Am J Epidemiol. 2020 Nov 2;189(11):1275-1277. doi: 10.1093/aje/kwaa147.
The coronavirus disease 2019 (COVID-19) pandemic presents a unique set of risk exposures for populations, which might lead to an increase in suicide. While large-scale traumatic events are known to increase psychological disorders, thus far the science has not shown a clear link between these events and suicide. In this issue of the Journal, Elbogen et al. (Am J Epidemiol. 2020;189(11):1266-1274) used representative data from the National Epidemiologic Survey on Alcohol and Related Conditions (NESARC) to show that 4 dimensions of financial strain-financial debt/crisis, unemployment, past homelessness, and lower income-are associated with subsequent suicide attempts. There are 3 main lessons we can take from Elbogen et al.: First, with populations facing record-breaking unemployment, economic recession, and reduced wages, we can anticipate an increase in suicide in the wake of the COVID-19 pandemic. Second, these data show the centrality of financial stressors, marking the current moment as distinct from other disasters or large-scale trauma. Third, the data teach us that financial stressors are linked and cumulative. In this way, Elbogen et al. provide a sobering harbinger of the potential effects on suicide of the collective stressors borne by the COVID-19 pandemic and other mass traumatic events that are accompanied by substantial financial stressors.
2019 年冠状病毒病(COVID-19)大流行给人群带来了一系列独特的风险暴露,这可能导致自杀率上升。虽然众所周知,大规模创伤事件会增加心理障碍,但到目前为止,科学并没有显示这些事件与自杀之间有明确的联系。在本期《美国流行病学杂志》(Am J Epidemiol. 2020;189(11):1266-1274)上,Elbogen 等人利用全国酒精相关状况流行病学调查(NESARC)的代表性数据表明,4 个财务压力维度——财务债务/危机、失业、过去无家可归和收入较低——与随后的自杀企图有关。我们可以从 Elbogen 等人的研究中得到以下 3 点主要启示:首先,随着人群面临创纪录的失业、经济衰退和工资降低,我们可以预料到 COVID-19 大流行后自杀人数会增加。其次,这些数据表明财务压力源的核心地位,这标志着当前时刻与其他灾难或大规模创伤事件不同。第三,数据表明财务压力源是相互关联和累积的。Elbogen 等人的研究为 COVID-19 大流行和其他伴有大量财务压力源的大规模创伤事件所带来的集体压力源对自杀的潜在影响提供了一个令人警醒的预兆。