The Influence of COVID-19 Pandemic on the Frequency of Suicides in Croatia

BACKGROUND

Suicides are among the leading causes of death in the world and pose a major public health problem. It is not yet entirely clear to what extent the 2019 coronavirus pandemic (COVID-19) affects suicide rates, but is likely to result in an increase in risk factors for suicidal behaviors. The research objective was to compare the suicide rate in 2019 with the suicide rate in 2020 in the Republic of Croatia.

SUBJECTS AND METHODS

A cross-sectional study was conducted for the period from January 2019 to December 2020. The necessary data on persons who committed suicide in the Republic of Croatia in that period were collected in cooperation with the Osijek-Baranja County Police Department. The number of suicides in that period was statistically processed according to demographic characteristics, suicide motives, days of the week and months by years.

RESULTS

There was no significant difference in the total number of suicides comparing 2019 and 2020. Observed by months, significantly more suicides were committed during February 2020 compared to February 2019 (χ²-test, p=0.04). According to marital status, in 2019 compared to 2020, significantly more suicides were recorded among married persons (χ²-test, p<0.001) and among those who were unemployed (χ²-test, p<0.001). Persons with the status of veterans committed suicide significantly more often in 2019, compared to 2020 (χ²-test, p<0.001) During 2019, compared to 2020, significantly more suicides were committed by persons working in service and trade occupations (χ²-test, p=0.001).

CONCLUSION

At the beginning of the pandemic in Croatia, in February 2020, there was a significant increase in suicides compared to 2019, which may indicate that the spread of the pandemic since the end of 2019, with uncertainty and cataclysmic atmosphere, had a negative effect on mental health.

Postmortem injury quantification for the fatally injured cyclists in the Osijek-Baranja county over a 21-year period

OBJECTIVE

The objective of this study was to quantify injuries in fatal cyclists' traffic crashes by performing injury analysis and determine injury trends as well as main epidemiological data of the cyclists' fatalities.

METHODS

The study was organized as a cross-sectional retrospective study, which included 125 cyclists' fatalities autopsied at the Clinical Department of Pathology and Forensic Medicine, Clinical Hospital Center Osijek from 1998 to 2018. We applied The Abbreviated Injury Scale (AIS©) classification for all fatally injured cyclists in traffic crashes and determined the severity of injuries by body region from the description of injuries reported in the autopsy report.

RESULTS

The majority of victims in our study (80%) were male and older than 45 (80.8%). A significant majority of cyclists (78.4%) were not wearing a helmet at the time of the fatal crash. For the rest of the cyclists (21.6%) we were not able to establish if they were wearing a helmet at the time of the crash based on the traffic police reports. Most of those who died on the spot or during transport had severe injuries to three or more ISS body regions (26/46 = 54%) and the majority of deceased cyclist had severe injuries to the head and brain, regardless of the time of death. Older cyclists died on the spot with lower injury severity scores (ISS).

CONCLUSIONS

Measures against dangerous cycling behavior such as driving under the influence of alcohol and driving without the helmet could lead to reduction of fatal, and probably, non-fatal bicycle crashes. We believe that policy change regarding mandatory helmet usage is of upmost importance. Injury analysis can provide us with valuable information regarding where the focus of treatment should be among severely injured cyclists as well as where the prevention should be targeted. Further injury analysis studies are needed, with studies including both fatal and non-fatal crashes. The Abbreviated Injury Scale represents a valuable system for describing (coding) and quantifying the severity of injuries during autopsies.