The increase in suicide risk in older adults in Taiwan during the COVID-19 outbreak.

BACKGROUND: Studies from Western countries indicated that older adults were more resilient than younger ones to deteriorating mental health during the COVID-19 pandemic. As high late-life suicide rates have been reported in East Asia, it is possible that the pandemic impact might differ between East and West. We investigated the pandemic impact on age-specific suicide patterns in Taiwan. METHODS: Interrupted time-series analysis was used to model the overall, and age-stratified, monthly suicide rates before (January 1st, 2017 to December 31st, 2019) and after (January 1st 2020 to December 31st 2021) the COVID-19 outbreak. Associations between confirmed COVID-19 deaths and suicide rates were also assessed. RESULTS: There was a significant decrease in overall suicide rates after the COVID-19 outbreak (p < 0.01) (annual average rates per 100,000 population of 16.4 prior, 15.2 after). The overall decrease was driven by fewer suicide deaths in the young- and older-middle-aged groups (25-44 and 45-64 years). However suicide rates in younger-age group (<25 years) were already increasing pre-pandemic, a trend which continued after the outbreak. Suicide rates for older people (≥65 years) also increased along with the increasing number of COVID-19 deaths during the pandemic period. LIMITATIONS: Under-reporting and/or misclassification of suicides were possible. CONCLUSIONS: The overall suicide rates in Taiwan did not change after the COVID-19 outbreak; however, suicide in older adults increased. Public health measures to reduce COVID-19 infections may have unintended and adverse consequences on the psychological wellbeing of older citizens.

Suicide Trends Varied by Age-Subgroups During the COVID-19 Pandemic in 2020 in Taiwan

<h4>Background/Purpose</h4> The outbreak of the Coronavirus disease 2019 (COVID-19) has led to unprecedented impact on mental health globally. Recent empirical data however, indicated that suicide rates in many countries remained unchanged or even decreased. Existing studies assessed the overall rates and did not stratify by age-subgroups. <h4>Methods</h4> We used an interrupted time-series analysis to model the age-stratified (<25, 25-44, 45-64, ≥ 65) trends in monthly suicide rates before (January 1st, 2017 to December 31st, 2019) and after (January 1st 2020 to December 31st 2020) the outbreak of COVID-19 in Taiwan. <h4>Results</h4> We found a slight decrease in overall suicide rates after the outbreak (annual average rates were 16.4 and 15.5 per 100,000 population, respectively, p=0.05). Age-stratified analysis indicated that suicide rates increased in younger (<25) and decreased in the middle age group (25-64 years). In older age groups (≥65), an immediate rate decrease was observed followed by a sustained upward trend during the onset of the pandemic. <h4>Conclusions</h4> Although an overall decrease in annual suicide rates was found after the outbreak, the age-specific subgroup analysis reveals a more nuanced picture. Stratified analysis is crucial to identify vulnerable subgroups in the midst of the pandemic.