Department of Psychiatry, Faculty of Medicine, University of Peradeniya, Peradeniya 20400, Sri Lanka.
South Asian Clinical Toxicology Research Collaboration, Faculty of Medicine, University of Peradeniya, Peradeniya 20400, Sri Lanka.
Int J Environ Res Public Health. 2023 Jan 19;20(3):1833. doi: 10.3390/ijerph20031833.
Evidence from high-income countries suggests that the impact of COVID-19 on suicide and self-harm has been limited, but evidence from low- and middle-income countries is lacking. Using data from a hospital-based self-poisoning register (January 2019-December 2021) and data from national records (2016-2021) of suicide in Sri Lanka, we aimed to assess the impact of the pandemic on both self-poisoning and suicide. We examined changes in admissions for self-poisoning and suicide using interrupted time series (ITS) analysis. For the self-poisoning hospital admission ITS models, we defined the lockdown periods as follows: (i) pre-lockdown: 01/01/2019-19/03/2020; (ii) first lockdown: 20/03/2020-27/06/2020; (iii) post-first lockdown: 28/06/2020-11/05/2021; (iv) second lockdown: 12/05/2021-21/06/2021; and (v) post-second lockdown: 22/06/2021-31/12/2021. For suicide, we defined the intervention according to the pandemic period. We found that during lockdown periods, there was a reduction in hospital admissions for self-poisoning, with evidence that admission following self-poisoning remained lower during the pandemic than would be expected based on pre-pandemic trends. In contrast, there was no evidence that the rate of suicide in the pandemic period differed from that which would be expected. As the long-term socioeconomic impacts of the pandemic are realised, it will be important to track rates of self-harm and suicide in LMICs to inform prevention.
来自高收入国家的证据表明，COVID-19 对自杀和自残的影响有限，但来自中低收入国家的证据尚缺乏。我们利用来自斯里兰卡一家医院基于自杀自残登记（2019 年 1 月至 2021 年 12 月）的数据和全国自杀记录（2016 年至 2021 年）的数据，旨在评估大流行对自杀自残的双重影响。我们使用中断时间序列（ITS）分析来评估自杀自残入院率的变化。对于自杀自残住院 ITS 模型，我们将封锁期定义如下：（i）封锁前：2019 年 1 月 1 日至 2020 年 3 月 19 日；（ii）第一轮封锁：2020 年 3 月 20 日至 2020 年 6 月 27 日；（iii）第一轮封锁后：2020 年 6 月 28 日至 2021 年 5 月 11 日；（iv）第二轮封锁：2021 年 5 月 12 日至 2021 年 6 月 21 日；（v）第二轮封锁后：2021 年 6 月 22 日至 2021 年 12 月 31 日。对于自杀，我们根据大流行时期定义了干预措施。我们发现，在封锁期间，自杀自残的住院人数有所减少，有证据表明，大流行期间的自杀自残后入院率仍低于大流行前的趋势。相比之下，没有证据表明大流行期间的自杀率与预期的有所不同。随着大流行对长期社会经济影响的逐渐显现，跟踪中低收入国家的自残和自杀率以提供预防措施的信息将非常重要。
