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Pirkis, Jane, Gunnell, David, Shin, Sangsoo, DelPozo-Banos, Marcos, Arya, Vikas, Analuisa Aguilar, Pablo, Appleby, Louis, Arafat, S. M. Yasir, Arensman, Ella, Ayuso-Mateos, Jose Luis, Balhara, Yatan Pal Singh, Bantjes, Jason, Baran, Anna, Behera, Chittaranjan, Bertolote, Jose, Borges, Guilherme, Bray, Michael, Brečić, Petrana, Caine, Eric D.; Calati, Raffaella, Carli, Vladimir, Castelpietra, Giulio, Chan, Lai Fong, Chang, Shu-Sen, Colchester, David, Coss-Guzmán, Maria, Crompton, David, Curkovic, Marko, Dandona, Rakhi, De Jaegere, Eva, De Leo, Diego, Deisenhammer, Eberhard, Dwyer, Jeremy, Erlangsen, Annette, Faust, Jeremy, Fornaro, Michele, Fortune, Sarah, Garrett, Andrew, Gentile, Guendalina, Gerstner, Rebekka, Gilissen, Renske, Gould, Madelyn, Gupta, Sudhir Kumar, Hawton, Keith, Holz, Franziska, Kamenshchikov, Iurii, Kapur, Navneet, Kasal, Alexandr, Khan, Murad, Kirtley, Olivia, Knipe, Duleeka, Kolves, Kairi, Kölzer, Sarah, Krivda, Hryhorii, Leske, Stuart, Madeddu, Fabio, Marshall, Andrew, Memon, Anjum, Mittendorfer-Rutz, Ellenor, Nestadt, Paul, Neznanov, Nikolay, Niederkrotenthaler, Thomas, Nielsen, Emma, Nordentoft, Merete, Oberlerchner, Herwig, O'Connor, Rory, Papsdorf, Rainer, Partonen, Timo, Michael, Phillips, Platt, Steve, Portzky, Gwendolyn, Psota, Georg, Qin, Ping, Radeloff, Daniel, Reif, Andreas, Reif-Leonhard, Christine, Rezaeian, Mohsen, Román-Vázquez, Nayda, Roskar, Saska, Rozanov, Vsevolod, Sara, Grant, Scavacini, Karen, Schneider, Barbara, Semenova, Natalia, Sinyor, Mark, Tambuzzi, Stefano, Townsend, Ellen, Ueda, Michiko, Wasserman, Danuta, Webb, Roger T.; Winkler, Petr, Yip, Paul S. F.; Zalsman, Gil, Zoja, Riccardo, John, Ann, Spittal, Matthew J..
SSRN; 2022.
Preprint in English | SSRN | ID: ppcovidwho-331684

ABSTRACT

Background When the COVID-19 pandemic began there were concerns that suicides might rise, but predicted increases were not generally observed in the pandemic’s early months. However, the picture may be changing and patterns may vary across demographic groups. We aimed to provide an up-to-date, granular picture of the impact of COVID-19 on suicides globally.Methods We identified suicide data from official public-sector sources for countries/areas-within-countries. We used interrupted time series (ITS) analyses to model the association between the pandemic’s emergence and total suicides and suicides by sex-, age- and sex-by-age in each country/area-within-country. We compared the observed number of suicides to the expected number in the pandemic’s first nine and first 10-15 months and used meta-regression to explore sources of variation.Findings We sourced data from 33 countries (24 high-income, six upper-middle-income, three lower-middle-income). There was no evidence of greater-than-expected numbers of suicides in the majority of countries/areas-within-countries in any analysis;more commonly, there was evidence of lower-than-expected numbers. Certain sex, age and sex-by-age groups stood out as potentially concerning, but these were not consistent across countries/areas-within-countries. In the meta-regression, different patterns were not explained by countries’ COVID-19 mortality rate, stringency of public health response, level of economic support, or presence of a national suicide prevention strategy. They were also not explained by countries’ income level, although the meta-regression only included data from high-income and upper-middle-income countries, and there were suggestions from the ITS analyses that lower-middle-income countries fared less well.Interpretation Although there are some countries/areas-within-countries where overall suicide numbers and numbers for certain sex- and age-based groups are greater-than-expected, these are in the minority. Any upward movement in suicide numbers in any place or group is concerning, and we need to remain alert to and respond to changes as the pandemic and its mental health and economic consequences continue.

2.
Lancet Psychiatry ; 8(7): 579-588, 2021 07.
Article in English | MEDLINE | ID: covidwho-1683800

ABSTRACT

BACKGROUND: 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. METHODS: 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). FINDINGS: 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]). INTERPRETATION: 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. FUNDING: None.


Subject(s)
COVID-19/complications , Global Health , Models, Statistical , Suicide/statistics & numerical data , Developed Countries/statistics & numerical data , Humans
3.
Lancet Psychiatry ; 8(7): 579-588, 2021 07.
Article in English | MEDLINE | ID: covidwho-1284642

ABSTRACT

BACKGROUND: 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. METHODS: 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). FINDINGS: 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]). INTERPRETATION: 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. FUNDING: None.


Subject(s)
COVID-19/complications , Global Health , Models, Statistical , Suicide/statistics & numerical data , Developed Countries/statistics & numerical data , Humans
5.
PLoS One ; 15(9): e0240008, 2020.
Article in English | MEDLINE | ID: covidwho-807110

ABSTRACT

Ecuador has been one of the most affected countries by the Corona Virus Disease 19 (COVID-19) pandemic, by April 2020 this country presented the highest rates of mortality in Latin America. The purpose of the present study was to identify behaviors during confinement and sociodemographic variables associated with the mental health status of confirmed or suspected COVID-19 patients who were part of the epidemiological surveillance program in Ecuador that included mandatory confinement and self-isolation. A cross-sectional study was performed from March 22th to April 18th, 2020 using an online survey. The survey collected socio-demographic information and severity of depressive symptoms using the Patient Health Questionnaire-9 and anxiety symptoms through the Generalized Anxiety Disorder-7. A total of 759 patients completed the questionnaire, 20.3% presented moderate to severe symptoms of depression and 22.5% moderate to severe symptoms of anxiety. Being a woman and from the Coastal region were risk factors. Exercising, maintaining daily routines, and keeping informed about the COVID-19 but limiting to an hour was associated with better mental health. Regression analysis indicated that the mentioned behaviors explained approximately 17% of the variance for depression sum scores and 11.8% of the variance for anxiety sum scores while controlling for gender and region. Understanding the association between sociodemographic variables and psychological states in patients with COVID-19 is relevant to tackle future public mental health problems and to implement health policies that are intended to palliate further psychiatric complications. Promotion of modifiable behaviors such as exercising, maintaining daily routines, and keeping informed about the COVID-19 but limiting to less than an hour is recommended.


Subject(s)
Anxiety/epidemiology , Coronavirus Infections/psychology , Depression/epidemiology , Pneumonia, Viral/psychology , Activities of Daily Living , Adolescent , Adult , Betacoronavirus , COVID-19 , Contact Tracing , Cross-Sectional Studies , Ecuador/epidemiology , Epidemiological Monitoring , Exercise , Female , Humans , Male , Mental Health , Middle Aged , Pandemics , Patient Health Questionnaire , Quarantine , Risk Factors , SARS-CoV-2 , Socioeconomic Factors , Young Adult
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