ABSTRACT
BackgroundVarious surveys have documented a negative impact of the COVID-19 pandemic on the populations mental health. There is widespread concern about a surge of suicides, but evidence supporting a link between global pandemics and suicide is very limited. Using historical data from the three major influenza pandemics of the 20th century, and recently released data from the first half of 2020, we aimed to investigate whether an association exists between influenza deaths and suicide deaths. MethodsAnnual data on influenza death rates and suicide rates were extracted from the Statistical Yearbook of Sweden from 1910-1978, covering the three 20th century pandemics, and from Statistics Sweden for the period from January to June of each year during 2000-2020. COVID-19 death data were available for the first half of 2020. We implemented non-linear autoregressive distributed lag (NARDL) models to explore if there is a short-term and/or long-term effect of increases and decreases in influenza death rates on suicide rates during 1910-1978. Analyses were done separately for men and women. Descriptive analyses were used for the available 2020 data. FindingsBetween 1910-1978, there was no evidence of either short-term or long-term significant associations between influenza death rates and changes in suicides. The same pattern emerged in separate analyses for men and women. Suicide rates in January-June 2020 revealed a slight decrease compared to the corresponding rates in January-June 2019 (relative decrease by -1.2% among men and -12.8% among women). InterpretationWe found no evidence of short or long-term association between influenza death rates and suicide death rates across three 20th century pandemics or during the first six months of 2020 (when the first wave of COVID-19 occurred). Concerns about a substantial increase of suicides may be exaggerated. The media should be cautious when reporting news about suicides during the current pandemic.
Subject(s)
COVID-19 , DeathABSTRACT
Introduction: Worries about the immediate and long-term consequences of the COVID-19 pandemic may for some individuals develop into pervasive worry that is disproportionate in its intensity or duration and significantly interferes with everyday life. Objective: The aim of this study was to investigate if a brief self-guided, online psychological intervention can reduce the degree of dysfunctional worry related to the COVID-19 pandemic and associated symptoms. Methods: 670 adults from the general Swedish general population reporting daily uncontrollable worry about COVID-19 and its possible consequences (e.g. illness, death, the economy, one’s family) were randomised (1:1 ratio) to a 3-week self-guided, online cognitive behavioural intervention targeting dysfunctional COVID-19 worry and associated symptoms, or a waiting list of equal duration. The primary outcome measure was a COVID-19 adapted version of the Generalised Anxiety Disorder 7-item scale assessed at baseline and weeks 1-3 (primary endpoint). Follow-up assessments were conducted one month after treatment completion. The trial was registered on ClinicalTrials.gov (NCT04341922) before inclusion of the first participant. Results: The main pre-specified intention-to-treat analysis indicated significant reductions in COVID-19-related worry for the intervention group compared to waiting list (=1.14, Z=9.27, p<.001), corresponding to a medium effect size (bootstrapped d=0.74 [95% CI; 0.58 to 0.90]). Improvements were also seen on all secondary measures, including mood, daily functioning, insomnia and intolerance of uncertainty. Participant satisfaction was high. No serious adverse events were recorded. Conclusions: A brief digital and easily scalable self-guided psychological intervention can significantly reduce dysfunctional worry and associated behavioural symptoms related to the COVID-19 pandemic.
Subject(s)
COVID-19 , Anxiety DisordersABSTRACT
Objective: To investigate if a brief self-guided, online cognitive behavioural intervention can reduce the degree of dysfunctional worry related to the covid-19 pandemic. Design: Randomised waiting list controlled trial. Setting: Swedish general population. Participants: Self-referred adults reporting daily uncontrollable worry about covid-19 and its possible consequences. The trial aims to include 670 participants in total. Here we present the results of a pre-specified interim analysis on data from the first 300 randomised participants. Intervention: A brief (3-week) self-guided, online cognitive behavioural intervention targeting dysfunctional worry related to the covid-19 pandemic. Main outcome measure: A covid-19 adapted version of the self-rated Generalised Anxiety Disorder 7-item scale assessed at baseline, week 1, week 2 and week 3 (primary endpoint). Results: The main pre-specified intention-to-treat analysis indicated significant reductions in covid-19-related worry for the intervention compared to waiting list (=2.64, Z=4.02, p<.001), corresponding to a medium effect size (bootstrapped d=0.69 [95% CI; 0.43 to 0.95]). Improvements were also seen on several secondary measures, including mood, daily functioning and intolerance of uncertainty. Participant satisfaction was high. No serious adverse events were recorded. Conclusions: A brief digital and easily scalable self-guided psychological intervention can significantly reduce dysfunctional worry and associated behavioural symptoms related to the covid-19 pandemic. The full trial will provide more precise estimates of the magnitude of the effects, their long-term durability, and potential adverse effects. Trial registration: ClinicalTrials.gov registration ID: NCT04341922, registered on April 10 2020 before inclusion of the first participant.
Subject(s)
COVID-19 , Anxiety DisordersABSTRACT
A global survey of the perceived impact of the COVID-19 outbreak on the severity of tics in persons with Tourette syndrome (TS) or chronic tic disorder (CTD). V2 (edited after peer-review)