Department of Health Economics and Health Services Research, Center for Psychosocial Medicine, University Medical Center Hamburg-Eppendorf, Martinistr. 52, Building W37, 20246, Hamburg, Germany.
Institute for Social Medicine, Occupational Medicine and Public Health, University Medical Center Leipzig, Leipzig, Germany.
Soc Psychiatry Psychiatr Epidemiol. 2024 Jul;59(7):1193-1200. doi: 10.1007/s00127-023-02584-z. Epub 2023 Nov 23.
In this study, we assess how the first and second waves of the COVID-19 pandemic influenced the suicide risk of patients with severe mental disorders in Germany.
We analyzed German health insurance claims data to compare the suicide risk of patients with severe mental disorders before and during the pandemic. We included n = 690,845 patients between October 2019 and March 2020 and n = 693,457 patients the corresponding period of the previous year and applied entropy balancing to adjust for confounding covariates. Given that the cause of death was unknown, we defined potential suicides as deaths of patients with a history of intentional self-harm whose passing could not be explained by COVID-19. Potential suicides were tracked in both cohorts over one year and compared using logistic regression.
128 potential suicides were identified in the period during and 101 before the pandemic. This corresponded to a significant increase in the risk for potential suicide of 27.4% compared to the control period (β = 0.24, z = 1.82, p < 0.05).
The noticeable increase in the risk for potential suicide for patients with severe pre-existing mental disorders emphasizes the call for additional efforts to prevent suicide and to help patients cope with their mental illness in the aftermath of the COVID-19 crisis.
本研究旨在评估 COVID-19 大流行的第一波和第二波如何影响德国严重精神障碍患者的自杀风险。
我们分析了德国健康保险索赔数据，以比较大流行前后严重精神障碍患者的自杀风险。我们纳入了 2019 年 10 月至 2020 年 3 月期间的 n = 690,845 名患者和前一年同期的 n = 693,457 名患者，并应用熵平衡调整混杂协变量。由于死因未知，我们将有自杀史的故意自残患者的死亡定义为潜在自杀，这些患者的死亡不能用 COVID-19 来解释。在两个队列中，我们在一年内跟踪潜在自杀事件，并使用逻辑回归进行比较。
在大流行期间和之前的 101 天内，共发现 128 例潜在自杀事件。与对照期相比，潜在自杀的风险显著增加了 27.4%（β=0.24，z=1.82，p<0.05）。
严重精神障碍患者潜在自杀风险的显著增加强调了在后 COVID-19 危机时期，需要进一步努力预防自杀，并帮助患者应对其精神疾病。
