1] F1000 Res. 2020;9 - PMC - PubMed

Publication types

Actions

MeSH terms

Actions
Actions
Actions
Actions
Actions
Actions

Grants and funding

LinkOut - more resources

Full Text Sources
Other Literature Sources
- H1 Connect - Access expert opinions and insights on biomedical research.
- scite Smart Citations
Medical
- ClinicalTrials.gov
- MedlinePlus Health Information
Miscellaneous
- NCI CPTAC Assay Portal

Save citation to file

Email citation

Add to Collections

Add to My Bibliography

Your saved search

Create a file for external citation management software

Your RSS Feed

Suicide trends in the early months of the COVID-19 pandemic: an interrupted time-series analysis of preliminary data from 21 countries

Affiliations

Suicide trends in the early months of the COVID-19 pandemic: an interrupted time-series analysis of preliminary data from 21 countries

Authors

Affiliations

Erratum in

Abstract

Conflict of interest statement

Figures

Comment in

Similar articles

Cited by

References

Publication types

MeSH terms

Grants and funding

LinkOut - more resources

Full Text Sources

Other Literature Sources

Medical

Miscellaneous

Erratum in

Abstract

Conflict of interest statement

Figures

Comment in

Similar articles

Cited by

References

Publication types

MeSH terms

Related information

Grants and funding

LinkOut - more resources

Full Text Sources

Other Literature Sources

Medical

Miscellaneous