Determining What Changed Japanese Suicide Mortality in 2020 Using Governmental Database.
Determining What Changed Japanese Suicide Mortality in 2020 Using Governmental Database.
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DOI：
10.3390/jcm10215199
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发表时间：
2021-11-07
影响因子：
3.9
通讯作者：
Okada M
中科院分区：
文献类型：
--
作者：
Matsumoto R;Motomura E;Fukuyama K;Shiroyama T;Okada M
2019年新型冠状病毒病(新冠肺炎)的大流行既造成了与新冠肺炎相关的健康危害，也造成了由于政府限制而导致的社会经济和社会心理地位的恶化。有人担心在新冠肺炎大流行期间自杀死亡率会增加；然而，最近的一项研究报告说，在大流行初期，21个国家的自杀死亡率没有增加。在日本，自杀死亡率从2009年到2019年有所下降，但与2019年相比，2020年每年的自杀受害者人数和全国自杀死亡率都有所上升。为了阐明2020年上半年和下半年日本自杀死亡率的差异，本研究使用线性混合影响模型确定了新冠肺炎大流行期间和大流行前按县、性别、年龄、经济状况、动机和家庭因素分列的年度和每月自杀死亡率。此外，自杀死亡率和新冠肺炎数据(感染率、死亡率和大流行持续时间)之间的关系使用具有稳健标准误差的分层线性回归进行了分析。在第一次居家命令(4月至5月)期间(女性：从10.1-10.2降至7.8-7.9；男性：从每10万人24.0-24.9降至21.6)，所有47个州的男女每月平均自杀死亡率均有所下降，但在第一次居家命令(7月至12月)结束后有所上升(女性：从7.5-9.5降至10.3-14.5；男性：从19.9-23.0降至每100,000人21.1-26.7)。新冠肺炎感染者和受害者的增加表明有抑制的趋势，但大流行的延长表明有增加女性自杀死亡率的趋势，而不影响男性的自杀死亡率。与全国模式相反，在大都市地区，没有观察到第一次居家期间自杀死亡率的下降。在30岁以下的人群中，没有观察到在第一个居家秩序期间自杀死亡率的下降，而在第一个居家秩序结束后，30岁以下的人群的自杀死亡率上升是主要的。在第一次居家命令期间，没有观察到一人家庭居民的自杀死亡率下降。男性和女性的上吊自杀死亡率在第一次居家订单结束期间和之后分别下降和增加；但在大都市地区没有下降。这些结果表明，2020年女性、年轻人口、城市居民和一人家庭居民的自杀死亡率比男性、老年人、农村居民和多人家庭居民的自杀死亡率有所上升。因此，日本新冠肺炎疫情期间自杀死亡率的意外剧烈波动可能是由本研究确定的各种因素中的复杂原因以及其他未知因素组成的。
The pandemic of 2019 novel coronavirus disease (COVID-19) caused both COVID-19-related health hazards and the deterioration of socioeconomic and sociopsychological status due to governmental restrictions. There were concerns that suicide mortality would increase during the COVID-19 pandemic; however, a recent study reported that suicide mortality did not increase in 21 countries during the early pandemic period. In Japan, suicide mortality was reduced from 2009 to 2019, but both the annual number of suicide victims and the national suicide mortality rates in 2020 increased compared to that in 2019. To clarify the discrepancy of suicide mortality between the first and second half of 2020 in Japan, the present study determines annual and monthly suicide mortality disaggregated by prefectures, gender, age, means, motive, and household factors during the COVID-19 pandemic and pre-pandemic periods using a linear mixed-effects model. Furthermore, the relationship between suicide mortality and COVID-19 data (the infection rate, mortality, and duration of the pandemic) was analysed using hierarchal linear regression with a robust standard error. The average of monthly suicide mortality of both males and females in all 47 prefectures decreased during the first stay-home order (April–May) (females: from 10.1–10.2 to 7.8–7.9; males: from 24.0–24.9 to 21.6 per 100,000 people), but increased after the end of the first stay-home order (July–December) (females: from 7.5–9.5 to 10.3–14.5; males: from 19.9–23.0 to 21.1–26.7 per 100,000 people). Increasing COVID-19-infected patients and victims indicated a tendency of suppression, but the prolongation of the pandemic indicated a tendency of increasing female suicide mortality without affecting that of males. Contrary to the national pattern, in metropolitan regions, decreasing suicide mortality during the first stay-home order was not observed. Decreasing suicide mortality during the first stay-home order was not observed in populations younger than 30 years old, whereas increasing suicide mortality of populations younger than 30 years old after the end of the first stay-home order was predominant. A decrease in suicide mortality of one-person household residents during the first stay-home order was not observed. The hanging suicide mortality of males and females was decreased and increased during and after the end of the first stay-home orders, respectively; however, there was no decrease in metropolitan regions. These results suggest that the suicide mortality in 2020 of females, younger populations, urban residents, and one-person household residents increased compared to those of males, the elderly, rural residents, and multiple-person household residents. Therefore, the unexpected drastic fluctuations of suicide mortality during the COVID-19 pandemic in Japan were probably composed of complicated reasons among various identified factors in this study, and other unknown factors.
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