Suicide trends in the early months of the COVID-19 pandemic: an interrupted time-series analysis of preliminary data from 21 countries.
Suicide trends in the early months of the COVID-19 pandemic: an interrupted time-series analysis of preliminary data from 21 countries.
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DOI：
10.1016/s2215-0366(21)00091-2
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发表时间：
2021-07
影响因子：
64.3
通讯作者：
Spittal, Matthew
中科院分区：
文献类型：
--
作者：
Pirkis, Jane;John, Ann;Shin, Sangsoo;DelPozo-Banos, Marcos;Arya, Vikas;Analuisa-Aguilar, Pablo;Appleby, Louis;Arensman, Ella;Bantjes, Jason;Baran, Anna;Bertolote, Jose;Borges, Guilherme;Brecic, Petrana;Caine, Eric;Castelpietra, Giulio;Chang, Shu-Sen;Colchester, David;Crompton, David;Curkovic, Marko;Deisenhammer, Eberhard;Du, Chengan;Dwyer, Jeremy;Erlangsen, Annette;Faust, Jeremy;Fortune, Sarah;Garrett, Andrew;George, Devin;Gerstner, Rebekka;Gilissen, Renske;Gould, Madelyn;Hawton, Keith;Kanter, Joseph;Kapur, Navneet;Khan, Murad;Kirtley, Olivia;Knipe, Duleeka;Kolves, Kairi;Leske, Stuart;Marahatta, Kedar;Mittendorfer-Rutz, Ellenor;Neznanov, Nikolay;Niederkrotenthaler, Thomas;Nielsen, Emma;Nordentoft, Merete;Oberlerchner, Herwig;O'Connor, Rory;Pearson, Melissa;Phillips, Michael;Platt, Steve;Plener, Paul;Psota, Georg;Qin, Ping;Radeloff, Daniel;Rados, Christa;Reif, Andreas;Reif-Leonhard, Christine;Rozanov, Vsevolod;Schlang, Christiane;Schneider, Barbara;Semenova, Natalia;Sinyor, Mark;Townsend, Ellen;Ueda, Michiko;Vijayakumar, Lakshmi;Webb, Roger;Weerasinghe, Manjula;Zalsman, Gil;Gunnell, David;Spittal, Matthew
COVID-19 大流行对许多人的心理健康产生了深远的影响。有人担心，在最极端的情况下，这些后果可能表现为自杀率上升。我们的目的是评估 COVID-19 大流行对世界各地自杀率的早期影响。我们通过系统的互联网搜索并利用我们的网络和已发表的文献，从国家或国家内的地区获取实时自杀数据。 2020年9月1日至11月1日期间，我们使用翻译后的搜索词“自杀”和“死因”搜索了这些国家卫生部、警察机构和政府统计机构或同等机构的官方网站，然后扩大搜索范围，试图通过其他公共来源识别数据。如果数据来自官方政府来源，并且至少在 2019 年 1 月 1 日至 2020 年 7 月 31 日期间按月提供，则包含来自特定国家或地区的数据。出于务实的原因，我们的互联网搜索仅限于居民超过 300 万的国家，但对于通过文献和我们的网络确定的国家，我们放宽了这一规则。国家内人口少于 300 万的地区也可包括在内。我们使用间断时间序列分析来模拟每个国家或国家内每个国家或地区在 COVID-19 之前（至少从 2019 年 1 月 1 日到 2020 年 3 月 31 日）的每月自杀趋势，将模型得出的预期自杀人数与大流行最初几个月（初步分析中为 2020 年 4 月 1 日到 7 月 31 日）观察到的自杀人数进行比较。我们的数据来自21个国家（16个高收入国家和5个中高收入国家），其中包括10个国家的全国数据和11个国家的各个地区数据。基于观察到的自杀人数与预期自杀人数的比率 (RR) 和 95% CI 显示，自大流行在任何国家或地区开始以来，没有证据表明自杀风险显着增加。有统计证据表明，与 12 个国家或地区的预期人数相比，自杀人数有所下降： 澳大利亚新南威尔士州（RR 0·81 [95% CI 0·72–0·91]）；加拿大艾伯塔省（0·80 [0·68–0·93]）；加拿大不列颠哥伦比亚省（0·76 [0·66–0·87]）；智利（0·85 [0·78–0·94]）；德国莱比锡 (0·49 [0·32–0·74])；日本（0·94 [0·91–0·96]）；新西兰（0·79 [0·68–0·91]）；韩国（0·94 [0·92–0·97]）；美国加利福尼亚州（0·90 [0·85–0·95]）；美国伊利诺伊州（库克县）（0·79 [0·67–0·93]）；美国德克萨斯州（四个县）（0·82 [0·68–0·98]）；和厄瓜多尔（0·74 [0·67–0·82]）。这是第一项调查多个国家在 COVID-19 大流行背景下发生的自杀事件的研究。在高收入和中高收入国家，与大流行前的预期水平相比，大流行最初几个月的自杀人数基本保持不变或有所下降。我们需要保持警惕，并准备好在疫情对心理健康和经济的长期影响显现时情况发生变化时做出反应。没有任何。
The COVID-19 pandemic is having profound mental health consequences for many people. Concerns have been expressed that, at their most extreme, these consequences could manifest as increased suicide rates. We aimed to assess the early effect of the COVID-19 pandemic on suicide rates around the world. We sourced real-time suicide data from countries or areas within countries through a systematic internet search and recourse to our networks and the published literature. Between Sept 1 and Nov 1, 2020, we searched the official websites of these countries’ ministries of health, police agencies, and government-run statistics agencies or equivalents, using the translated search terms “suicide” and “cause of death”, before broadening the search in an attempt to identify data through other public sources. Data were included from a given country or area if they came from an official government source and were available at a monthly level from at least Jan 1, 2019, to July 31, 2020. Our internet searches were restricted to countries with more than 3 million residents for pragmatic reasons, but we relaxed this rule for countries identified through the literature and our networks. Areas within countries could also be included with populations of less than 3 million. We used an interrupted time-series analysis to model the trend in monthly suicides before COVID-19 (from at least Jan 1, 2019, to March 31, 2020) in each country or area within a country, comparing the expected number of suicides derived from the model with the observed number of suicides in the early months of the pandemic (from April 1 to July 31, 2020, in the primary analysis). We sourced data from 21 countries (16 high-income and five upper-middle-income countries), including whole-country data in ten countries and data for various areas in 11 countries). Rate ratios (RRs) and 95% CIs based on the observed versus expected numbers of suicides showed no evidence of a significant increase in risk of suicide since the pandemic began in any country or area. There was statistical evidence of a decrease in suicide compared with the expected number in 12 countries or areas: New South Wales, Australia (RR 0·81 [95% CI 0·72–0·91]); Alberta, Canada (0·80 [0·68–0·93]); British Columbia, Canada (0·76 [0·66–0·87]); Chile (0·85 [0·78–0·94]); Leipzig, Germany (0·49 [0·32–0·74]); Japan (0·94 [0·91–0·96]); New Zealand (0·79 [0·68–0·91]); South Korea (0·94 [0·92–0·97]); California, USA (0·90 [0·85–0·95]); Illinois (Cook County), USA (0·79 [0·67–0·93]); Texas (four counties), USA (0·82 [0·68–0·98]); and Ecuador (0·74 [0·67–0·82]). This is the first study to examine suicides occurring in the context of the COVID-19 pandemic in multiple countries. In high-income and upper-middle-income countries, suicide numbers have remained largely unchanged or declined in the early months of the pandemic compared with the expected levels based on the pre-pandemic period. We need to remain vigilant and be poised to respond if the situation changes as the longer-term mental health and economic effects of the pandemic unfold. None.