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. 2022 Jan 4;5(1):e2145870.
doi: 10.1001/jamanetworkopen.2021.45870.

Reasons for Suicide During the COVID-19 Pandemic in Japan

Masahide Koda  1 , Nahoko Harada  2 , Akifumi Eguchi  3 , Shuhei Nomura  4   5   6 , Yasushi Ishida  1
Affiliations

Reasons for Suicide During the COVID-19 Pandemic in Japan

Masahide Koda et al. JAMA Netw Open. .

Erratum in

  • Error in Results.
    [No authors listed] [No authors listed] JAMA Netw Open. 2022 Feb 1;5(2):e223161. doi: 10.1001/jamanetworkopen.2022.3161. JAMA Netw Open. 2022. PMID: 35191976 Free PMC article. No abstract available.

Abstract

Importance: Although the suicide rate in Japan increased during the COVID-19 pandemic, the reasons for suicide have yet to be comprehensively investigated.

Objective: To assess which reasons for suicide had rates that exceeded the expected number of suicide deaths for that reason during the COVID-19 pandemic.

Design, setting, and participants: This national, population-based cross-sectional study of data on suicides gathered by the Ministry of Health, Labor, and Welfare from January 2020 to May 2021 used a times-series analysis on the numbers of reason-identified suicides. Data of decedents were recorded by the National Police Agency and compiled by the Ministry of Health, Labor, and Welfare.

Exposure: For category analysis, we compared data from January 2020 to May 2021 with data from December 2014 to June 2020. For subcategory analysis, data from January 2020 to May 2021 were compared with data from January 2019 to June 2020.

Main outcomes and measures: The main outcome was the monthly excess suicide rate, ie, the difference between the observed number of monthly suicide deaths and the upper bound of the 1-sided 95% CI for the expected number of suicide deaths in that month. Reasons for suicide were categorized into family, health, economy, work, relationships, school, and others, which were further divided into 52 subcategories. A quasi-Poisson regression model was used to estimate the expected number of monthly suicides. Individual regression models were used for each of the 7 categories, 52 subcategories, men, women, and both genders.

Results: From the 29 938 suicides (9984 [33.3%] women; 1093 [3.7%] aged <20 years; 3147 [10.5%] aged >80 years), there were 21 027 reason-identified suicides (7415 [35.3%] women). For both genders, all categories indicated monthly excess suicide rates, except for school in men. October 2020 had the highest excess suicide rates for all cases (observed, 1577; upper bound of 95% CI for expected number of suicides, 1254; 25.8% greater). In men, the highest monthly excess suicide rate was 24.3% for the other category in August 2020 (observed, 87; upper bound of 95% CI for expected number, 70); in women, it was 85.7% for school in August 2020 (observed, 26; upper bound of 95% CI for expected number, 14).

Conclusions and relevance: In this study, observed suicides corresponding to all 7 categories of reasons exceeded the monthly estimates (based on data from before or during the COVID-19 pandemic), except for school-related reasons in men. This study can be used as a basis for developing intervention programs for suicide prevention.

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Conflict of interest statement

Conflict of Interest Disclosures: Dr Ishida reported receiving grants from the Japan Society for the Promotion of Science. No other disclosures were reported.

Figures

Figure.
Figure.. Suicides Overall and by Gender From January 2020 to May 2021
Information about how the expected number of suicides per month appears in the Methods section.
See this image and copyright information in PMC

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