Division of Medical Toxicology, Department of Emergency Medicine, University of Virginia School of Medicine, Charlottesville, Virginia.
MMWR Morb Mortal Wkly Rep. 2023 Apr 21;72(16):426-430. doi: 10.15585/mmwr.mm7216a3.
The World Health Organization declared COVID-19 a global pandemic on March 11, 2020 (1). As strategies to mitigate the pandemic were implemented, concerns were raised that the containment efforts through quarantine and social distancing practices were negatively affecting the mental and physical health of children and adolescents (2). Suicide is a growing public health problem in the United States. In 2020, suicide was the second leading cause of death among persons aged 10-14 years and the third leading cause among those aged 15-24 years (3). The National Poison Data System (NPDS) database was used to examine trends in suspected suicide attempts by self-poisoning among persons aged 10-19 years before and during the COVID-19 pandemic. Compared with 2019 (prepandemic), during 2021, the overall rate of suspected suicide attempts by self-poisoning increased by 30.0% (95% CI = 28.6%-30.9%), rates among children aged 10-12 years, adolescents aged 13-15 years, and females increased 73.0% (67.4%-80.0%), 48.8% (46.7%-50.9%), and 36.8% (35.4%-38.2%), respectively, and these trends continued into the third quarter of 2022. Substances most frequently involved in overdoses were acetaminophen, ibuprofen, sertraline, fluoxetine, and diphenhydramine. Acetaminophen-involved overdoses increased 71% (67.4%-74.9%) in 2021 and 58.0% (54.5%-61.6%) in 2022. Diphenhydramine-involved overdoses increased 24.2% (19.9%-28.7%) in 2021 and 35.8% (31.2%-40.5%) in 2022. A comprehensive public health approach to suicide prevention, focused on children and adolescents and involving a partnership between families, school teachers, mental health professionals, and public health leadership is needed. The 9-8-8 Suicide and Crisis Lifeline provides crisis support for persons experiencing mental health-related distress and assists community members who are concerned about persons experiencing a mental health crisis.
世界卫生组织于 2020 年 3 月 11 日宣布 COVID-19 为全球大流行疾病(1)。随着缓解大流行的策略的实施,人们开始担心隔离和社会疏远措施的实施会对儿童和青少年的身心健康产生负面影响(2)。自杀是美国日益严重的公共卫生问题。2020 年,自杀是 10-14 岁人群中第二大死亡原因,也是 15-24 岁人群中第三大死亡原因(3)。利用国家中毒数据系统(NPDS)数据库,研究了 COVID-19 大流行前后 10-19 岁人群疑似自杀未遂的自伤中毒趋势。与 2019 年(大流行前)相比,2021 年疑似自杀未遂的自伤中毒总发生率增加了 30.0%(95%CI=28.6%-30.9%),10-12 岁儿童、13-15 岁青少年和女性的发生率分别增加了 73.0%(67.4%-80.0%)、48.8%(46.7%-50.9%)和 36.8%(35.4%-38.2%),这些趋势一直持续到 2022 年第三季度。药物过量最常涉及的物质是对乙酰氨基酚、布洛芬、舍曲林、氟西汀和苯海拉明。2021 年对乙酰氨基酚中毒增加了 71%(67.4%-74.9%),2022 年增加了 58.0%(54.5%-61.6%)。2021 年苯海拉明中毒增加了 24.2%(19.9%-28.7%),2022 年增加了 35.8%(31.2%-40.5%)。需要采取以儿童和青少年为重点的、由家庭、学校教师、心理健康专业人员和公共卫生领导层共同参与的综合性公共卫生方法预防自杀。9-8-8 自杀和危机热线为经历心理健康相关困扰的人提供危机支持,并协助关注经历心理健康危机的人的社区成员。