Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2024 Dec 16;54(16):1-9.
doi: 10.1017/S003329172400299X. Online ahead of print.

Suicidal behavior in patients with severe mental disorders prior to and during the COVID-19 pandemic

Ellenor Mittendorfer-Rutz  1 , Jakob Bergström  1 , Pontus Josefsson  1 , Heidi Taipale  1 , Marit Sijbrandij  2 , Anke Witteveen  2 , Matteo Monzio Compagnoni  3   4 , Antonio Lora  4   5 , Mireia Felez-Nobrega  6   7 , Josep Maria Haro  6   7   8 , Maria Melchior  9 , Judith van der Waerden  9 , Katalin Gemes  1 , Ridwanul Amin  1   10
Affiliations

Suicidal behavior in patients with severe mental disorders prior to and during the COVID-19 pandemic

Ellenor Mittendorfer-Rutz et al. Psychol Med. .

Abstract

Background: Determining whether the incidence of suicidal behavior during the COVID-19 pandemic changed for those with severe mental disorders is essential to ensure the provision of suicide preventive initiatives in the case of future health crises.

Methods: Using population-based registers, quarterly cohorts from the first quarter of 2018 (2018Q1) to 2021Q4 were formed including all Swedish-residents >10 years old. Interrupted time series and generalized estimating equations analyses were used to evaluate changes in Incidence Rates (IR) of specialised healthcare use for suicide attempt and death by suicide per 10 000 person-years for individuals with or without specific severe mental disorders (SMDs) during, compared to before the pandemic.

Results: The IR (95% Confidence interval, CI) of suicide in individuals with SMDs decreased from 16.0 (15.0-17.1) in 2018Q1 to 11.6 (10.8-12.5) in 2020Q1 (i.e. the quarter before the start of the pandemic), after which it dropped further to 6.7 (6.3-7.2) in 2021Q2. In contrast, IRs of suicide attempt in SMDs showed more stable trends, as did the trends regarding suicide and suicide attempt for individuals without SMD. These discrepancies were most evident for individuals with substance use disorder and ASD/ADHD. Changes in IRs of suicide v. suicide attempt for one quarter during the pandemic for substance misuse were 11.2% v. 3.6% respectively. These changes for ASD/ADHD were 10.7% v. 3.6%.

Conclusions: The study shows pronounced decreases in suicide rates in individuals with SMDs during the pandemic. Further studies aiming to understand mechanisms behind these trends are warranted to consult future suicide prevention strategies.

Keywords: Covid-19 pandemic; mental disorder; suicide.

PubMed Disclaimer

Conflict of interest statement

HT and EMR have participated in research projects funded by Janssen outside of the submitted work. HT received personal fees from Gedeon Richter, Janssen, Lundbeck and Otsuka, outside of the submitted work. None declared for the remaining authors.

Figures

Figure 1.
Figure 1.
Crude observed and estimated incidence rates of suicide per 10 000 person-years with 95% confidence intervals during the years preceding the start of the Covid-19 pandemic (first quarter 2018 or 2018Q1–2020Q1) and the years after start of the pandemic (2020Q2–2021Q2) for individuals with specific severe mental disorders treated in specialized healthcare and individuals without such treated disorders the year preceding the start of the respective quarter, covering the entire population > 10 years of age in Sweden, stratified by sex; ASD/ADHD, Autism spectrum disorders/Attention deficit hyperactivity disorders.
Figure 2.
Figure 2.
Crude observed and estimated incidence rates of suicide attempt per 10 000 person-years with 95% confidence intervals during the years preceding the start of the Covid-19 pandemic (first quarter 2018 or 2018Q1–2020Q1) and the years after start of the pandemic (2020Q2–2021Q4) for individuals with specific severe mental disorders treated in specialized healthcare and individuals without such treated disorders the year preceding the start of the respective quarter, covering the entire population > 10 years of age in Sweden, stratified by sex; ASD/ADHD, Autism spectrum disorders/Attention deficit hyperactivity disorders.
See this image and copyright information in PMC

Similar articles

See all similar articles

References

    1. Akbar, R., Arya, V., Conroy, E., Wilcox, H. C., & Page, A. (2023). Posttraumatic stress disorder and risk of suicidal behavior: A systematic review and meta-analysis. Suicide and Life-Threatening Behavior, 53(1), 163–184. doi: 10.1111/sltb.12931 - DOI - PubMed
    1. Bachmann, S. (2018). Epidemiology of suicide and the psychiatric perspective. International Journal of Environmental Research and Public Health, 15(7), 1425–1448. doi: 10.3390/ijerph15071425 - DOI - PMC - PubMed
    1. Berardelli, I., Sarubbi, S., Rogante, E., Cifrodelli, M., Erbuto, D., Innamorati, M., … Pompili, M. (2021). The impact of the COVID-19 pandemic on suicide ideation and suicide attempts in a sample of psychiatric inpatients. Psychiatry Research, 303, 114072. 10.1016/j.psychres.2021.114072 - DOI - PMC - PubMed
    1. Brooke, H. L., Talbäck, M., Hörnblad, J., Johansson, L. A., Ludvigsson, J. F., Druid, H., … Ljung, R. (2017). The Swedish cause of death register. European Journal of Epidemiology, 32(9), 765–773. doi: 10.1007/s10654-017-0316-1 - DOI - PMC - PubMed
    1. Chesney, E., Goodwin, G. M., & Fazel, S. (2014). Risks of all-cause and suicide mortality in mental disorders: A meta-review. World Psychiatry, 13(2), 153–160. doi: 10.1002/wps.20128 - DOI - PMC - PubMed