Trends in Suicide Rates During the COVID-19 Pandemic Restrictions in a Major German City

Overview

Journal Epidemiol Psychiatr Sci

Publisher Cambridge University Press

Specialties Psychiatry
Public Health

Date 2021 Jan 19

PMID 33461639

Citations 46

Authors

Daniel Radeloff

Rainer Papsdorf

Kirsten Uhlig

Andreas Vasilache

Karen Putnam

Kai von Klitzing

Affiliations

Soon will be listed here.

Abstract

Aims: It remains unclear whether the coronavirus disease 2019 (COVID-19) pandemic is having an impact on suicide rates (SR). Economic insecurity and mental disorders are risk factors for suicide, which may increase during the pandemic.

Methods: Data on suicide events in a major city in Germany, and the corresponding life years (LY) were provided by the local authorities. For the year 2020, periods without restrictions on freedom of movement and social contact were compared with periods of moderate and severe COVID-19 restrictions. To avoid distortions due to seasonal fluctuations and linear time trends, suicide risk during the COVID-19 pandemic was compared with data from 2010 to 2019 using an interrupted time series analysis.

Results: A total of 643 suicides were registered and 6 032 690 LY were spent between 2010 and 2020. Of these, 53 suicides and 450 429 LY accounted for the year 2020.In 2020, SR (suicides per 100 000 LY) were lower in periods with severe COVID-19 restrictions (SR = 7.2, χ2 = 4.033, p = 0.045) compared with periods without restrictions (SR = 16.8). A comparison with previous years showed that this difference was caused by unusually high SR before the imposition of restrictions, while SR during the pandemic were within the trend corridor of previous years (expected suicides = 32.3, observed suicides = 35; IRR = 1.084, p = 0.682).

Conclusions: SR during COVID-19 pandemic are in line with the trend in previous years. Careful monitoring of SR in the further course of the COVID-19 crisis is urgently needed. The findings have regional reference and should not be over-generalised.

Citing Articles

Particular vulnerability of patients with borderline personality disorder during the COVID-19 pandemic - a retrospective chart review.

Kippe Y, Gutwinski S, Adam M, Finck A, Schouler-Ocak M, Goldschmidt T BMC Psychiatry. 2024; 24(1):950.

PMID: 39731055 PMC: 11673360. DOI: 10.1186/s12888-024-06366-y.

Suicidal behaviours and associated factors among residents of Jimma Town, Southwest Ethiopia: a community-based cross-sectional study.

Tessema S, Torba A, Tesfaye E, Alemu B, Oblath R BMJ Open. 2024; 14(9):e085810.

PMID: 39317502 PMC: 11423752. DOI: 10.1136/bmjopen-2024-085810.

Impact of the Early COVID-19 Pandemic on Suicide Attempts and Suicide Deaths in South Korea, 2016-2020: An Interrupted Time Series Analysis.

Kim S, An M, Lee D, Kim M, Hwang G, Heo Y Psychiatry Investig. 2024; 21(9):1007-1015.

PMID: 39219379 PMC: 11421915. DOI: 10.30773/pi.2024.0089.

Psychological distress among individuals with a suicide attempt or suicidal ideation and suicide attempts patterns: first two years of the pandemic.

Groh A, Bahlmann L, Colic L, Schulz A, Kastner U, Polzer U Front Psychiatry. 2024; 15:1366191.

PMID: 38544853 PMC: 10966906. DOI: 10.3389/fpsyt.2024.1366191.

Comparison of all completed suicides in Frankfurt am Main (Hessen) before and during the early COVID-19 pandemic.

Koelzer S, Verhoff M, Toennes S, Wunder C, Kettner M, Kern N Forensic Sci Med Pathol. 2023; 20(4):1178-1186.

PMID: 38017259 PMC: 11790808. DOI: 10.1007/s12024-023-00754-8.

References

Patsali M, Mousa D, Papadopoulou E, Papadopoulou K, Kaparounaki C, Diakogiannis I . University students' changes in mental health status and determinants of behavior during the COVID-19 lockdown in Greece. Psychiatry Res. 2020; 292:113298. PMC: 7357537. DOI: 10.1016/j.psychres.2020.113298. View

Zortea T, Brenna C, Joyce M, McClelland H, Tippett M, Tran M . The Impact of Infectious Disease-Related Public Health Emergencies on Suicide, Suicidal Behavior, and Suicidal Thoughts. Crisis. 2020; 42(6):474-487. PMC: 8689932. DOI: 10.1027/0227-5910/a000753. View

Jacobson N, Lekkas D, Price G, Heinz M, Song M, OMalley A . Flattening the Mental Health Curve: COVID-19 Stay-at-Home Orders Are Associated With Alterations in Mental Health Search Behavior in the United States. JMIR Ment Health. 2020; 7(6):e19347. PMC: 7265799. DOI: 10.2196/19347. View

Wand A, Zhong B, Chiu H, Draper B, De Leo D . COVID-19: the implications for suicide in older adults. Int Psychogeriatr. 2020; 32(10):1225-1230. PMC: 7235297. DOI: 10.1017/S1041610220000770. View

Rachiotis G, Stuckler D, Mckee M, Hadjichristodoulou C . What has happened to suicides during the Greek economic crisis? Findings from an ecological study of suicides and their determinants (2003-2012). BMJ Open. 2015; 5(3):e007295. PMC: 4386238. DOI: 10.1136/bmjopen-2014-007295. View

Smalley C, Malone Jr D, Meldon S, Borden B, Simon E, Muir M . The impact of COVID-19 on suicidal ideation and alcohol presentations to emergency departments in a large healthcare system. Am J Emerg Med. 2020; 41:237-238. PMC: 7263212. DOI: 10.1016/j.ajem.2020.05.093. View

Huikari S, Miettunen J, Korhonen M . Economic crises and suicides between 1970 and 2011: time trend study in 21 developed countries. J Epidemiol Community Health. 2019; 73(4):311-316. DOI: 10.1136/jech-2018-210781. View

Hamm M, Brown P, Karp J, Lenard E, Cameron F, Dawdani A . Experiences of American Older Adults with Pre-existing Depression During the Beginnings of the COVID-19 Pandemic: A Multicity, Mixed-Methods Study. Am J Geriatr Psychiatry. 2020; 28(9):924-932. PMC: 7305766. DOI: 10.1016/j.jagp.2020.06.013. View

Sakelliadis E, Katsos K, Zouzia E, Spiliopoulou C, Tsiodras S . Impact of Covid-19 lockdown on characteristics of autopsy cases in Greece. Comparison between 2019 and 2020. Forensic Sci Int. 2020; 313:110365. PMC: 7291972. DOI: 10.1016/j.forsciint.2020.110365. View

10.

Cheung Y, Chau P, Yip P . A revisit on older adults suicides and Severe Acute Respiratory Syndrome (SARS) epidemic in Hong Kong. Int J Geriatr Psychiatry. 2008; 23(12):1231-8. DOI: 10.1002/gps.2056. View

11.

Chang Y, Chang S, Hsu C, Gunnell D . Impact of Pandemic on Suicide: Excess Suicides in Taiwan During the 1918-1920 Influenza Pandemic. J Clin Psychiatry. 2020; 81(6). DOI: 10.4088/JCP.20l13454. View

12.

Fitzpatrick K, Harris C, Drawve G . How bad is it? Suicidality in the middle of the COVID-19 pandemic. Suicide Life Threat Behav. 2020; 50(6):1241-1249. PMC: 7361329. DOI: 10.1111/sltb.12655. View

13.

Niederkrotenthaler T, Gunnell D, Arensman E, Pirkis J, Appleby L, Hawton K . Suicide Research, Prevention, and COVID-19. Crisis. 2020; 41(5):321-330. PMC: 8729451. DOI: 10.1027/0227-5910/a000731. View

14.

Nordt C, Warnke I, Seifritz E, Kawohl W . Modelling suicide and unemployment: a longitudinal analysis covering 63 countries, 2000-11. Lancet Psychiatry. 2015; 2(3):239-45. DOI: 10.1016/S2215-0366(14)00118-7. View

15.

Van Orden K, Witte T, Cukrowicz K, Braithwaite S, Selby E, Joiner Jr T . The interpersonal theory of suicide. Psychol Rev. 2010; 117(2):575-600. PMC: 3130348. DOI: 10.1037/a0018697. View

16.

McIntyre R, Lee Y . Preventing suicide in the context of the COVID-19 pandemic. World Psychiatry. 2020; 19(2):250-251. PMC: 7214950. DOI: 10.1002/wps.20767. View

17.

Oyesanya M, Lopez-Morinigo J, Dutta R . Systematic review of suicide in economic recession. World J Psychiatry. 2015; 5(2):243-54. PMC: 4473496. DOI: 10.5498/wjp.v5.i2.243. View

18.

Knipe D, Evans H, Marchant A, Gunnell D, John A . Mapping population mental health concerns related to COVID-19 and the consequences of physical distancing: a Google trends analysis. Wellcome Open Res. 2020; 5:82. PMC: 7331103. DOI: 10.12688/wellcomeopenres.15870.2. View

19.

Chan S, Chiu F, Lam C, Leung P, Conwell Y . Elderly suicide and the 2003 SARS epidemic in Hong Kong. Int J Geriatr Psychiatry. 2006; 21(2):113-8. DOI: 10.1002/gps.1432. View

20.

Kawohl W, Nordt C . COVID-19, unemployment, and suicide. Lancet Psychiatry. 2020; 7(5):389-390. PMC: 7185950. DOI: 10.1016/S2215-0366(20)30141-3. View