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. 2022 Jul 19:13:927696.
doi: 10.3389/fpsyt.2022.927696. eCollection 2022.

Quality and quantity of serious violent suicide attempts during the COVID-19 pandemic

Tazio Maleitzke  1   2   3 , Dario Zocholl  4 , Tobias Topp  5 , Annika Dimitrov-Discher  1 , Elly Daus  1 , Gabriel Reaux  1 , Malin Zocholl  6 , Rolf Nicolas Conze  6 , Moritz Kolster  7 , Philipp Weber  8 , Florian Nima Fleckenstein  3   9 , Louise Scheutz Henriksen  10   11 , Ulrich Stöckle  1 , Thomas Fuchs  6 , Denis Gümbel  7 , Nikolai Spranger  7 , Alexander Ringk  8 , Sven Märdian  1
Affiliations

Quality and quantity of serious violent suicide attempts during the COVID-19 pandemic

Tazio Maleitzke et al. Front Psychiatry. .

Abstract

Background: While repeated shutdown and lockdown measures helped contain the spread of SARS-CoV-2 during the COVID-19 pandemic, social distancing and self-isolation negatively impacted global mental health in 2020 and 2021. Although suicide rates did reportedly not increase during the first months of the pandemic, long-term data, and data on the quality of serious violent suicide attempts (SVSAs) are not available to date.

Materials and methods: Orthopaedic trauma patient visits to the emergency department (ED), ED trauma team activations, and SVSAs were retrospectively evaluated from January 2019 until May 2021 in four Level-I Trauma Centers in Berlin, Germany. SVSAs were assessed for suicide method, injury pattern and severity, type of treatment, and length of hospital stay.

Results: Significantly fewer orthopaedic trauma patients presented to EDs during the pandemic (n = 70,271) compared to the control (n = 84,864) period (p = 0.0017). ED trauma team activation numbers remained unchanged. SVSAs (corrected for seasonality) also remained unchanged during control (n = 138) and pandemic (n = 129) periods, and no differences were observed for suicide methods, injury patterns, or length of hospital stay.

Conclusion: Our data emphasize that a previously reported rise in psychological stress during the COVID-19 pandemic does not coincide with increased SVSA rates or changes in quality of SVSAs.

Keywords: COVID-19; SARS-CoV-2; death; injury; mortality; violent suicide attempts.

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Figures

Figure 1
Figure 1
Longitudinal time chart of analyzed periods and COVID-19 related shutdowns implemented in Berlin, Germany during 2020 and 2021.
Figure 2
Figure 2
Overall and hospital-specific distribution of (A) orthopaedic trauma patients, (B) trauma team activations, and (C) SVSAs during the 14-month control (blue) and pandemic period (purple). Longitudinal distribution of (D) orthopaedic trauma patients, (E) trauma team activations, and (F) SVSAs per month during the control (blue) and pandemic period (purple). March 2020 (black dot) was excluded from the analyses. SVSAs, serious violent suicide attempts.
Figure 3
Figure 3
Odds ratios (ORs) for (A) demographics and suicide methods, (B) osseous injury patterns, (C) non-osseous injury patterns, (D) Injury Severity Score (ISS), treatment and outcomes of patients who undertook serious violent suicide attempts (SVSAs) during the COVID-19 pandemic and a proceeding control period. Green confidence intervals (95% CIs) indicate an event happening less often during the pandemic, whereas gray 95% CIs represent events happening more often during the pandemic. To obtain symmetric CIs, a log-scaled x-axis was used (few, very wide CIs were cut for proper display). ED, emergency department; C spine, cervical spine; ICU, intensive care unit, L spine, lumbar spine, O-C spine, occipito-cervical spine, T spine, thoracic spine.
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