Els Johnré Retief, Hendrikse Clint, Taljaard Luan
Division of Emergency Medicine, Department of Family, Community and Emergency Care, Faculty of Health Sciences, University of Cape Town, Cape Town, South Africa.
Department of Emergency Medicine, Frere Hospital, East London, Eastern Cape, South Africa.
Afr J Emerg Med. 2024 Dec;14(4):268-272. doi: 10.1016/j.afjem.2024.08.005. Epub 2024 Sep 19.
Suicidal behaviour is a public health emergency, causing an estimated one million deaths globally each year. The impact of the COVID-19 pandemic on suicidal behaviour is not fully understood. This study aimed to describe the impact of the COVID-19 pandemic on presentations with suicidal behaviour at a tertiary hospital in the Eastern Cape, South Africa.
This study was a retrospective cross-sectional analysis of patients with fatal and nonfatal suicidal behaviour who presented to Frere Hospital Emergency Centre in the Eastern Cape, South Africa. The analysis included three study periods: August to October 2019 (pre-COVID-19), August to October 2020 (wave 1), and August to October 2021(wave 3).
A total of 16 419 patients presented to the Frere Hospital Emergency Centre during the study period, with 6 204 in 2019, 4 909 in 2020, and 5 306 in 2021. These correspond to the research periods from August to October for each successive year. The overall prevalence of suicidal behaviour was 1.6 % but decreased marginally during the pandemic (1.8 % in 2019 vs. 1.4 % in 2021) - contrary to what occurred in high-income countries. The prevalence demonstrated a clinically insignificant stepwise decline as the pandemic progressed and was inversely associated with the number of daily new COVID-19 cases nationally. A significant increase in the emergency centre's total length of stay was however observed during the COVID-19 period (143 vs. 80 min, < 0.001). The high proportion (66 %) of patients with suicidal behaviour requiring admissions increased further during the COVID-19 study period, placing an additional burden on inpatient disciplines. The proportion of social worker consultations increased significantly during the COVID-19 period (65% vs. 44 %, <.05).
The COVID-19 pandemic marginally reduced the prevalence of presentations with suicidal behaviour to the Emergency Centre, contrary to what was observed in high-income countries.
自杀行为是一种公共卫生突发事件，全球每年估计有100万人死于自杀。新型冠状病毒肺炎（COVID-19）大流行对自杀行为的影响尚未完全明确。本研究旨在描述COVID-19大流行对南非东开普省一家三级医院自杀行为就诊情况的影响。
本研究是对南非东开普省弗雷尔医院急诊中心出现致命和非致命自杀行为患者的回顾性横断面分析。分析包括三个研究时间段：2019年8月至10月（COVID-19之前）、2020年8月至10月（第1波）和2021年8月至10月（第3波）。
在研究期间，共有16419名患者到弗雷尔医院急诊中心就诊，2019年有6204名，2020年有4909名，2021年有5306名。这些分别对应每年8月至10月的研究时间段。自杀行为的总体患病率为1.6%，但在大流行期间略有下降（2019年为1.8%，2021年为1.4%），这与高收入国家的情况相反。随着大流行进展，患病率呈临床上无显著意义的逐步下降，且与全国每日新增COVID-19病例数呈负相关。然而，在COVID-19期间，急诊中心的总住院时间显著增加（143分钟对80分钟，P<0.001）。在COVID-19研究期间，需要住院治疗的自杀行为患者比例较高（66%），这给住院科室带来了额外负担。在COVID-19期间，社会工作者会诊比例显著增加（65%对44%，P<0.05）。
与高收入国家观察到的情况相反，COVID-19大流行使急诊中心自杀行为就诊的患病率略有降低。
