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2.
Psychiatry Res ; 301: 113998, 2021 07.
Article in English | MEDLINE | ID: covidwho-1475002

ABSTRACT

COVID-19, and efforts to mitigate its spread, are creating extensive mental health problems. Experts have speculated the mental, economic, behavioral, and psychosocial problems linked to the COVID-19 pandemic may lead to a rise in suicide behavior. However, a quantitative synthesis is needed to reach an overall conclusion regarding the pandemic-suicide link. In the most comprehensive test of the COVID-19-suicidality link to date, we meta-analyzed data from 308,596 participants across 54 studies. Our results suggested increased event rates for suicide ideation (10.81%), suicide attempts (4.68%), and self-harm (9.63%) during the COVID-19 pandemic when considered against event rates from pre-pandemic studies. Moderation analysis indicated younger people, women, and individuals from democratic countries are most susceptible to suicide ideation during the COVID-19 pandemic. Policymakers and helping professionals are advised that suicide behaviors are alarmingly common during the COVID-19 pandemic and vary based upon age, gender, and geopolitics. Strong protections from governments (e.g., implementing best practices in suicide prevention) are urgently needed to reduce suicide behaviors during the COVID-19 pandemic.


Subject(s)
COVID-19/psychology , Suicidal Ideation , Suicide, Attempted/psychology , Suicide/prevention & control , COVID-19/epidemiology , Female , Humans , Male , Pandemics , SARS-CoV-2 , Self-Injurious Behavior/psychology , Suicide/psychology , Suicide, Attempted/statistics & numerical data
3.
J Korean Med Sci ; 36(34): e243, 2021 Aug 30.
Article in English | MEDLINE | ID: covidwho-1379957

ABSTRACT

BACKGROUND: The coronavirus disease 2019 (COVID-19) pandemic may increase the total number of suicide attempts and the proportion of low-rescue attempts. We investigated the factors affecting low-rescue suicide attempts using the risk-rescue rating scale (RRRS) among patients who visited the emergency department (ED) after attempting suicide before or during the COVID-19 pandemic. METHODS: We retrospectively investigated suicide attempts made by patients who visited our ED from March 2019 to September 2020. Patients were classified into two groups based on whether they attempted suicide before or during the COVID-19 pandemic. Data on demographic variables, psychiatric factors, suicide risk factors and rescue factors were collected and compared. RESULTS: A total of 518 patients were included in the study, 275 (53.1%) of whom attempted suicide during the COVID-19 pandemic. The proportion of patients who made low-rescue suicide attempts differed before and during the COVID-19 pandemic (37.1% vs. 28.8%) (P = 0.046). However, the proportions of patients who made high-risk suicide attempts and high-lethality suicide attempts did not significantly differ between the two periods. The independent risk factors for low-rescue suicide attempts were age and the COVID-19 pandemic (odds ratio [OR], 1.02; 95% confidence interval [CI], 1.00-1.03; P = 0.006) (OR, 1.52; 95% CI, 1.03-2.25; P = 0.034). CONCLUSION: The COVID-19 pandemic was associated with low-rescue suicide attempts in patients visiting the ED after attempting suicide. Thus, we need to consider the implementation of measures to prevent low-rescue suicide attempts during similar infectious disease crises.


Subject(s)
COVID-19/epidemiology , Failure to Rescue, Health Care/statistics & numerical data , Suicide, Attempted/prevention & control , Adolescent , Adult , COVID-19/virology , Emergency Service, Hospital , Female , Hospitals, University , Humans , Logistic Models , Male , Middle Aged , Odds Ratio , Republic of Korea/epidemiology , Retrospective Studies , Risk Factors , SARS-CoV-2/isolation & purification , Suicide, Attempted/statistics & numerical data , Tertiary Care Centers , Young Adult
4.
J Child Psychol Psychiatry ; 62(8): 919-921, 2021 08.
Article in English | MEDLINE | ID: covidwho-1360502

ABSTRACT

This editorial discusses lessons learned from the COVID-19 public health emergency as they relate to the prevention of suicide, the second leading cause of death in adolescents and young adults globally. Recognizing that COVID-19 impact and response varied across nations, we offer a US perspective, addressing two questions: (a) what have we learned from this pandemic and mitigation strategies used to reduce cases of COVID-19 illness and deaths; and (b) how can our research advance knowledge and be advanced by work aimed at understanding the impact of this 'unusual' period? Provisional data indicate that during the pandemic and lockdown period, there were some declines in suicide rates for the total US population and no change in youth. However, data also indicate increases in reported suicidal ideation and behavior, mental health-related ED visits, and ED visits for suicidal ideation and behavior in youth. Heterogeneity of pandemic effects is noteworthy, with ethnic and racial minority populations suffering the most from COVID-19, COVID-19-related risk factors, and possibly suicide deaths. As vaccinations can prevent severe COVID-19 cases and deaths, we also have demonstrations of effective 'psychological inoculations' such as community-based interventions for reducing suicide attempts and deaths. During COVID-19, we mobilized to provide clinical care through telehealth and digital interventions. The challenge now is to continue to put our science to work to mitigate the adverse impacts of the pandemic on suicide and suicide risk factors, our children's mental health, and enhance mental health and well-being in our communities.


Subject(s)
COVID-19 , Psychology, Child , Suicidal Ideation , Suicide, Attempted/prevention & control , Suicide, Attempted/statistics & numerical data , Adolescent , COVID-19/epidemiology , Child , Child, Preschool , Communicable Disease Control , Humans , SARS-CoV-2 , Young Adult
5.
Scand J Work Environ Health ; 47(7): 509-520, 2021 10 01.
Article in English | MEDLINE | ID: covidwho-1359380

ABSTRACT

OBJECTIVE: High-quality longitudinal evidence exploring the mental health risk associated with low-quality employment trajectories is scarce. We therefore aimed to investigate the risk of being diagnosed with common mental disorders, substance use disorders, or suicide attempt according to low-quality employment trajectories. METHODS: A longitudinal register-study based on the working population of Sweden (N=2 743 764). Employment trajectories (2005-2009) characterized by employment quality and pattern (constancy, fluctuation, mobility) were created. Hazard ratios (HR) were estimated using Cox proportional hazards regression models for first incidence (2010-2017) diagnosis of common mental disorders, substance use disorders and suicide attempt as dependent on employment trajectories. RESULTS: We identified 21 employment trajectories, 10 of which were low quality (21%). With the exception of constant solo self-employment, there was an increased risk of common mental disorders (HR 1.07-1.62) and substance use disorders (HR 1.05-2.19) for all low-quality trajectories. Constant solo self-employment increased the risk for substance use disorders among women, while it reduced the risk of both disorders for men. Half of the low-quality trajectories were associated with a risk increase of suicide attempt (HR 1.08-1.76). CONCLUSIONS: Low-quality employment trajectories represent risk factors for mental disorders and suicide attempt in Sweden, and there might be differential effects according to sex - especially in terms of self-employment. Policies ensuring and maintaining high-quality employment characteristics over time are imperative. Similar prospective studies are needed, also in other contexts, which cover the effects of the Covid-19 pandemic as well as the mechanisms linking employment trajectories with mental health.


Subject(s)
Employment/statistics & numerical data , Mental Disorders/epidemiology , Substance-Related Disorders , Suicide, Attempted/statistics & numerical data , COVID-19 , Female , Humans , Incidence , Longitudinal Studies , Male , Mental Disorders/complications , Middle Aged , Prospective Studies , Risk Factors , Sex Factors , Substance-Related Disorders/epidemiology , Substance-Related Disorders/etiology , Sweden/epidemiology
6.
S Afr Med J ; 111(7): 668-673, 2021 06 30.
Article in English | MEDLINE | ID: covidwho-1302747

ABSTRACT

BACKGROUND: COVID-19 national lockdown measures in South Africa (SA) have been under scrutiny since they were implemented in March 2020. Currently there are no studies showing the effect of the first lockdown on hospital admissions in the northern provinces of SA. OBJECTIVES: To evaluate the impact of national lockdown restrictions on musculoskeletal injury admissions in three hospitals across three provinces (Gauteng, Limpopo and North West). METHODS: In a retrospective review, we compared orthopaedic trauma admissions from 1 April 2020 to 30 June 2020 (during alert level 5 of the national lockdown) with cases admitted during the same period in 2019 (non-lockdown). We reviewed the number of admissions, demographic data and mechanisms of injury in the adult and paediatric population groups. RESULTS: A total of 449 patients were admitted with musculoskeletal injuries during the lockdown period compared with 664 patients in 2019, equating to a 32% reduction in total admissions. While there was an 8% increase in paediatric admissions during lockdown at Dr George Mukhari Academic Hospital, adult admissions decreased in all centres. More young males were admitted during both lockdown (mean age 39.8 years) and non-lockdown (mean age 41.2 years) periods than females (p=0.004). There were significant reductions in the number of injuries due to motor vehicle accidents (59%) and in the number of gunshot wounds (36%) during lockdown. However, we observed an 11% rise in injuries related to suicide attempts among adult admissions during the lockdown period. CONCLUSIONS: Lockdown restrictions resulted in a significant reduction in orthopaedic trauma admissions, and were effective in terms of allowing institutions to direct resources to the management of COVID-19 patients. In the light of the increased suicide attempts observed during lockdown, future lockdown regulations should include comprehensive measures to relieve socioeconomic stress.


Subject(s)
COVID-19 , Hospitalization/statistics & numerical data , Musculoskeletal Diseases/epidemiology , Suicide, Attempted/statistics & numerical data , Adolescent , Adult , Age Distribution , Child , Child, Preschool , Female , Humans , Infant , Infant, Newborn , Male , Middle Aged , Retrospective Studies , Sex Distribution , South Africa/epidemiology , Wounds and Injuries/epidemiology , Young Adult
7.
J Epidemiol ; 31(9): 511-517, 2021 09 05.
Article in English | MEDLINE | ID: covidwho-1285238

ABSTRACT

BACKGROUND: Hardships associated with the ongoing coronavirus disease 2019 (COVID-19) pandemic can affect mental health, potentially leading to increased risk of suicide. We examined the relationship between the COVID-19 outbreak and suicide attempts in Okayama, Japan using information from emergency dispatches. METHODS: This was a descriptive epidemiological study. We collected information on emergency dispatches in Okayama City and Kibichuo from March to August in 2018, 2019, and 2020 (n = 47,770 cases). We compared emergency dispatches and their demographic characteristics, especially focusing on suicide attempts, during these 3 years. RESULTS: The number of emergency dispatches in 2020 decreased compared with the previous 2 years, while the number and proportion of emergency dispatches related to suicide attempts increased. This increase was more pronounced among women and those aged 25-49 years. Among women aged 25-49 years, there was a cumulative total of 43 suicide attempts in 2018 and 2019 and 73 suicide attempts in 2020. CONCLUSIONS: The number and proportion of emergency dispatches related to suicide attempts increased in 2020 compared with the previous 2 years, especially among women and those aged 25-49 years. This increase may be partly explained by hardships, such as economic losses or reduced social ties, during the COVID-19 outbreak.


Subject(s)
COVID-19/epidemiology , Disease Outbreaks , Emergency Medical Dispatch/statistics & numerical data , Suicide, Attempted/statistics & numerical data , Adolescent , Adult , Aged , Epidemiologic Studies , Female , Humans , Japan/epidemiology , Male , Middle Aged , Young Adult
8.
MMWR Morb Mortal Wkly Rep ; 70(24): 888-894, 2021 Jun 18.
Article in English | MEDLINE | ID: covidwho-1278793

ABSTRACT

Beginning in March 2020, the COVID-19 pandemic and response, which included physical distancing and stay-at-home orders, disrupted daily life in the United States. Compared with the rate in 2019, a 31% increase in the proportion of mental health-related emergency department (ED) visits occurred among adolescents aged 12-17 years in 2020 (1). In June 2020, 25% of surveyed adults aged 18-24 years reported experiencing suicidal ideation related to the pandemic in the past 30 days (2). More recent patterns of ED visits for suspected suicide attempts among these age groups are unclear. Using data from the National Syndromic Surveillance Program (NSSP),* CDC examined trends in ED visits for suspected suicide attempts† during January 1, 2019-May 15, 2021, among persons aged 12-25 years, by sex, and at three distinct phases of the COVID-19 pandemic. Compared with the corresponding period in 2019, persons aged 12-25 years made fewer ED visits for suspected suicide attempts during March 29-April 25, 2020. However, by early May 2020, ED visit counts for suspected suicide attempts began increasing among adolescents aged 12-17 years, especially among girls. During July 26-August 22, 2020, the mean weekly number of ED visits for suspected suicide attempts among girls aged 12-17 years was 26.2% higher than during the same period a year earlier; during February 21-March 20, 2021, mean weekly ED visit counts for suspected suicide attempts were 50.6% higher among girls aged 12-17 years compared with the same period in 2019. Suicide prevention measures focused on young persons call for a comprehensive approach, that is adapted during times of infrastructure disruption, involving multisectoral partnerships (e.g., public health, mental health, schools, and families) and implementation of evidence-based strategies (3) that address the range of factors influencing suicide risk.


Subject(s)
COVID-19/epidemiology , Emergency Service, Hospital/statistics & numerical data , Suicide, Attempted/statistics & numerical data , Adolescent , Adult , Child , Female , Humans , Male , United States/epidemiology , Young Adult
9.
Psychiatry Res ; 301: 113990, 2021 07.
Article in English | MEDLINE | ID: covidwho-1237855

ABSTRACT

This longitudinal study aimed to investigate the predictive factors of suicidal ideation during the second lockdown in Greece. The respondents presented a 4.32% suicidal ideation in the second lockdown, which did not differ significantly to the initial 4.81%. Anxiety, depression, suicidal ideation during the first lockdown and living with a person with frail health and vulnerable for COVID-19 severe infection emerged as significant risk factors for suicidal ideation during the second lockdown, after controlling for gender, age, and mental health history. Depression was found as the only significant prognostic factor for suicidal ideation incidence of the second lockdown.


Subject(s)
Anxiety/psychology , COVID-19/psychology , Depression/psychology , Stress, Psychological , Suicidal Ideation , Suicide, Attempted/psychology , Suicide/psychology , Adult , Anxiety Disorders/epidemiology , Anxiety Disorders/psychology , COVID-19/epidemiology , Communicable Disease Control , Depression/epidemiology , Greece/epidemiology , Humans , Longitudinal Studies , Male , Mental Health , Middle Aged , Prevalence , Risk Factors , SARS-CoV-2 , Suicide/statistics & numerical data , Suicide, Attempted/statistics & numerical data
10.
Am J Emerg Med ; 48: 238-242, 2021 10.
Article in English | MEDLINE | ID: covidwho-1227964

ABSTRACT

OBJECTIVE: During the deconfinement period after the coronavirus disease-2019 (COVID-19) pandemic, the number and characteristics of psychiatric visits changed in our emergency department (ED). We aimed to assess changes in the number of visits and characterize the profiles of these patients. METHODS: In this retrospective observational study, we examined the number of psychiatric ED visits and their proportion among the total number of ED visits. We also evaluated psychiatric visits characteristics during a one-month period after the declaration of deconfinement, and we compared those characteristics to characteristics observed during the same month over the previous 4 years. RESULTS: The number of psychiatric visits to our emergency department during deconfinement was similar to the number observed in the same month of previous years. However, the proportion of psychiatric visits to our emergency department among all visits to the ED rose during deconfinement to a level never before observed. The mean proportion of psychiatric admissions to all ED admissions rose from 3.5% in past years to 5.3% during deconfinement (p = 0.013). Moreover, during deconfinement, more visits (80%) were without an acute intoxication compared to past years (58.5%; p = 0.031). Also, in the deconfinement period, more visits lacked a follow-up consultation organized at discharge (40%) compared to the historical period (25%, p = 0.036). CONCLUSIONS: The deconfinement period after the first wave COVID-19 changed the number and type of psychiatric emergency medicine consultations at our hospital, suggesting a psychiatric impact of confinement during this pandemic. These findings will be of interest to practitioners and politicians in the coming months.


Subject(s)
Anxiety/epidemiology , COVID-19 , Communicable Disease Control , Depression/epidemiology , Emergency Service, Hospital/statistics & numerical data , Mental Disorders/epidemiology , Public Policy , Suicide, Attempted/statistics & numerical data , Adult , Aftercare , Alcoholic Intoxication/epidemiology , Belgium/epidemiology , Emergencies , Female , Humans , Male , Personality Disorders/epidemiology , Retrospective Studies , SARS-CoV-2 , Substance-Related Disorders/epidemiology
12.
J Epidemiol Community Health ; 75(10): 963-969, 2021 10.
Article in English | MEDLINE | ID: covidwho-1158117

ABSTRACT

OBJECTIVE: Determine the early impact of the COVID-19 pandemic on emergency department (ED) encounters for suicide attempt and intentional self-harm at a regional tertiary academic medical centre in Washtenaw County, Michigan, which is one of the wealthier and more diverse counties in the state. METHODS: Interrupted time series analysis of daily ED encounters from October 2015 through October 2020 for suicide attempt and intentional self-harm (subject n=3002; 62% female; 78% Caucasian) using an autoregressive integrated moving average modelling approach. RESULTS: There were 39.9% (95% CI 22.9% to 53.1%) fewer ED encounters for suicide attempt and intentional self-harm during the first 7 months of the COVID-19 pandemic (ie, on or after 10 March 2020, when the first cases of COVID-19 were identified in Michigan). CONCLUSIONS: Fewer individuals sought emergency care for suicide-related behaviour during the earlier phase of the COVID-19 pandemic than expected when compared to prior years. This suggests initial outbreaks of COVID-19 and state of emergency executive orders did not increase suicide-related behaviour in the short term. More work is needed to determine long-term impacts of the COVID-19 pandemic on suicide-related behaviour and whether there are high-risk groups.


Subject(s)
COVID-19 , Pandemics , Self-Injurious Behavior , Suicide, Attempted , Adolescent , Adult , Aged , COVID-19/epidemiology , COVID-19/psychology , Emergency Service, Hospital/statistics & numerical data , Female , Humans , Interrupted Time Series Analysis , Male , Michigan/epidemiology , Middle Aged , Self-Injurious Behavior/epidemiology , Suicide, Attempted/statistics & numerical data , Young Adult
14.
J Trauma Acute Care Surg ; 90(4): 714-721, 2021 04 01.
Article in English | MEDLINE | ID: covidwho-1145211

ABSTRACT

BACKGROUND: The COVID-19 pandemic resulted in a statewide stay-at-home (SAH) order in California beginning March 19, 2020, forcing large-scale behavioral changes and taking an emotional and economic toll. The effects of SAH orders on the trauma population remain unknown. We hypothesized an increase in rates of penetrating trauma, gunshot wounds, suicide attempts, and domestic violence in the Southern California trauma population after the SAH order. METHODS: A multicenter retrospective analysis of all trauma patients presenting to 11 American College of Surgeons levels I and II trauma centers spanning seven counties in California was performed. Demographic data, injury characteristics, clinical data, and outcomes were collected. Patients were divided into three groups based on injury date: before SAH from January 1, 2020, to March 18, 2020 (PRE), after SAH from March 19, 2020, to June 30, 2020 (POST), and a historical control from March 19, 2019, to June 30, 2019 (CONTROL). POST was compared with both PRE and CONTROL in two separate analyses. RESULTS: Across all periods, 20,448 trauma patients were identified (CONTROL, 7,707; PRE, 6,022; POST, 6,719). POST had a significantly increased rate of penetrating trauma (13.0% vs. 10.3%, p < 0.001 and 13.0% vs. 9.9%, p < 0.001) and gunshot wounds (4.5% vs. 2.4%, p = 0.002 and 4.5% vs. 3.7%, p = 0.025) compared with PRE and CONTROL, respectively. POST had a suicide attempt rate of 1.9% and a domestic violence rate of 0.7%, which were similar to PRE (p = 0.478, p = 0.514) and CONTROL (p = 0.160, p = 0.618). CONCLUSION: This multicenter Southern California study demonstrated an increased rate of penetrating trauma and gunshot wounds after the COVID-19 SAH orders but no difference in attempted suicide or domestic violence rates. These findings may provide useful information regarding resource utilization and a target for societal intervention during the current or future pandemic(s). LEVEL OF EVIDENCE: Epidemiological, level IV.


Subject(s)
COVID-19 , Domestic Violence/statistics & numerical data , Physical Distancing , Suicide, Attempted/statistics & numerical data , Wounds, Gunshot/epidemiology , Wounds, Penetrating/epidemiology , Adult , COVID-19/epidemiology , COVID-19/prevention & control , COVID-19/psychology , California/epidemiology , Female , Historically Controlled Study , Humans , Male , Retrospective Studies , SARS-CoV-2
16.
Drug Saf ; 43(12): 1315-1322, 2020 12.
Article in English | MEDLINE | ID: covidwho-1092872

ABSTRACT

INTRODUCTION: In the stressful context of the coronavirus disease 2019 (COVID-19) pandemic, some reports have raised concerns regarding psychiatric disorders with the use of hydroxychloroquine. In this study, we reviewed all psychiatric adverse effects with hydroxychloroquine in COVID-19 patients, as well as in other indications, reported in VigiBase, the World Health Organization's (WHO) global database of individual case safety reports. METHODS: First, we analyzed all psychiatric adverse effects, including suicide, of hydroxychloroquine in COVID-19 patients reported to 16 June 2020. We also performed disproportionality analysis to investigate the risk of reporting psychiatric disorders with hydroxychloroquine compared with remdesivir, tocilizumab, or lopinavir/ritonavir prescribed in COVID-19 patients. We used reporting odds ratios (RORs) and their 95% confidence intervals (CIs) to calculate disproportionality. Second, we sought to examine the psychiatric safety profile of hydroxychloroquine in other indications (before 2020). RESULTS: Among the 1754 reports with hydroxychloroquine in COVID-19 patients, we found 56 psychiatric adverse effects. Half of these adverse effects were serious, including four completed suicides, three cases of intentional self-injury, and 12 cases of psychotic disorders with hallucinations. Compared with remdesivir, tocilizumab, or lopinavir/ritonavir, the use of hydroxychloroquine was associated with an increased risk of reporting psychiatric disorders (ROR 6.27, 95% CI 2.74-14.35). Before 2020, suicide was the main cause of death among all adverse drug reactions reported with hydroxychloroquine, followed by cardiac adverse effects (cardiomyopathy) and respiratory failure. CONCLUSIONS: This pharmacovigilance analysis suggests that COVID-19 patients exposed to hydroxychloroquine experienced serious psychiatric disorders, and, among these patients, some committed suicide. Further real-world studies are needed to quantify the psychiatric risk associated with hydroxychloroquine during the COVID-19 pandemic.


Subject(s)
Antiviral Agents/adverse effects , COVID-19/drug therapy , Hallucinations/chemically induced , Hydroxychloroquine/adverse effects , Psychoses, Substance-Induced/etiology , Self-Injurious Behavior/chemically induced , Suicide/statistics & numerical data , Adenosine Monophosphate/adverse effects , Adenosine Monophosphate/analogs & derivatives , Adult , Aged , Aged, 80 and over , Alanine/adverse effects , Alanine/analogs & derivatives , Antibodies, Monoclonal, Humanized/adverse effects , Databases, Pharmaceutical , Drug Combinations , Female , Hallucinations/epidemiology , Humans , Lopinavir/adverse effects , Male , Mental Disorders/chemically induced , Mental Disorders/epidemiology , Middle Aged , Psychoses, Substance-Induced/epidemiology , Ritonavir/adverse effects , Self-Injurious Behavior/epidemiology , Suicide, Attempted/statistics & numerical data , Young Adult
17.
Asian J Psychiatr ; 56: 102509, 2021 Feb.
Article in English | MEDLINE | ID: covidwho-1064770

ABSTRACT

Coronavirus disease 2019 (COVID-19) was recently declared a pandemic by the WHO. This outbreak threatens not only physical health but also has significant repercussions on mental health. In recent world history, major infectious outbreaks were associated with severe mental health sequelae, including suicide. In this study, we systematically review the literature on suicidal outcomes during major international respiratory outbreaks, including COVID-19. We reviewed descriptive and analytic articles addressing suicide during major international respiratory outbreaks. We searched PubMed, Medline, Embase, Scopus, and PsycInfo databases and then utilized an independent method for study selection by a pair of reviewers. Two reviewers completed data abstraction and conducted a narrative summary of the findings. Our search generated 2,153 articles. Nine studies (three descriptive, five analytical, and one with mixed methodology) were eligible. The included studies were heterogeneous, divergent in methods, and with a low degree of evidence. Deducing an association between pandemics, suicide, and suicide-related outcomes remains thus poorly supported. Future research with better methodological characteristics, the use of longitudinal studies, and a focus on suicide as the primary outcome would allow for an in-depth understanding and formulation of the scope of this problem.


Subject(s)
COVID-19/epidemiology , Disease Outbreaks , Influenza, Human/epidemiology , Severe Acute Respiratory Syndrome/epidemiology , Suicidal Ideation , Suicide/statistics & numerical data , Coronavirus Infections/epidemiology , Humans , SARS-CoV-2 , Suicide, Attempted/statistics & numerical data , Suicide, Completed/statistics & numerical data
18.
JAMA Psychiatry ; 78(4): 372-379, 2021 04 01.
Article in English | MEDLINE | ID: covidwho-1060999

ABSTRACT

Importance: The coronavirus disease 2019 (COVID-19) pandemic, associated mitigation measures, and social and economic impacts may affect mental health, suicidal behavior, substance use, and violence. Objective: To examine changes in US emergency department (ED) visits for mental health conditions (MHCs), suicide attempts (SAs), overdose (OD), and violence outcomes during the COVID-19 pandemic. Design, Setting, and Participants: This cross-sectional study used data from the Centers for Disease Control and Prevention's National Syndromic Surveillance Program to examine national changes in ED visits for MHCs, SAs, ODs, and violence from December 30, 2018, to October 10, 2020 (before and during the COVID-19 pandemic). The National Syndromic Surveillance Program captures approximately 70% of US ED visits from more than 3500 EDs that cover 48 states and Washington, DC. Main Outcomes and Measures: Outcome measures were MHCs, SAs, all drug ODs, opioid ODs, intimate partner violence (IPV), and suspected child abuse and neglect (SCAN) ED visit counts and rates. Weekly ED visit counts and rates were computed overall and stratified by sex. Results: From December 30, 2018, to October 10, 2020, a total of 187 508 065 total ED visits (53.6% female and 46.1% male) were captured; 6 018 318 included at least 1 study outcome (visits not mutually exclusive). Total ED visit volume decreased after COVID-19 mitigation measures were implemented in the US beginning on March 16, 2020. Weekly ED visit counts for all 6 outcomes decreased between March 8 and 28, 2020 (March 8: MHCs = 42 903, SAs = 5212, all ODs = 14 543, opioid ODs = 4752, IPV = 444, and SCAN = 1090; March 28: MHCs = 17 574, SAs = 4241, all ODs = 12 399, opioid ODs = 4306, IPV = 347, and SCAN = 487). Conversely, ED visit rates increased beginning the week of March 22 to 28, 2020. When the median ED visit counts between March 15 and October 10, 2020, were compared with the same period in 2019, the 2020 counts were significantly higher for SAs (n = 4940 vs 4656, P = .02), all ODs (n = 15 604 vs 13 371, P < .001), and opioid ODs (n = 5502 vs 4168, P < .001); counts were significantly lower for IPV ED visits (n = 442 vs 484, P < .001) and SCAN ED visits (n = 884 vs 1038, P < .001). Median rates during the same period were significantly higher in 2020 compared with 2019 for all outcomes except IPV. Conclusions and Relevance: These findings suggest that ED care seeking shifts during a pandemic, underscoring the need to integrate mental health, substance use, and violence screening and prevention services into response activities during public health crises.


Subject(s)
COVID-19/epidemiology , Drug Overdose , Emergency Service, Hospital , Mental Disorders , Suicide, Attempted , Violence , Adult , Drug Overdose/epidemiology , Emergency Service, Hospital/statistics & numerical data , Emergency Service, Hospital/trends , Epidemiological Monitoring , Female , Humans , Male , Mental Disorders/epidemiology , Mental Disorders/therapy , Mental Health/statistics & numerical data , Outcome Assessment, Health Care/trends , Patient Acceptance of Health Care/psychology , Patient Acceptance of Health Care/statistics & numerical data , SARS-CoV-2 , Suicide, Attempted/psychology , Suicide, Attempted/statistics & numerical data , United States/epidemiology , Violence/psychology , Violence/statistics & numerical data
19.
J Psychiatr Res ; 134: 32-38, 2021 02.
Article in English | MEDLINE | ID: covidwho-997202

ABSTRACT

Evidence suggests that the negative consequences of COVID-19 may extend far beyond its considerable death toll, having a significant impact on psychological well-being. Despite work highlighting the link between previous epidemics and elevated suicide rates, there is limited research on the relationship between the COVID-19 pandemic and suicidal thoughts and behaviors. Utilizing an online survey, the current study aimed to better understand the presence, and extent, of the association between COVID-19-related experiences and past-month suicidal thoughts and behaviors among adults in the United States recruited via Amazon Mechanical Turk (n = 907). Results support an association between several COVID-19-related experiences (i.e., general distress, fear of physical harm, effects of social distancing policies) and past-month suicidal ideation and suicide attempts. Further, a significant proportion of those with recent suicidal ideation explicitly link their suicidal thoughts to COVID-19. Exploratory analyses highlight a potential additional link between COVID-19 and suicidal behavior, suggesting that a portion of individuals may be intentionally exposing themselves to the virus with intent to kill themselves. These findings underscore the need for suicide risk screening and access to mental health services during the current pandemic. Particular attention should be paid to employing public health campaigns to disseminate information on such services to reduce the enormity of distress and emotional impairment associated with COVID-19 in the United States.


Subject(s)
COVID-19/psychology , Quarantine/psychology , Suicidal Ideation , Suicide, Attempted/psychology , Suicide, Attempted/statistics & numerical data , Adolescent , Adult , Aged , Female , Humans , Male , Middle Aged , Risk , SARS-CoV-2 , United States , Young Adult
20.
Pediatrics ; 147(3)2021 03.
Article in English | MEDLINE | ID: covidwho-983656

ABSTRACT

OBJECTIVES: Elevated rates of mental health concerns have been identified during the coronavirus disease 2019 (COVID-19) pandemic. In this study, we sought to evaluate whether youth reported a greater frequency of suicide-related behaviors during the 2020 COVID-19 pandemic as compared with 2019. We hypothesized that rates of suicide-related behaviors would be elevated between the months of March and July 2020 as compared with 2019, corresponding to the onset of the COVID-19 pandemic. METHODS: Routine suicide-risk screening was completed with youth aged 11 to 21 in a pediatric emergency department. Electronic health records data for suicide-risk screens completed between January and July 2019 and January and July 2020 were evaluated. A total of 9092 completed screens were examined (mean age 14.72 years, 47.7% Hispanic and/or Latinx, 26.7% non-Hispanic white, 18.7% non-Hispanic Black). RESULTS: Rates of positive suicide-risk screen results from January to July 2020 were compared with corresponding rates from January to July 2019. Results indicated a significantly higher rate of suicide ideation in March and July 2020 and higher rates of suicide attempts in February, March, April, and July 2020 as compared with the same months in 2019. CONCLUSIONS: Rates of suicide ideation and attempts were higher during some months of 2020 as compared with 2019 but were not universally higher across this period. Months with significantly higher rates of suicide-related behaviors appear to correspond to times when COVID-19-related stressors and community responses were heightened, indicating that youth experienced elevated distress during these periods.


Subject(s)
COVID-19/psychology , Emergency Service, Hospital/statistics & numerical data , Hospitals, Pediatric/statistics & numerical data , Suicidal Ideation , Suicide, Attempted/statistics & numerical data , Adolescent , COVID-19/epidemiology , Child , Female , Humans , Male , Pandemics , Prevalence , SARS-CoV-2 , Stress, Psychological , United States/epidemiology , Young Adult
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