Suicide numbers during the first 9-15 months of the COVID-19 pandemic compared with pre-existing trends: An interrupted time series analysis in 33 countries

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dc.contributor.authorPirkis, Jane
dc.contributor.authorGunnell, David
dc.contributor.authorShin, Sangsoo
dc.contributor.authorDel Pozo-Banos, Marcos
dc.contributor.authorArya, Vikas
dc.contributor.authorAguilar, Pablo Analuisa
dc.contributor.authorAppleby, Louis
dc.contributor.authorArafat, S. M. Yasir
dc.contributor.authorArensman, Ella
dc.contributor.authorAyuso-Mateos, Jose Luis
dc.contributor.authorBalhara, Yatan Pal Singh
dc.contributor.authorBantjes, Jason
dc.contributor.authorBaran, Anna
dc.contributor.authorBehera, Chittaranjan
dc.contributor.authorBertolote, Jose [UNESP]
dc.contributor.authorBorges, Guilherme
dc.contributor.authorBray, Michael
dc.contributor.authorBrečić, Petrana
dc.contributor.authorCaine, Eric
dc.contributor.authorCalati, Raffaella
dc.contributor.authorCarli, Vladimir
dc.contributor.authorCastelpietra, Giulio
dc.contributor.authorChan, Lai Fong
dc.contributor.authorChang, Shu-Sen
dc.contributor.authorColchester, David
dc.contributor.authorCoss-Guzmán, Maria
dc.contributor.authorCrompton, David
dc.contributor.authorĆurković, Marko
dc.contributor.authorDandona, Rakhi
dc.contributor.authorDe Jaegere, Eva
dc.contributor.authorDe Leo, Diego
dc.contributor.authorDeisenhammer, Eberhard A.
dc.contributor.authorDwyer, Jeremy
dc.contributor.authorErlangsen, Annette
dc.contributor.authorFaust, Jeremy S.
dc.contributor.authorFornaro, Michele
dc.contributor.authorFortune, Sarah
dc.contributor.authorGarrett, Andrew
dc.contributor.authorGentile, Guendalina
dc.contributor.authorGerstner, Rebekka
dc.contributor.authorGilissen, Renske
dc.contributor.authorGould, Madelyn
dc.contributor.authorGupta, Sudhir Kumar
dc.contributor.authorHawton, Keith
dc.contributor.authorHolz, Franziska
dc.contributor.authorKamenshchikov, Iurii
dc.contributor.authorKapur, Navneet
dc.contributor.authorKasal, Alexandr
dc.contributor.authorKhan, Murad
dc.contributor.authorKirtley, Olivia J.
dc.contributor.authorKnipe, Duleeka
dc.contributor.authorKõlves, Kairi
dc.contributor.authorKölzer, Sarah C.
dc.contributor.authorKrivda, Hryhorii
dc.contributor.authorLeske, Stuart
dc.contributor.authorMadeddu, Fabio
dc.contributor.authorMarshall, Andrew
dc.contributor.authorMemon, Anjum
dc.contributor.authorMittendorfer-Rutz, Ellenor
dc.contributor.authorNestadt, Paul
dc.contributor.authorNeznanov, Nikolay
dc.contributor.authorNiederkrotenthaler, Thomas
dc.contributor.authorNielsen, Emma
dc.contributor.authorNordentoft, Merete
dc.contributor.authorOberlerchner, Herwig
dc.contributor.authorO'Connor, Rory C.
dc.contributor.authorPapsdorf, Rainer
dc.contributor.authorPartonen, Timo
dc.contributor.authorPhillips, Michael R.
dc.contributor.authorPlatt, Steve
dc.contributor.authorPortzky, Gwendolyn
dc.contributor.authorPsota, Georg
dc.contributor.authorQin, Ping
dc.contributor.authorRadeloff, Daniel
dc.contributor.authorReif, Andreas
dc.contributor.authorReif-Leonhard, Christine
dc.contributor.authorRezaeian, Mohsen
dc.contributor.authorRomán-Vázquez, Nayda
dc.contributor.authorRoskar, Saska
dc.contributor.authorRozanov, Vsevolod
dc.contributor.authorSara, Grant
dc.contributor.authorScavacini, Karen
dc.contributor.authorSchneider, Barbara
dc.contributor.authorSemenova, Natalia
dc.contributor.authorSinyor, Mark
dc.contributor.authorTambuzzi, Stefano
dc.contributor.authorTownsend, Ellen
dc.contributor.authorUeda, Michiko
dc.contributor.authorWasserman, Danuta
dc.contributor.authorWebb, Roger T.
dc.contributor.authorWinkler, Petr
dc.contributor.authorYip, Paul S.F.
dc.contributor.authorZalsman, Gil
dc.contributor.authorZoja, Riccardo
dc.contributor.authorJohn, Ann
dc.contributor.authorSpittal, Matthew J.
dc.contributor.institutionUniversity of Melbourne
dc.contributor.institutionUniversity of Bristol
dc.contributor.institutionSwansea University Medical School
dc.contributor.institutionMinistry of Public Health
dc.contributor.institutionUniversity of Manchester
dc.contributor.institutionEnam Medical College and Hospital
dc.contributor.institutionUniversity College Cork
dc.contributor.institutionGriffith University
dc.contributor.institutionCentre for Biomedical Research in Mental Health (CIBERSAM)
dc.contributor.institutionAll India Institute of Medical Sciences
dc.contributor.institutionSouth African Medical Research Council
dc.contributor.institutionStellenbosch University
dc.contributor.institutionMinistry of Health
dc.contributor.institutionLinnaeus University
dc.contributor.institutionBlekinge Hospital
dc.contributor.institutionUniversidade Estadual Paulista (UNESP)
dc.contributor.institutionInstituto Nacional de Psiquiatría Ramon de la Fuente Muñiz
dc.contributor.institutionJohns Hopkins University School of Medicine
dc.contributor.institutionSchool of Medicine University of Zagreb
dc.contributor.institutionUniversity of Rochester Medical Center
dc.contributor.institutionUniversity of Milan-Bicocca
dc.contributor.institutionNimes University Hospital
dc.contributor.institutionKarolinska Institutet
dc.contributor.institutionOutpatient and Inpatient Care Service
dc.contributor.institutionNational University of Malaysia
dc.contributor.institutionNational Taiwan University
dc.contributor.institutionThames Valley Police
dc.contributor.institutionPuerto Rico Department of Health's Commission on Suicide Prevention
dc.contributor.institutionPublic Health Foundation of India
dc.contributor.institutionUniversity of Washington
dc.contributor.institutionGhent University
dc.contributor.institutionMedical University of Innsbruck
dc.contributor.institutionCoroners Court of Victoria
dc.contributor.institutionMental Health Centre Copenhagen
dc.contributor.institutionCopenhagen Research Centre for Mental Health
dc.contributor.institutionAustralian National University
dc.contributor.institutionJohns Hopkins Bloomberg School of Public Health
dc.contributor.institutionHarvard Medical School
dc.contributor.institutionFederico II University of Naples
dc.contributor.institutionThe University of Auckland
dc.contributor.institutionTasmanian Magistrates Court
dc.contributor.institutionUniversity of Milan
dc.contributor.institutionGerman Institute for Medical Mission
dc.contributor.institutionResearch Department
dc.contributor.institutionColumbia University Medical Center/New York State Psychiatric Institute
dc.contributor.institutionUniversity of Oxford
dc.contributor.institutionGoethe University Frankfurt
dc.contributor.institutionUdmurtia Republican Clinical Psychiatric Hospital
dc.contributor.institutionGreater Manchester Mental Health NHS Foundation Trust
dc.contributor.institutionNational Institute of Mental Health
dc.contributor.institutionCharles University
dc.contributor.institutionAga Khan University
dc.contributor.institutionCenter for Contextual Psychiatry
dc.contributor.institutionOdessa National Medical University
dc.contributor.institutionBrighton and Sussex Medical School
dc.contributor.institutionBekhterev National Medical Research Center of Psychiatry and Neurology
dc.contributor.institutionPavlov First Saint Petersburg State Medical University
dc.contributor.institutionMedical University of Vienna
dc.contributor.institutionUniversity of Nottingham
dc.contributor.institutionKlinikum Klagenfurt am Wörthersee
dc.contributor.institutionUniversity of Glasgow
dc.contributor.institutionUniversity Hospital Leipzig
dc.contributor.institutionFinnish Institute for Health and Welfare
dc.contributor.institutionShanghai Jiao Tong University School of Medicine
dc.contributor.institutionColumbia University
dc.contributor.institutionUniversity of Edinburgh
dc.contributor.institutionPsychosocial Services in Vienna
dc.contributor.institutionUniversity of Oslo
dc.contributor.institutionUniversity Hospital Frankfurt - Goethe University
dc.contributor.institutionRafsanjan University of Medical Sciences
dc.contributor.institutionNational Institute of Public Health
dc.contributor.institutionSaint Petersburg State University
dc.contributor.institutionNSW Ministry of Health
dc.contributor.institutionInstituto Vita Alere
dc.contributor.institutionPsychiatry and Psychotherapy
dc.contributor.institutionSunnybrook Health Sciences Centre
dc.contributor.institutionUniversity of Toronto
dc.contributor.institutionFaculty of Political Science and Economics
dc.contributor.institutionThe University of Hong Kong
dc.contributor.institutionTel Aviv University
dc.date.accessioned2023-03-01T21:04:17Z
dc.date.available2023-03-01T21:04:17Z
dc.date.issued2022-09-01
dc.description.abstractBackground: Predicted increases in suicide were not generally observed in the early months of the COVID-19 pandemic. However, the picture may be changing and patterns might vary across demographic groups. We aimed to provide a timely, granular picture of the pandemic's impact on suicides globally. Methods: We identified suicide data from official public-sector sources for countries/areas-within-countries, searching websites and academic literature and contacting data custodians and authors as necessary. We sent our first data request on 22nd June 2021 and stopped collecting data on 31st October 2021. 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 and expected numbers of suicides 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; 25 with whole-country data, 12 with data for area(s)-within-the-country, four with both). 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, economic support level, or presence of a national suicide prevention strategy. Nor were they 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 countries/areas-within-countries 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. Funding: None.en
dc.description.affiliationCentre for Mental Health Melbourne School of Population and Global Health University of Melbourne
dc.description.affiliationNational Institute of Health Research Biomedical Research Centre University Hospitals Bristol and Weston NHS Foundation Trust University of Bristol
dc.description.affiliationSwansea University Medical School
dc.description.affiliationMinistry of Public Health Department of Health Promotion
dc.description.affiliationNational Confidential Inquiry into Suicide and Safety in Mental Health University of Manchester
dc.description.affiliationDepartment of Psychiatry Enam Medical College and Hospital
dc.description.affiliationSchool of Public Health National Suicide Research Foundation University College Cork
dc.description.affiliationAustralian Institute for Suicide Research and Prevention School of Applied Psychology Griffith University
dc.description.affiliationDepartment of Psychiatry Universidad Autonoma de Madrid Centre for Biomedical Research in Mental Health (CIBERSAM)
dc.description.affiliationNational Drug Dependence Treatment Center and Department of Psychiatry All India Institute of Medical Sciences
dc.description.affiliationAlcohol Tobacco and Other Drug Research Unit South African Medical Research Council
dc.description.affiliationInstitute for Life Course Health Research Department of Global Health Stellenbosch University
dc.description.affiliationWorking Group on Prevention of Suicide and Depression at Public Health Council Ministry of Health
dc.description.affiliationDepartment of Medicine and Optometry Linnaeus University
dc.description.affiliationDepartment of Psychiatry Blekinge Hospital
dc.description.affiliationDepartment of Forensic Medicine and Toxicology All India Institute of Medical Sciences
dc.description.affiliationDepartment of Neurology Psychology and Psychiatry Botucatu Medical School Universidade Estadual Paulista (UNESP)
dc.description.affiliationDepartment of Global Mental Health Instituto Nacional de Psiquiatría Ramon de la Fuente Muñiz
dc.description.affiliationDepartment of Psychiatry and Behavioural Sciences Johns Hopkins University School of Medicine
dc.description.affiliationDepartment for Psychiatry University Psychiatric Hospital Vrapče School of Medicine University of Zagreb
dc.description.affiliationUniversity of Rochester Medical Center
dc.description.affiliationDepartment of Psychology University of Milan-Bicocca
dc.description.affiliationDepartment of Psychiatry Nimes University Hospital
dc.description.affiliationNational Centre for Suicide Research and Prevention of Mental Ill-Health (NASP) Karolinska Institutet
dc.description.affiliationRegion Friuli Venezia Giulia Central Health Directorate Outpatient and Inpatient Care Service
dc.description.affiliationDepartment of Psychiatry Faculty of Medicine National University of Malaysia
dc.description.affiliationInstitute of Health Behaviors and Community Sciences College of Public Health National Taiwan University
dc.description.affiliationThames Valley Police
dc.description.affiliationPuerto Rico Department of Health's Commission on Suicide Prevention
dc.description.affiliationSchool of Applied Psychology Griffith University
dc.description.affiliationDepartment for Medical Ethics University Psychiatric Hospital Vrapče School of Medicine University of Zagreb
dc.description.affiliationPublic Health Foundation of India
dc.description.affiliationInstitute for Health Metrics and Evaluation University of Washington
dc.description.affiliationFlemish Centre of Expertise in Suicide Prevention Department of Head and Skin Ghent University
dc.description.affiliationGriffith University
dc.description.affiliationDepartment of Psychiatry Psychotherapy Psychosomatics and Medical Psychology University Hospital for Psychiatry 2 Medical University of Innsbruck
dc.description.affiliationCoroners Court of Victoria
dc.description.affiliationDanish Research Institute for Suicide Prevention Mental Health Centre Copenhagen
dc.description.affiliationCopenhagen Research Centre for Mental Health
dc.description.affiliationCentre for Mental Health Research Australian National University
dc.description.affiliationDepartment of Mental Health Johns Hopkins Bloomberg School of Public Health
dc.description.affiliationBrigham and Women's Hospital Department of Emergency Medicine Harvard Medical School
dc.description.affiliationDepartment of Psychiatry Neuroscience Institute Federico II University of Naples
dc.description.affiliationSchool of Population Health The University of Auckland
dc.description.affiliationCoronial Division Tasmanian Magistrates Court
dc.description.affiliationInstitute of Forensic Medicine Department of Biomedical Sciences for Health University of Milan
dc.description.affiliationUndersecretary of Health Services Ministry of Public Health
dc.description.affiliationMonitoring and Evaluation German Institute for Medical Mission
dc.description.affiliation113 Suicide Prevention Research Department
dc.description.affiliationDepartments of Psychiatry and Epidemiology Columbia University Medical Center/New York State Psychiatric Institute
dc.description.affiliationCentre for Suicide Research Department of Psychiatry University of Oxford
dc.description.affiliationInstitute of Legal Medicine University Hospital Frankfurt Goethe University Frankfurt
dc.description.affiliationUdmurtia Republican Clinical Psychiatric Hospital
dc.description.affiliationCentre for Mental Health and Safety and National Institute for Health Research (NIHR) Patient Safety Translational Research Centre University of Manchester
dc.description.affiliationGreater Manchester Mental Health NHS Foundation Trust
dc.description.affiliationNational Institute of Mental Health
dc.description.affiliationFaculty of Social Sciences Charles University
dc.description.affiliationDepartment of Psychiatry Aga Khan University
dc.description.affiliationKU Leuven Center for Contextual Psychiatry
dc.description.affiliationPopulation Health Sciences Bristol Medical School University of Bristol
dc.description.affiliationDepartment of Forensic Medicine Odessa National Medical University, Odessa
dc.description.affiliationBrigham and Women's Hospital Harvard Medical School
dc.description.affiliationDepartment of Primary Care and Public Health Brighton and Sussex Medical School
dc.description.affiliationDivision of Insurance Medicine Department of Clinical Neuroscience Karolinska Institutet
dc.description.affiliationBekhterev National Medical Research Center of Psychiatry and Neurology
dc.description.affiliationPavlov First Saint Petersburg State Medical University
dc.description.affiliationUnit Suicide Research and Mental Health Promotion Department of Social and Preventive Medicine Center for Public Health Medical University of Vienna
dc.description.affiliationSchool of Psychology University of Nottingham
dc.description.affiliationDepartment of Psychiatry and Psychotherapy Klinikum Klagenfurt am Wörthersee
dc.description.affiliationSuicidal Behaviour Research Lab Institute of Health and Wellbeing University of Glasgow
dc.description.affiliationDepartment of Child and Adolescent Psychiatry Psychotherapy and Psychosomatics University Hospital Leipzig
dc.description.affiliationDepartment of Public Health and Welfare Finnish Institute for Health and Welfare
dc.description.affiliationShanghai Mental Health Center Shanghai Jiao Tong University School of Medicine
dc.description.affiliationDepartments of Psychiatry and Epidemiology Columbia University
dc.description.affiliationUsher Institute University of Edinburgh
dc.description.affiliationPsychosocial Services in Vienna
dc.description.affiliationNational Centre for Suicide Research and Prevention Institute of Clinical Medicine University of Oslo
dc.description.affiliationDepartment of Psychiatry Psychosomatic Medicine and Psychotherapy University Hospital Frankfurt - Goethe University
dc.description.affiliationDepartment of Epidemiology and Biostatistics Occupational Environment Research Center Medical School Rafsanjan University of Medical Sciences
dc.description.affiliationNational Institute of Public Health
dc.description.affiliationSaint Petersburg State University
dc.description.affiliationSystem Information and Analytics Branch NSW Ministry of Health
dc.description.affiliationInstituto Vita Alere
dc.description.affiliationLVR Klinik Köln Department of Addictive Disorders Psychiatry and Psychotherapy
dc.description.affiliationOrganizational-Scientific Department Bekhterev National Medical Research Center of Psychiatry and Neurology
dc.description.affiliationDepartment of Psychiatry Sunnybrook Health Sciences Centre
dc.description.affiliationDepartment of Psychiatry University of Toronto
dc.description.affiliationWaseda University Faculty of Political Science and Economics
dc.description.affiliationHong Kong Jockey Club Centre for Suicide Research and Prevention Department of Social Work and Social Administration The University of Hong Kong
dc.description.affiliationGeha Mental Health Center Sackler Faculty of Medicine Tel Aviv University
dc.description.affiliationUnespDepartment of Neurology Psychology and Psychiatry Botucatu Medical School Universidade Estadual Paulista (UNESP)
dc.description.sponsorshipMedical Research Council
dc.description.sponsorshipNational Natural Science Foundation of China
dc.description.sponsorshipHealth and Care Research Wales
dc.description.sponsorshipFonds Wetenschappelijk Onderzoek
dc.description.sponsorshipUniverzita Karlova v Praze
dc.description.sponsorshipIdNational Natural Science Foundation of China: 81761128031
dc.description.sponsorshipIdHealth and Care Research Wales: CA04
dc.description.sponsorshipIdFonds Wetenschappelijk Onderzoek: FWO 1257821N
dc.description.sponsorshipIdUniverzita Karlova v Praze: GA UK 552119
dc.description.sponsorshipIdUniverzita Karlova v Praze: SVV 260 596
dc.identifierhttp://dx.doi.org/10.1016/j.eclinm.2022.101573
dc.identifier.citationeClinicalMedicine, v. 51.
dc.identifier.doi10.1016/j.eclinm.2022.101573
dc.identifier.issn2589-5370
dc.identifier.scopus2-s2.0-85135354142
dc.identifier.urihttp://hdl.handle.net/11449/241459
dc.language.isoeng
dc.relation.ispartofeClinicalMedicine
dc.sourceScopus
dc.subjectCOVID-19
dc.subjectMonitoring
dc.subjectPandemic
dc.subjectSuicide
dc.titleSuicide numbers during the first 9-15 months of the COVID-19 pandemic compared with pre-existing trends: An interrupted time series analysis in 33 countriesen
dc.typeArtigo
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