Impact of the COVID-19 Pandemic on Adolescent Self-Harm: Based on a National Emergency Department Information System

Republic of Korea's suicide rate is the highest among Organization for Economic Co-operation and Development countries. In Republic of Korea, suicide is the leading cause of death among young people aged 10-19 years. This study aimed to identify changes in patients aged 10-19 years who visited the emergency department in Republic of Korea after inflicting self-harm over the past five years and to compare the situations before and after the outbreak of the COVID-19 pandemic. Analysis of government data revealed that the average daily visits per 100,000 were 6.25, 8.18, 13.26, 15.31, and 15.71 from 2016 to 2020, respectively. The study formed four groups for further analysis, with the population divided by sex and age (10-14 and 15-19 years old). The late-teenage female group showed the sharpest increase and was the only group that continued to increase. A comparison of the figures 10 months before and after the outbreak of the pandemic revealed a statistically significant increase in self-harm attempts by only the late-teenage female group. Meanwhile, visits (per day) in the male group did not increase, but the rates of death and ICU admission increased. Additional studies and preparations that account for age and sex are warranted.

Suicide and Suicide Prevention Activities Following the Great East Japan Earthquake 2011: A Literature Review

BACKGROUND

Since the Great East Japan Earthquake (GEJE), numerous studies have been conducted, but no comprehensive review study has been carried out. Thus, this literature review aimed to examine how the GEJE might affect suicide and suicidal behaviors from a long-term perspective.

METHODS

For the literature review, a search of electronic databases was carried out to find articles written in English and in Japanese that were related to suicide and its risk factors, as well as suicide prevention activities following the GEJE. Thirty-two articles were then selected for the review.

RESULTS

There were several findings, as follows: (1) gender differences in suicide rates in the affected area: nationwide, the suicide rates in men showed a delayed increase, whereas suicide rates in women increased temporarily immediately after the GEJE; (2) the suicide rates increased again in the recovery phase; (3) the background of the suicides was linked to both disaster-related experiences, and indirect reasons pertaining to the GEJE; and (4) intensive intervention combined with a high-risk and community-focused approach could prevent suicides following the disaster.

CONCLUSIONS

Although further accumulation of knowledge about suicide and suicide prevention is essential, these findings can contribute to response, recovery, and preparedness in relation to future disasters.

Seasonality of Suicides among Victims Who Are under the Influence of Alcohol

Introduction: Suicide is one of the most frequent causes of death. According to the World Health Organization (WHO), each year, over eight hundred thousand people worldwide die as a result of suicide. The most common risk factors for suicide are depressive disorders and alcohol dependence. Alcohol can directly influence a decision about suicide, or be a factor facilitating this decision. The aim of the study was to analyse the seasonality of suicides among persons under the influence of alcohol. Material and Methods: Data for analysis were obtained from the Department of Forensic Medicine (DFM) of the Medical University of Warsaw. A retrospective analysis was performed on 317 victims of suicides by hanging, those which were entered into the registry of deaths kept by the DFM in the years 2009–2013. The analysis took into account the age and sex of victims, initial cause of death, date of post-mortem examination, autopsy result and alcohol concentration in the blood or muscles of the victims. Statistical analysis was performed using IBM SPSS Statistics version 20. Results: In the analysis, a spring peak of suicides was found for men, and an autumn peak was revealed for women. In addition, a significant correlation was observed between the age of victims and the concentration of alcohol; the older the victims, the higher the alcohol concentration. However, this correlation was reported only in the spring months. Conclusions: The results of the analysis seem to be consistent with seasonal patterns observed in other studies, and they indicate the occurrence of suicide seasonality. In order to improve the strategies of suicide prevention, it is necessary to identify factors which are related to the seasonal variation of suicidal behaviours, as well as to gain knowledge about the mechanisms behind this phenomenon.

Ambient air pollution and suicide in Tokyo, 2001-2011

BACKGROUND

Some evidence suggests an association may exist between the level of air pollution and suicide mortality. However, this relation has been little studied to date. The current study examined the association in Tokyo, Japan.

METHODS

Suicide mortality data for Tokyo for the 11-year period 2001-2011 were obtained together with data on four air pollutants: fine particulate matter (PM2.5), suspended particulate matter (SPM), sulphur dioxide (SO2) and nitrogen dioxide (NO2). A time-stratified case-crossover study design was used to examine the daily association between the level of air pollution and suicide mortality.

RESULTS

During the study period there were 29,939 suicide deaths. In stratified analyses an interquartile range (IQR) increase in the same-day concentration of NO2 was linked to increased suicide mortality among those aged under 30 (percentage change: 6.73%, 95% CI: 0.69-13.12%). An IQR increase in PM2.5 and SO2 was associated with a 10.55% (95% CI: 2.05-19.75%) and 11.47% (95% CI: 3.60-19.93%) increase, respectively, in suicide mortality among widowed individuals for mean exposure on the first four days (average lags 0-3). Positive associations were observed for the air pollutants in the summer although associations were reversed in autumn.

LIMITATIONS

We relied on monitoring data to approximate individual exposure to air pollutants.

CONCLUSIONS

Higher levels of air pollution are associated with increased suicide mortality in some population subgroups in Tokyo. Further research is needed to elucidate the mechanisms linking air pollutants and suicide in this setting.

Variations in suicide method and in suicide occurrence by season and day of the week in Russia and the Nenets Autonomous Okrug, Northwestern Russia: a retrospective population-based mortality study

BACKGROUND

Suicide is an important world health issue, especially in territories inhabited by indigenous people. This investigated differences in suicide rates, suicide methods, and suicide occurrence by month and day of the week among the indigenous and non-indigenous populations of the Nenets Autonomous Okrug (NAO) and to compare the findings from the NAO with national Russian statistics.

METHODS

In this retrospective population-based mortality study we investigated all suicides that occurred in the NAO in 2002-2012 (N = 252). Suicide method and the month and day of the week suicide occurred was taken from autopsy reports and disaggregated by ethnic group (indigenous and non-indigenous) and sex. Data from the NAO were then compared with national data from the Russian Federal Statistics Service (Rosstat).

RESULTS

Hanging was the most common suicide method in the NAO in both indigenous and non-indigenous populations. The proportion of suicides by hanging among males was lower in the NAO than in national data (69.3 vs 86.2 %), but the inverse was true for females (86.5 vs 74.9 %). Suicide by firearm and by cutting was significantly higher among the indigenous population in the NAO when compared with national data. Peaks in suicide occurrence were observed in May and September in the NAO, whereas national data showed only one peak in May. Suicide occurrence in the indigenous population of the NAO was highest in April, while the non-indigenous population showed peaks in May and September. Suicide occurrence in the NAO was highest on Fridays; in national data this occurrence was highest on Mondays.

CONCLUSIONS

We showed different relative frequencies of suicide by hanging, cutting, and firearm, as well as different suicide occurrence by month and day of the week in the NAO compared with Russia as a whole. These results can be used to plan suicide prevention activities in the Russian Arctic.

Seasonality of child and adolescent injury mortality in Japan, 2000-2010

OBJECTIVE

Injury is the leading cause of death among children and adolescents in Japan. Despite this, until now there has been comparatively little research on this phenomenon. The purpose of this study was to examine if there was seasonal variation in child and adolescent injury mortality in Japan in 2000-2010.

METHODS

Vital statistics injury mortality data were obtained from the Ministry of Health, Labour and Welfare of Japan. The seasonality of the major causes of unintentional injury (transport accidents, drowning and suffocation) and intentional injury (suicide and homicide) mortality was examined for children and adolescents aged 0-19. Incidence ratios (IR) with 95% confidence intervals (CI) were calculated to determine the difference between the numbers of observed and expected seasonal deaths.

RESULTS

The annual average injury mortality rate among children and adolescents was 9.0 per 100,000. Deaths from transport accidents, drowning, suffocation and suicide had a significant seasonality. There was a summer peak for transport accidents (IR 1.15, 95% CI 1.10-1.19) and drowning (IR 2.00, 95% CI 1.88-2.11), a spring peak for suicide (IR 1.09, 95% CI 1.04-1.14), while the incidence of suffocation was higher in winter (IR 1.12, 95% CI 1.03-1.21).

CONCLUSION

Child and adolescent injury mortality from transport accidents, drowning, suffocation and suicide has a pronounced seasonality in Japan. More research is now needed to find the circumstances underpinning different forms of injury mortality in different periods of the year so that effective interventions can be designed and implemented to reduce the burden of injury mortality among Japanese children.