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The impact of the COVID-19 pandemic on presentations to health services following self-harm: systematic review.
Steeg, Sarah; John, Ann; Gunnell, David J; Kapur, Nav; Dekel, Dana; Schmidt, Lena; Knipe, Duleeka; Arensman, Ella; Hawton, Keith; Higgins, Julian P T; Eyles, Emily; Macleod-Hall, Catherine; McGuiness, Luke A; Webb, Roger T.
  • Steeg S; Centre for Mental Health and Safety, Division of Psychology and Mental Health, University of Manchester, UK; and Manchester Academic Health Science Centre, UK.
  • John A; Medical School, Swansea University, UK; and Public Health Wales NHS Trust, UK.
  • Gunnell DJ; Population Health Sciences, Bristol Medical School, University of Bristol, UK; and National Institute for Health Research Biomedical Research Centre, University Hospitals Bristol and Weston NHS Foundation Trust and the University of Bristol, UK.
  • Kapur N; Division of Psychology and Mental Health, University of Manchester, UK;NIHR Greater Manchester Patient Safety Translational Research Centre, UK; and Greater Manchester Mental Health NHS Foundation Trust, UK.
  • Dekel D; Department of Population Psychiatry, Suicide and Informatics, Swansea University, UK.
  • Schmidt L; Sciome LLC, North Carolina, USA; Population Health Sciences, Bristol Medical School, University of Bristol, UK.
  • Knipe D; Population Health Sciences, Bristol Medical School, University of Bristol, UK.
  • Arensman E; School of Public Health and National Suicide Research Foundation, University College Cork, Ireland; and Australian Institute for Suicide Research and Prevention, School of Applied Psychology, Griffith University, Australia.
  • Hawton K; Centre for Suicide Research, Department of Psychiatry, University of Oxford, UK; and Warneford Hospital, Oxford Health NHS Foundation Trust, UK.
  • Higgins JPT; National Institute for Health Research Biomedical Research Centre, University Hospitals Bristol and Weston NHS Foundation Trust and the University of Bristol, UK; National Institute for Health Research Applied Research Collaboration West, University Hospitals Bristol and Weston NHS Foundation Trust,
  • Eyles E; National Institute for Health Research Applied Research Collaboration West, University Hospitals Bristol and Weston NHS Foundation Trust, UK; and Population Health Sciences, Bristol Medical School, University of Bristol, UK.
  • Macleod-Hall C; Population Health Sciences, Bristol Medical School, University of Bristol, UK.
  • McGuiness LA; Population Health Sciences, Bristol Medical School, University of Bristol, UK.
  • Webb RT; Division of Psychology and Mental Health, University of Manchester, UK; and NIHR Greater Manchester Patient Safety Translational Research Centre, UK.
Br J Psychiatry ; 221(4): 603-612, 2022 10.
Article in English | MEDLINE | ID: covidwho-1933167
ABSTRACT

BACKGROUND:

Evidence on the impact of the pandemic on healthcare presentations for self-harm has accumulated rapidly. However, existing reviews do not include studies published beyond 2020.

AIMS:

To systematically review evidence on presentations to health services following self-harm during the COVID-19 pandemic.

METHOD:

A comprehensive search of databases (WHO COVID-19 database; Medline; medRxiv; Scopus; PsyRxiv; SocArXiv; bioRxiv; COVID-19 Open Research Dataset, PubMed) was conducted. Studies published from 1 January 2020 to 7 September 2021 were included. Study quality was assessed with a critical appraisal tool.

RESULTS:

Fifty-one studies were included 57% (29/51) were rated as 'low' quality, 31% (16/51) as 'moderate' and 12% (6/51) as 'high-moderate'. Most evidence (84%, 43/51) was from high-income countries. A total of 47% (24/51) of studies reported reductions in presentation frequency, including all six rated as high-moderate quality, which reported reductions of 17-56%. Settings treating higher lethality self-harm were overrepresented among studies reporting increased demand. Two of the three higher-quality studies including study observation months from 2021 reported reductions in self-harm presentations. Evidence from 2021 suggests increased numbers of presentations among adolescents, particularly girls.

CONCLUSIONS:

Sustained reductions in numbers of self-harm presentations were seen into the first half of 2021, although this evidence is based on a relatively small number of higher-quality studies. Evidence from low- and middle-income countries is lacking. Increased numbers of presentations among adolescents, particularly girls, into 2021 is concerning. Findings may reflect changes in thresholds for help-seeking, use of alternative sources of support and variable effects of the pandemic across groups.
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Full text: Available Collection: International databases Database: MEDLINE Main subject: Self-Injurious Behavior / COVID-19 Type of study: Experimental Studies / Observational study / Prognostic study / Randomized controlled trials / Reviews / Systematic review/Meta Analysis Limits: Adolescent / Female / Humans Language: English Journal: Br J Psychiatry Year: 2022 Document Type: Article Affiliation country: Bjp.2022.79

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Full text: Available Collection: International databases Database: MEDLINE Main subject: Self-Injurious Behavior / COVID-19 Type of study: Experimental Studies / Observational study / Prognostic study / Randomized controlled trials / Reviews / Systematic review/Meta Analysis Limits: Adolescent / Female / Humans Language: English Journal: Br J Psychiatry Year: 2022 Document Type: Article Affiliation country: Bjp.2022.79