The impact of the COVID-19 pandemic on self-harm and suicidal behaviour: update of living systematic review

Abstract

Background: The COVID-19 pandemic has caused considerable morbidity, mortality and disruption to people’s lives around the world. There are concerns that rates of suicide and suicidal behaviour may rise during and in its aftermath. Our living systematic review synthesises findings from emerging literature on incidence and prevalence of suicidal behaviour as well as suicide prevention efforts in relation to COVID-19, with this iteration synthesising relevant evidence up to 19 th October 2020. Method: Automated daily searches feed into a web-based database with screening and data extraction functionalities. Eligibility criteria include incidence/prevalence of suicidal behaviour, exposure-outcome relationships and effects of interventions in relation to the COVID-19 pandemic. Outcomes of interest are suicide, self-harm or attempted suicide and suicidal thoughts. No restrictions are placed on language or study type, except for single-person case reports. We exclude one-off cross-sectional studies without either pre-pandemic measures or comparisons of COVID-19 positive vs. unaffected individuals. Results: Searches identified 6,226 articles. Seventy-eight articles met our inclusion criteria. We identified a further 64 relevant cross-sectional studies that did not meet our revised inclusion criteria. Thirty-four articles were not peer-reviewed (e.g. research letters, pre-prints). All articles were based on observational studies. There was no consistent evidence of a rise in suicide but many studies noted adverse economic effects were evolving. There was evidence of a rise in community distress, fall in hospital presentation for suicidal behaviour and early evidence of an increased frequency of suicidal thoughts in those who had become infected with COVID-19. Conclusions: Research evidence of the impact of COVID-19 on suicidal behaviour is accumulating rapidly. This living review provides a regular synthesis of the most up-to-date research evidence to guide public health and clinical policy to mitigate the impact of COVID-19 on suicide risk as the longer term impacts of the pandemic on suicide risk are researched.

References 147

1. 1.

   Acharya SR Shin YC Moon DH: COVID-19 outbreak and suicides in Nepal: Urgency of immediate action. Int J Soc Psychiatry. 2020; 0020764020963150.

   Not in our library10.1177/0020764020963150

2. 2.

   Ahmed S Khaium MO Tazmeem F: COVID-19 lockdown in India triggers a rapid rise in suicides due to the alcohol withdrawal symptoms: Evidence from media reports. Int J Soc Psychiatry. 2020;66(8):827–829.

   Not in our library10.1177/0020764020938809

3. 3.

   Akl EA Meerpohl JJ Elliott J: Living systematic reviews: 4. Living guideline recommendations. J Clin Epidemiol. 2017;91:47–53.

   Not in our library10.1016/j.jclinepi.2017.08.009

4. 4.

   Ando M Furuichi M: The impact of COVID-19 employment shocks on suicide and safety net use: An early-stage investigation*. medRxiv. 2020.

   Not in our library10.1101/2020.11.16.20232850

5. 5.

   Anestis MD Bond AE Daruwala SE: Suicidal Ideation Among Individuals Who Have Purchased Firearms During COVID-19. Am J Prev Med. 2021;60(3):311–317.

   Not in our library10.1016/j.amepre.2020.10.013

6. 6.

   Bhatia R: Predictions of Covid-19 Related Unemployment On Suicide and Excess Mortality in the United States. medRxiv. 2020a.

   Not in our library10.1101/2020.05.02.20089086

7. 7.

   Bhatia R: Predictions of Covid-19 Related Unemployment On Suicide and Excess Mortality in the United States. medRxiv. 2020b.

   Not in our library10.1101/2020.05.02.20089086v3

8. 8.
   COVID-19-Related Suicides in Bangladesh Due to Lockdown and Economic Factors: Case Study Evidence from Media Reports · 2020

   No notice
9. 9.

   Boshra SN Islam MM: The Status and Risk Factors of COVID-19 Related Suicides in Bangladesh. medRxiv. 2020a. Reference Source

   Not in our library

10. 10.

    Boshra SN Islam MM Griffiths MD: The demography and apparent risk factors of COVID-19-related suicides in Bangladesh in a seven-month period of the pandemic. medRxiv. 2020b.

    Not in our library10.1101/2020.08.11.20171272

11. 11.

    Bray MJC Daneshvari NO Radhakrishnan I: Racial Differences in Statewide Suicide Mortality Trends in Maryland During the Coronavirus Disease 2019 (COVID-19) Pandemic. JAMA Psychiatry. 2021;78(4):444–447.

    Not in our library10.1001/jamapsychiatry.2020.3938

12. 12.

    Buschmann C Tsokos M: Corona-associated suicide - Observations made in the autopsy room. Leg Med (Tokyo). 2020a;46:101723.

    Not in our library10.1016/j.legalmed.2020.101723

13. 13.

    Buschmann C Tsokos M: Corona-associated suicide - Observations made in the autopsy room. Leg Med (Tokyo). 2020b;46:101723.

    Not in our library10.1016/j.legalmed.2020.101723

14. 14.

    Cai Q Feng H Huang J: The mental health of frontline and non-frontline medical workers during the coronavirus disease 2019 (COVID-19) outbreak in China: A case-control study. J Affect Disord. 2020;275:210–215.

    Not in our library10.1016/j.jad.2020.06.031

15. 15.

    Calderon-Anyosa RJC Kaufman JS: Impact of COVID-19 lockdown policy on homicide, suicide, and motor vehicle deaths in Peru. medRxiv. 2020.

    Not in our library10.1101/2020.07.11.20150193

16. 16.

    Capuzzi E di Brita C Caldiroli A: Psychiatric emergency care during Coronavirus 2019 (COVID 19) pandemic lockdown: results from a Department of Mental Health and Addiction of northern Italy. Psychiatry Res. 2020;293:113463.

    Not in our library10.1016/j.psychres.2020.113463

17. 17.

    Chang SS Stuckler D Yip P: Impact of 2008 global economic crisis on suicide: time trend study in 54 countries. BMJ. 2013;347:f5239.

    Not in our library10.1136/bmj.f5239

18. 18.

    Chang YH Chang SS Hsu CY: Impact of Pandemic on Suicide: Excess Suicides in Taiwan During the 1918-1920 Influenza Pandemic. J Clin Psychiatry. 2020;81(6):20l13454.

    Not in our library10.4088/jcp.20l13454

19. 19.

    Chen S Jones PB Underwood BR: The early impact of COVID-19 on mental health and community physical health services and their patients' mortality in Cambridgeshire and Peterborough, UK. J Psychiatr Res. 2020;131:244–254.

    Not in our library10.1016/j.jpsychires.2020.09.020

20. 20.

    Cheung Y Chau PH Yip PS: A revisit on older adults suicides and Severe Acute Respiratory Syndrome (SARS) epidemic in Hong Kong. Int J Geriatr Psychiatry. 2008;23(12):1231–1238.

    Not in our library10.1002/gps.2056

21. 21.

    Cox J Holden J Sagovsky R: Detection of postnatal depression: Development of the 10-item Edinburgh Postnatal Depression Scale. Br J Psychiatry. 1987;150(6):782–786.

    Not in our library10.1192/bjp.150.6.782

22. 22.
    A repeated cross-sectional survey assessing university students' stress, depression, anxiety, and suicidality in the early stages of the COVID-19 pandemic in Poland · 2020

    No notice
23. 23.

    Deeks JJ Higgins JPT Altman DG: Analysing data and undertaking meta-analyses. Cochrane handbook for systematic reviews of interventions. 2nd ed.: John Wiley & Sons,2019.

    Not in our library10.1002/9781119536604.ch10

24. 24.

    Deisenhammer EA Kemmler G: Decreased suicide numbers during the first 6 months of the COVID-19 pandemic. Psychiatry Res. 2021;295:113623.

    Not in our library10.1016/j.psychres.2020.113623

25. 25.

    Dragovic M Pascu V Hall T: Emergency department mental health presentations before and during the COVID-19 outbreak in Western Australia. Australas Psychiatry. 2020;28(6):627–631.

    Not in our library10.1177/1039856220960673

26. 26.

    Dsouza DD Quadros S Hyderabadwala ZJ: Aggregated COVID-19 suicide incidences in India: Fear of COVID-19 infection is the prominent causative factor. Psychiatry Res. 2020;290:113145.

    Not in our library10.1016/j.psychres.2020.113145

27. 27.

    Elliott JH Synnot A Turner T: Living systematic review: 1. Introduction-the why, what, when, and how. J Clin Epidemiol. 2017;91:23–30.

    Not in our library10.1016/j.jclinepi.2017.08.010

28. 28.
    Living Systematic Reviews: An Emerging Opportunity to Narrow the Evidence-Practice Gap · 2014

    No notice
29. 29.
    From “It Has Stopped Our Lives” to “Spending More Time Together Has Strengthened Bonds”: The Varied Experiences of Australian Families During COVID-19 · 2020

    No notice
30. 30.

    Fancourt D Steptoe A: COVID-19 social study.2020. Reference Source

    Not in our library

31. 31.

    Faust JS Shah SB Du C: Suicide Deaths during the Stay-at-Home Advisory in Massachusetts. medRxiv. 2020.

    Not in our library10.1101/2020.10.20.20215343

32. 32.

    Finlay I Gilmore I: Covid-19 and alcohol—a dangerous cocktail. BMJ. 2020;369:m1987.

    Not in our library10.1136/bmj.m1987

33. 33.

    Fountoulakis KN Pantoula E Siamouli M: Development of the Risk Assessment Suicidality Scale (RASS): a population-based study. J Affect Disord. 2012;138(3):449–457.

    Not in our library10.1016/j.jad.2011.12.045

34. 34.

    Gonçalves-Pinho M Mota P Ribeiro J: The Impact of COVID-19 Pandemic on Psychiatric Emergency Department Visits - A Descriptive Study. Psychiatr Q. 2021;92(2):621–631.

    Not in our library10.1007/s11126-020-09837-z

35. 35.

    Griffiths MD Mamun MA: COVID-19 suicidal behavior among couples and suicide pacts: Case study evidence from press reports. Psychiatry Res. 2020;289:113105.

    Not in our library10.1016/j.psychres.2020.113105

36. 36.

    Gunnell D Appleby L Arensman E: Suicide risk and prevention during the COVID-19 pandemic. Lancet Psychiatry. 2020;7(6):468–471.

    Not in our library10.1016/s2215-0366(20)30171-1

37. 37.

    Hamm ME Brown PJ Karp JF: Experiences of American older adults with pre-existing depression during the beginnings of the covid-19 pandemic: A multicity, mixed-methods study. Am J Geriatr Psychiatry. 2020;28(9):924–932.

    Not in our library10.1016/j.jagp.2020.06.013

38. 38.

    Hamza CA Ewing L Heath NL: When social isolation is nothing new: A longitudinal study on psychological distress during COVID-19 among university students with and without preexisting mental health concerns. Can Psychol. 2021;62(1):20–30.

    Not in our library10.1037/cap0000255

39. 39.

    Hawton K Casey D Bale E: Self-harm during the early period of the COVID-19 Pandemic in England: comparative trend analysis of hospital presentations. medRxiv. 2020a.

    Not in our library10.1101/2020.11.25.20238030

40. 40.

    Hawton K Lascelles K Brand F: Self-harm and the COVID-19 pandemic: a study of factors contributing to self-harm during lockdown restrictions. medRxiv. 2020b.

    Not in our library10.1101/2020.12.04.20244129

Reads

A person counts once a day per paper. We keep no cookie and no address: a reader is a hash that changes every day. Any month under five reads shows no number.