Department of Psychiatry, Faculty of Medicine, University of Geneva (UNIGE), Geneva.
University of Genoa.
Acta Biomed. 2021 Oct 1;92(S6):e2021417. doi: 10.23750/abm.v92iS6.12249.
Suicide risk and resilience strategies during the different phases of the COVID-19 pandemic are of great interest to researchers. At the pandemic onset, a dramatic suicides exacerbation was feared. Some authoritative authors warned the scientific and clinical community about this risk by pointing out that especially psychiatric, psychological, and social factors could interact with each other to create a vicious cycle. While worldwide case-reports and studies conducted at emergency departments did indeed find an increase in suicidal behavior, recent systematic reviews, meta-analyses, and time-series analyses could not confirm this for the first COVID-19 wave. Instead, it appears that the increased suicide risk outlasted the acute phase of the pandemic and thus affected people more during the pandemic following phases. One possible reason for this phenomenon may be a persistent state of insecurity regarding the economic crisis evolution with serious financial stressors in terms of income decrease, unemployment, repaying debts difficulty, home loss, one's social status derive, social hierarchy drop, and poverty. During the COVID-19 first wave, with particular regard to vulnerable populations, one of the postulated theories unifying different risk factors under a single frame was the "Interpersonal Theory of Suicide". Conversely, the "Interpersonal Trust" theory emerged as a protective factor even during an economic crisis. In a possible mirroring of the two theories, it seems to be feasible to find common themes between them and, above all, to gain relevant insights to devise effective prevention and supportive strategies for dealing with suicide risk challenges that COVID-19 will continue to pose in the foreseeable future. (www.actabiomedica.it).
在 COVID-19 大流行的不同阶段,自杀风险和应对策略引起了研究人员的极大关注。在大流行开始时,人们担心自杀率会急剧上升。一些权威作者通过指出精神病学、心理学和社会因素可能相互作用,形成恶性循环,警告科学界和临床界注意这一风险。虽然世界各地的病例报告和急诊科的研究确实发现自杀行为有所增加,但最近的系统评价、荟萃分析和时间序列分析并没有在第一波 COVID-19 中证实这一点。相反,自杀风险似乎持续存在于大流行的后期阶段,因此在大流行的后续阶段对人们的影响更大。这种现象的一个可能原因可能是人们对经济危机演变的持续不安全感,导致收入减少、失业、偿债困难、失去家园、社会地位下降、社会阶层下降和贫困等严重的经济压力。在 COVID-19 大流行的第一波期间,特别是对于弱势群体,将不同风险因素统一在一个框架下的一个假设理论是“人际理论自杀”。相反,即使在经济危机期间,“人际信任”理论也成为了一个保护因素。在这两种理论的可能镜像中,似乎可以找到它们之间的共同主题,尤其是获得相关见解,为应对 COVID-19 在可预见的未来将继续带来的自杀风险挑战制定有效的预防和支持策略。(www.actabiomedica.it)。