. 2022 Jul 29;12(1):303.

doi: 10.1038/s41398-022-02045-2.

Suicidality in clinically stable bipolar disorder and schizophrenia patients during the COVID-19 pandemic

Yu-Chen Li^#¹, Wei Bai^#^{2

3

4}, Hong Cai^#^{2

3

4}, Yuxuan Wu^#^{5

6}, Ling Zhang^#⁷, Yan-Hong Ding^#⁸, Juan-Juan Yang^#^{9

10}, Xiangdong Du⁶, Zhen-Tao Zeng⁷, Chang-Mou Lu⁷, Ke-Xin Feng¹¹, Wen-Fang Mi⁸, Lan Zhang⁸, Huan-Zhong Liu^{9

10}, Lloyd Balbuena¹², Teris Cheung¹³, Zhaohui Su¹⁴, Feng-Rong An¹⁵, Yu-Tao Xiang^{16

17

18}

Affiliations

¹ Department of Psychiatry, Xiamen Xianyue Hospital, Xiamen, China.
² Unit of Psychiatry, Department of Public Health and Medicinal Administration, & Institute of Translational Medicine, Faculty of Health Sciences, University of Macau, Macao SAR, China.
³ Centre for Cognitive and Brain Sciences, University of Macau, Macao SAR, China.
⁴ Institute of Advanced Studies in Humanities and Social Sciences, University of Macau, Macao SAR, China.
⁵ Medical College of Soochow University, Suzhou, China.
⁶ Guangji Hospital Affiliated to Soochow University, Suzhou, Jiangsu province, China.
⁷ Nanning Fifth People's Hospital, Nanning, Guangxi province, China.
⁸ Department of Psychiatry, Lanzhou University Second Hospital, Lanzhou, Gansu province, China.
⁹ Department of Psychiatry, Chaohu Hospital, Anhui Medical University, Hefei, China.
¹⁰ School of Mental Health and Psychological Sciences, Anhui Medical University, Hefei, China.
¹¹ School of Public Health, Lanzhou University, Lanzhou, Gansu province, China.
¹² Department of Psychiatry, University of Saskatchewan, Saskatoon, SK, Canada.
¹³ School of Nursing, Hong Kong Polytechnic University, Hong Kong SAR, China.
¹⁴ School of Public Health, Southeast University, Nanjing, China.
¹⁵ The National Clinical Research Center for Mental Disorders & Beijing Key Laboratory of Mental Disorders, Beijing Anding Hospital & the Advanced Innovation Center for Human Brain Protection, Capital Medical University, Beijing, China. afrylm@sina.com.
¹⁶ Department of Psychiatry, Xiamen Xianyue Hospital, Xiamen, China. xyutly@gmail.com.
¹⁷ Unit of Psychiatry, Department of Public Health and Medicinal Administration, & Institute of Translational Medicine, Faculty of Health Sciences, University of Macau, Macao SAR, China. xyutly@gmail.com.
¹⁸ Centre for Cognitive and Brain Sciences, University of Macau, Macao SAR, China. xyutly@gmail.com.

^# Contributed equally.

PMID: 35906234
PMCID: PMC9335454
DOI: 10.1038/s41398-022-02045-2

Suicidality in clinically stable bipolar disorder and schizophrenia patients during the COVID-19 pandemic

Yu-Chen Li et al. Transl Psychiatry. 2022.

. 2022 Jul 29;12(1):303.

doi: 10.1038/s41398-022-02045-2.

Authors

Affiliations

¹ Department of Psychiatry, Xiamen Xianyue Hospital, Xiamen, China.
² Unit of Psychiatry, Department of Public Health and Medicinal Administration, & Institute of Translational Medicine, Faculty of Health Sciences, University of Macau, Macao SAR, China.
³ Centre for Cognitive and Brain Sciences, University of Macau, Macao SAR, China.
⁴ Institute of Advanced Studies in Humanities and Social Sciences, University of Macau, Macao SAR, China.
⁵ Medical College of Soochow University, Suzhou, China.
⁶ Guangji Hospital Affiliated to Soochow University, Suzhou, Jiangsu province, China.
⁷ Nanning Fifth People's Hospital, Nanning, Guangxi province, China.
⁸ Department of Psychiatry, Lanzhou University Second Hospital, Lanzhou, Gansu province, China.
⁹ Department of Psychiatry, Chaohu Hospital, Anhui Medical University, Hefei, China.
¹⁰ School of Mental Health and Psychological Sciences, Anhui Medical University, Hefei, China.
¹¹ School of Public Health, Lanzhou University, Lanzhou, Gansu province, China.
¹² Department of Psychiatry, University of Saskatchewan, Saskatoon, SK, Canada.
¹³ School of Nursing, Hong Kong Polytechnic University, Hong Kong SAR, China.
¹⁴ School of Public Health, Southeast University, Nanjing, China.
¹⁵ The National Clinical Research Center for Mental Disorders & Beijing Key Laboratory of Mental Disorders, Beijing Anding Hospital & the Advanced Innovation Center for Human Brain Protection, Capital Medical University, Beijing, China. afrylm@sina.com.
¹⁶ Department of Psychiatry, Xiamen Xianyue Hospital, Xiamen, China. xyutly@gmail.com.
¹⁷ Unit of Psychiatry, Department of Public Health and Medicinal Administration, & Institute of Translational Medicine, Faculty of Health Sciences, University of Macau, Macao SAR, China. xyutly@gmail.com.
¹⁸ Centre for Cognitive and Brain Sciences, University of Macau, Macao SAR, China. xyutly@gmail.com.

^# Contributed equally.

PMID: 35906234
PMCID: PMC9335454
DOI: 10.1038/s41398-022-02045-2

Abstract

The coronavirus disease 2019 (COVID-19) pandemic has a disproportionate impact on vulnerable subpopulations, including those with severe mental illness (SMI). This study examined the one-year prevalence of suicidal ideation (SI), suicide plans (SP), and suicide attempts (SA) in bipolar disorder (BD) and schizophrenia (SCZ) patients during the pandemic. Prevalence rates were compared between the two disorders and associated factors were examined. A survey was conducted in six tertiary psychiatric hospitals and psychiatric units. People with a diagnosis of BD or SCZ were invited to participate. SI, SP, and SA (suicidality for short) were assessed and associated factors were examined using binary logistical regression. The 1-year prevalence of SI, SP and SA in BD patients were 58.3%, (95% CI: 54.1-62.6%), 38.4% (95% CI: 34.3-42.6%) and 38.6% (95% CI: 34.5-42.8%), respectively, which were higher than the corresponding figures in SCZ patients (SI: 33.2%, 95% CI: 28.6-37.8%; SP: 16.8%, 95% CI: 13.2-20.5%; SA: 19.4%, 95% CI: 15.5-23.3%). Patients with younger age, experience of cyberbullying, a history of SA among family or friends, a higher fatigue and physical pain score, inpatient status, and severe depressive symptoms were more likely to have suicidality. The COVID-19 pandemic was associated with increased risk of suicidality, particularly in BD patients. It is of importance to regularly screen suicidality in BD and SCZ patients during the pandemic even if they are clinically stable.

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Conflict of interest statement

The authors declare no competing interests.

Figures

**Fig. 1. Distribution of suicide plan and suicide attempt in patients with and without suicidal ideation.**
Note: Numbers in bar graphs indicate patient counts. a shows counts of suicide plans (SP) and suicide attempts (SA) in BD patients by presence of SI. b shows SP and SA in SCZ by presence of SI. SI increases the risk for SP and SA in both disorders (p < 0.001).

**Fig. 2. Independent correlates of suicidal ideation, suicide plan and suicide attempt in patients with bipolar disorder by multiple logistic regression analyses.**
Note: a, suicidal ideation; b, suicide plan; c, suicide attempt.

**Fig. 3. Independent correlates of suicidal ideation, suicide plan and suicide attempt in patients with schizophrenia by multiple logistic regression analyses.**
Note: a, suicidal ideation; b, suicide plan; c, suicide attempt.

See this image and copyright information in PMC

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Suicidality in clinically stable bipolar disorder and schizophrenia patients during the COVID-19 pandemic

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Suicidality in clinically stable bipolar disorder and schizophrenia patients during the COVID-19 pandemic

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