Suicide Attempts in Children Aged 10-14 Years During the First Year of the COVID-19 Pandemic

Abstract

Purpose: To determine if suicide attempts increased during the first year of the pandemic among young adolescents in Quebec, Canada.

Methods: We analyzed children aged 10-14 years who were hospitalized for a suicide attempt between January 2000 and March 2021. We calculated age-specific and sex-specific suicide attempt rates and the proportion of hospitalizations for suicide attempts before and during the pandemic and compared rates with patients aged 15-19 years. We used interrupted time series regression to measure changes in rates during the first (March 2020 to August 2020) and second (September 2020 to March 2021) waves and difference-in-difference analysis to determine if the pandemic had a greater impact on girls than boys.

Results: Suicide attempt rates decreased for children aged 10-14 years during the first wave. However, rates increased sharply during the second wave for girls, without changing for boys. Girls aged 10-14 years had an excess of 5.1 suicide attempts per 10,000 at the start of wave 2, with rates continuing to increase by 0.6 per 10,000 every month thereafter. Compared with the prepandemic period, the increase in the proportion of girls aged 10-14 years hospitalized for a suicide attempt was 2.2% greater than that of boys during wave 2. The pattern seen in girls aged 10-14 years was not present in girls aged 15-19 years.

Discussion: Hospitalizations for suicide attempts among girls aged 10-14 years increased considerably during the second wave of the pandemic, compared with boys and older girls. Young adolescent girls may benefit from screening and targeted interventions to address suicidal behavior.

Keywords: Adolescent; Attempted suicide; COVID-19; Pandemics; Self-injurious behavior.

Figure 1

Interrupted time series of suicide attempt hospitalization rates for youth before and during the pandemic^a. ^aRates of suicide attempt hospitalizations before the pandemic (January 2000 to February 2020), during wave 1 (March 2020 to August 2020), and during wave 2 (September 2020 to March 2021). Monthly change refers to change in the suicide attempt hospitalization rate per 10,000 population.

Figure 2

Difference-in-difference analysis of the change in proportion of suicide attempts for girls versus boys aged 10–14 years during the pandemic^a. ^aPrepandemic period extends from August 23, 2019, to February 24, 2020, wave 1 from February 25, 2020, to August 22, 2020, and wave 2 from August 23, 2020, to March 31, 2021. Dotted line represents the expected increase in the proportion of hospitalizations for suicide attempts had girls experienced the same increase as boys.

Figure 3

Use of violent means for suicide attempts in youth before versus during the pandemic^a. ^aProportion of hospitalizations for suicide attempts due to self-poisoning versus violent means before the pandemic (January 2000 to February 2020), during wave 1 (March 2020 to August 2020), and during wave 2 (September 2020 to March 2021). Monthly change refers to change in the proportion of hospitalizations in percentage points.