Beijing Suicide Research and Prevention Center, Beijing Hui Long Guan Hospital, 7 Nan Dian Road, Changping, Beijing, 100096, China.
WHO Collaborating Center for Research and Training in Suicide Prevention, Beijing, China.
BMC Psychiatry. 2021 Jul 20;21(1):363. doi: 10.1186/s12888-021-03371-3.
The coronavirus disease 2019 (COVID-19) pandemic profoundly impacts on mental health, yet it is still unclear whether COVID-19 distress makes people more vulnerable to suicidal behavior. The present study aims to examine the association between COVID-19 related psychological distress and risk for suicide attempt, and moderators of this association, among hotline callers.
This case-control study was conducted at the largest psychological support hotline in China. Hotline callers who sought help for psychological distress and reported whether or not they attempted suicide in the last 2 weeks (recent suicide attempt) were analyzed. The primary predictor of recent suicide attempt was the presence or absence of COVID-19 related psychological distress. Demographic variables and common risk and protective factors for suicidal behavior were also studied. Callers with COVID-19 related distress (COVID-19 callers) and those without such distress (non-COVID-19 callers) were compared on these variables. Recent suicide attempt was regressed on COVID-19 related distress and the other variables, and significant interaction terms of aforementioned predictors by COVID-19 related distress, to identify variables that moderate the association of COVID-19 related distress and recent suicide attempt.
Among 7337 included callers, there were 1252 COVID-19 callers (17.1%) and 6085 non-COVID-19 callers (82.9%). The COVID-19 callers were less likely to report recent suicide attempt (n = 73, 5.8%) than the non-COVID-19 callers (n = 498, 8.2%, P = 0.005). The COVID-19 callers were also less likely to have high scores on depressive symptoms (22.6% vs 26.3%, P < 0.001) and psychological distress (19.5% vs 27.3%, P < 0.001), and were more likely to have high hopefulness scores (46.5% vs 38.0%, P < 0.001). Tests of moderating effects showed that acute life events were associated with one-half lower risk (P = 0.021), and a trend that suicide attempt history was associated with two-thirds greater risk (P = 0.063) for recent suicide attempt, among COVID-19 callers than non-COVID-19 callers.
The COVID-19 calls are from individuals with lower suicide-related risk compared to more typical callers. Acute stressful life events provided a key context for suicide attempt in non-COVID-19 callers, i.e., more typical calls.
2019 年冠状病毒病（COVID-19）大流行对心理健康产生了深远影响，但 COVID-19 带来的困扰是否会使人更容易产生自杀行为仍不清楚。本研究旨在探讨热线来电者中与 COVID-19 相关的心理困扰与自杀企图风险之间的关联，以及这种关联的调节因素。
这是一项在中国最大的心理支持热线中进行的病例对照研究。分析了因心理困扰寻求帮助并报告在过去 2 周内是否有过自杀企图（近期自杀企图）的热线来电者。近期自杀企图的主要预测因素是是否存在与 COVID-19 相关的心理困扰。还研究了自杀行为的常见风险和保护因素。将有 COVID-19 相关困扰的来电者（COVID-19 来电者）和没有这种困扰的来电者（非 COVID-19 来电者）进行比较。将近期自杀企图回归到 COVID-19 相关困扰和其他变量上，并检验上述预测因素与 COVID-19 相关困扰的显著交互项，以确定调节 COVID-19 相关困扰和近期自杀企图之间关联的变量。
在纳入的 7337 名来电者中，有 1252 名 COVID-19 来电者（17.1%）和 6085 名非 COVID-19 来电者（82.9%）。COVID-19 来电者报告近期自杀企图的可能性（n=73，5.8%）低于非 COVID-19 来电者（n=498，8.2%，P=0.005）。COVID-19 来电者的抑郁症状（22.6%比 26.3%，P<0.001）和心理困扰（19.5%比 27.3%，P<0.001）评分也较低，而希望水平评分较高（46.5%比 38.0%，P<0.001）。调节效应检验表明，急性生活事件使近期自杀企图的风险降低了一半（P=0.021），自杀企图史使近期自杀企图的风险增加了三分之二（P=0.063），这与 COVID-19 来电者而非非 COVID-19 来电者有关。
与更典型的来电者相比，COVID-19 来电者的自杀相关风险较低。急性应激性生活事件为非 COVID-19 来电者的自杀企图提供了一个关键背景，即更典型的来电者。
