Increased incidence of high-lethality suicide attempts after the declaration of the state of alarm due to the COVID-19 pandemic in Salamanca: A real-world observational study

Trends in medically serious suicide attempts before and after COVID-19: a four-year retrospective analysis (2018-2022)

BACKGROUND

Suicide has become a first-order public health concern after the negative impact of COVID-19 on the general population's mental health. Several studies have analyzed the trends in suicide attempts (SA) before and after the onset of the pandemic, but few studies focus on the impact of the pandemic on medically serious suicide attempts (MSSA).

METHODS

Participants were 385 hospitalized individuals ≥ 16 years old who made MSSA identified retrospectively through a review of e-medical records between 2018 and 2022 ("pre-COVID-19" and "COVID" periods). The two groups were compared on sociodemographic and clinical variables using Chi-square or Exact Fisher's tests for categorical variables and a Mann-Whitney test for continuous variables. To study the variation in MSSA over time, MSSA were aggregated monthly. Joinpoint regression analyses were used to assess time trends.

RESULTS

A sample of 161 MSSA patients, 80 women and 81 men, were selected from 385 admissions after a suicide attempt (SA) in the four years (n = 160 pre-COVID period vs. n = 225 COVID period) (OR = 1.41; CI 95% = 1.0003-1.7223, p < 0.001). Sixty-eight patients with MSSA were admitted during the first period, and 93 during the COVID period (OR = 1.4 ; CI 95% = 1-1.9 ; p < 0.05). MSSA patients were more likely to be admitted to an intensive care unit during the COVID period than during the pre-COVID period (OR = 3.5; CI 95% = 1.7-6.9; p < 0.001).

CONCLUSIONS

This study highlights the need for research on suicide risk during and after crisis periods, such as the COVID-19 pandemic. It provides valuable knowledge on the incidence of SA needing hospitalization, MSSA, and highly severe MSSA for four years before and after the pandemic onset.

Anticipating influential factors on suicide outcomes through machine learning techniques: Insights from a suicide registration program in western Iran

Suicide is a global public health concern, with increasing rates observed in various regions, including Iran. This study focuses on the province of Hamadan, Iran, where suicide rates have been on the rise. The research aims to predict factors influencing suicide outcomes by leveraging machine learning techniques on the Hamadan Suicide Registry Program data collected from 2016 to 2017. The study employs Naïve Bayes and Random Forest algorithms, comparing their performance to logistic regression. Results highlight the superiority of the Random Forest model. Based on the variable importance and multiple logistic regression analyses, the most important determinants of suicide outcomes were identified as suicide method, age, and timing of attempts, income, and motivation. The findings emphasize the cultural context's impact on suicide methods and underscore the importance of tailoring prevention programs to address specific risk factors, especially for older individuals. This study contributes valuable insights for suicide prevention efforts in the region, advocating for context-specific interventions and further research to refine predictive models and develop targeted prevention strategies.

Follow-up of telemedicine mental health interventions amid COVID-19 pandemic

The initiation of the program Mental Health Support Program for Coronavirus Infection addressed the increased demand for mental health services in the province of Salamanca, resulting from the COVID-19 pandemic. The psychiatry service provided care for COVID-19 patients, their families, and healthcare workers who treated them, as these groups were identified as being at risk. This study aims to describe the assistance provided, including personnel and resources utilized, types of interventions carried out, and to assess the demand for mental health care and predominant symptoms and emotions experienced by patients. Billboards and the complex's intranet publicized the program. Specific clinical approach using telemedicine were provide from March 2020 to December 2021 to COVID-19 patients, their relatives, and healthcare workers. 216 patients were included with a mean age of 53.2 years, with women comprising 77.3% of this group. All the groups received treatment in similar proportions. Over a period of 730 h, a total of 1376 interventions were performed, with an average duration of 31.8 min per intervention. The program could treat 79.6% of these patients without requiring referrals to other services. When the program concluded, only 21 participants (9.7%) were discharged to the local mental health network to continue their mental health treatment. The program effectively reduced the burden on regular mental health services due to its ability to treat most patients without requiring referrals. The program was able to attend to most mental health requests with minimal involvement of the regular mental health service.

Post-Pandemic Evolution of Suicide Risk in Children and Adolescents Attending a General Hospital Accident and Emergency Department

BACKGROUND

Lockdowns and other health protective measures, such as social distancing, imposed during the COVID-19 pandemic nurtured unprecedented levels of stress and social isolation around the world. This scenario triggered an increase in suicide thoughts and self-harm behaviours among children and young people. However, the longer-term impact of the pandemic on children's and adolescents' mental health, especially with regard to self-harm, is still to be fully discovered.

METHODS

We carried out a retrospective study where we collected data related to suicide ideation and self-harm behaviours in all patients aged under 18 that required on-call psychiatric services at the General Hospital Accident and Emergency (A&E) department in Salamanca, Spain, during 2019 (pre-pandemic) and in both 2021 and 2022 to capture possible variation at different time points during the post-pandemic period.

RESULTS

A total of 316 patients aged under 18 were seen by on-call psychiatric services at the A&E department during the three time periods: 78 in 2019, 98 in 2021 and 140 in 2022. The mean age was 15.12 (SD 2.25) and females represented more than twice the number of males each year. More than half of all patients assessed during 2022 disclosed suicide thoughts, whilst in 2019, it was near 25%. This increase in suicide ideation rates was more marked among females (X2 = 15.127; p = 0.001), those aged over 15 (X2 = 16.437; p < 0.001) and/or those with a previous history of mental health problems (X2 = 17.823; p < 0.001). We identified an increase in the proportion of males with suicide ideas, especially between 2021 and 2022 (X2 = 8.396; p = 0.015).

CONCLUSIONS

Our study suggests that children's and adolescents' demand for urgent mental healthcare and their clinical presentations in A&E departments with suicide thoughts and/or self-injuries do not seem to be declining after the pandemic but increasing over time. More research is warranted to understand possible factors involved in this sustained upward trend.

The Risk of Suicide in the Post-COVID-19 Emergency Era: Psychological and Forensic Implications

The emergence of the coronavirus disease 2019 (COVID-19) pandemic brought numerous challenges, including the management of psychological and psychiatric disorders, leading to an increased risk of suicide. At the end of the COVID-19 emergency, we wonder what the impact of the pandemic has been, and still is, on the state of public mental health with respect to the phenomenon of suicide. Therefore, this review aims to explore the psychological and forensic aspects of suicide in the post-COVID-19 emergency era. The paper will delve into the various psychiatric disorders associated in the literature with COVID-19, the risk factors for suicide during the pandemic, and measures that can be taken to prevent suicide in the post-COVID-19 era. Additionally, the paper will look at how forensic experts investigate suicide cases due to COVID-19 and the legal implications of suicide due to the pandemic. The findings of this study will provide insights into the psychological and forensic aspects of suicide in the post-COVID era, and emphasize interventions and policy development to address this growing public health concern.

Suicidal Ideation and Death by Suicide as a Result of the COVID-19 Pandemic in Spanish-Speaking Countries: Systematic Review

Suicidal behaviors and constructs are putting at risk the accomplishment of Objective 3 of Agenda 2030 for sustainable development in Spanish-speaking countries. The current study's principal objective is to explain the presence of suicidal ideation and deaths by suicide as a result of the COVID-19 pandemic in Spanish-speaking countries based on a review of the scientific literature. The PRISMA model was used as the main method while considering the criteria of periodicity, language, typology, and country in order to choose the 28 articles that were analyzed from the following three databases: SCOPUS, Web of Science, and ProQuest Coronavirus Research Database. Suicidal ideation and death by suicide exhibited a growth trend during the COVID-19 pandemic, including post-pandemic, especially in kids, adolescents, and young women of university age belonging to lower socioeconomic strata and presenting risk factors like living in rural areas, poor mental health, unemployment, and family death due to COVID-19.

Prevalence of suicidal ideation and correlated risk factors during the COVID-19 pandemic: A meta-analysis of 113 studies from 31 countries

The purpose of this study was to estimate the prevalence of suicidal ideation and correlated risk factors during the COVID-19 pandemic. Web of Science (WOS) and PubMed were searched according to a pre-set strategy. A total of 132 studies were identified, 104 of which were included in the meta-analysis. The prevalence of suicidal ideation was approximately 14.7% (95%CI: 12.5%, 16.8%, P < 0.01) in the general population, approximately 22.4% (95%CI: 17.1%, 27.8%, P < 0.01）in adolescents, approximately 21.0% (95%CI: 12.8%, 29.2%, P < 0.01) in psychiatric patients, approximately 20.6% (95%CI: 18.7%, 22.5%, P < 0.01）in university students, approximately 18.9% (95%CI: 8.3%, 29.5%, P < 0.01) in younger adults, approximately 10.6% (95%CI: 1.0%, 20.2%, P = 0.031) in COVID-19 patients and approximately 7.4% (95%CI: 4.3%, 10.5%, P < 0.01) in healthcare workers. The prevalence in North America was approximately 16.0% (95%CI: 13.6%-18.4%, P < 0.001), approximately 14.5% in Asia (95%CI: 9.5%-19.4%, P < 0.001), approximately 10.5% in Europe (95%CI: 8.5%-12.4%, P < 0.001), and approximately 20.5% in South America (95%CI: 19.5%-21.5%, P < 0.001). The following were risk factors which might be correlated with suicidal ideation: severe anxiety symptoms, mild to moderate depression, a strong feeling of loneliness/social isolation, poor sleep quality, having COVID-19-related experience, having quarantine or lockdown experience, being female, being single or divorced, having financial problems and having a history of suicidal ideation/attempt. This article reports the prevalence of suicidal ideation and discussing potential risk factors during the pandemic among general population and vulnerable groups. Early detection and follow-up were necessary for the noteworthy population.

Epidemiology of suicide and suicide attempts in Jahrom district, Southern Iran in light of COVID pandemic: A prospective observational study

Background and Aims

Suicide is a global public health issue. The covid-19 epidemic has led to disturbance in daily life and economic activity. It is assumed that increased stress and anxiety cause suicide. This study aimed to describe the causes and methods of committing suicide during the COVID pandemic.

Methods

This descriptive study was conducted on all outpatients, inpatients, and those who died during the period from March 21, 2021 to March 20, 2022 due to suicide attempts, referred to hospitals and clinics affiliated with Jahrom University of Medical Sciences or were identified by the social emergency and welfare organization.

Results

A total of 330 suicide attempters with an average age of 26.74 ± 0.64 years were studied. They were 220 women (66.67%), 159 single (48.18%), and 309 (73.64%) people who had diplomas and high school degrees. In general, the three main reasons for committing suicide were emotional issues and problems with 169 people (51.21%), family violence with 127 people (38.48%), and economic issues and problems with 90 people (27.27%). In terms of suicide manners, 283 people (85.76%) used medicine (or pharmaceuticals), 16 people (4.85%) used agricultural pesticides, and 11 people (3.33%) used rodenticides. Furthermore, 164 people (49.70%) suffered from depression, 94 people (28.49%) were children of divorce, 60 people (18.18%) were drug users, 151 people (45.76%) had a history of alcohol consumption, and 116 people (35.15%) had a history of committing suicide. A total of 6 cases of complete suicide (leading to death) have occurred.

Conclusion

The most important factors for suicide throughout the covid-19 epidemic were emotional issues, marital incompatibility, and economic issues. Medicine poisoning was the most important method of committing suicide. In times of crisis, a multisectoral public health approach is needed to prevent increased anxiety, stress, and subsequent suicide attempts.