Mittendorfer-Rutz Ellenor, Bergström Jakob, Josefsson Pontus, Taipale Heidi, Sijbrandij Marit, Witteveen Anke, Monzio Compagnoni Matteo, Lora Antonio, Felez-Nobrega Mireia, Haro Josep Maria, Melchior Maria, van der Waerden Judith, Gemes Katalin, Amin Ridwanul
Department of Clinical Neuroscience, Division of Insurance Medicine, Karolinska Institutet, Stockholm, Sweden.
Department of Clinical, Neuro- and Developmental Psychology, VU University Amsterdam, WHO Collaborating Center for Research and Dissemination of Psychological Interventions, Amsterdam Public Health Research Institute, Amsterdam, the Netherlands.
Psychol Med. 2024 Dec 16;54(16):1-9. doi: 10.1017/S003329172400299X.
Determining whether the incidence of suicidal behavior during the COVID-19 pandemic changed for those with severe mental disorders is essential to ensure the provision of suicide preventive initiatives in the case of future health crises.
Using population-based registers, quarterly cohorts from the first quarter of 2018 (2018Q1) to 2021Q4 were formed including all Swedish-residents >10 years old. Interrupted time series and generalized estimating equations analyses were used to evaluate changes in Incidence Rates (IR) of specialised healthcare use for suicide attempt and death by suicide per 10 000 person-years for individuals with or without specific severe mental disorders (SMDs) during, compared to before the pandemic.
The IR (95% Confidence interval, CI) of suicide in individuals with SMDs decreased from 16.0 (15.0-17.1) in 2018Q1 to 11.6 (10.8-12.5) in 2020Q1 (i.e. the quarter before the start of the pandemic), after which it dropped further to 6.7 (6.3-7.2) in 2021Q2. In contrast, IRs of suicide attempt in SMDs showed more stable trends, as did the trends regarding suicide and suicide attempt for individuals without SMD. These discrepancies were most evident for individuals with substance use disorder and ASD/ADHD. Changes in IRs of suicide suicide attempt for one quarter during the pandemic for substance misuse were 11.2% 3.6% respectively. These changes for ASD/ADHD were 10.7% 3.6%.
The study shows pronounced decreases in suicide rates in individuals with SMDs during the pandemic. Further studies aiming to understand mechanisms behind these trends are warranted to consult future suicide prevention strategies.
确定在新冠疫情期间患有严重精神障碍者的自杀行为发生率是否发生变化，对于在未来健康危机情况下确保提供自杀预防措施至关重要。
利用基于人群的登记数据，形成了从2018年第一季度（2018Q1）到2021年第四季度的季度队列，纳入了所有年龄超过10岁的瑞典居民。采用中断时间序列分析和广义估计方程分析，以评估在疫情期间与疫情前相比，患有或未患有特定严重精神障碍（SMD）的个体每10000人年自杀未遂和自杀死亡的专科医疗使用发生率（IR）的变化。
患有SMD的个体的自杀IR（95%置信区间，CI）从2018年第一季度的16.0（15.0 - 17.1）降至2020年第一季度（即疫情开始前的那个季度）的11.6（10.8 - 12.5），之后在2021年第二季度进一步降至6.7（6.3 - 7.2）。相比之下，SMD患者自杀未遂的IR呈现出更稳定的趋势，没有SMD的个体的自杀和自杀未遂趋势也是如此。这些差异在患有物质使用障碍和自闭症谱系障碍/注意力缺陷多动障碍（ASD/ADHD）的个体中最为明显。在疫情期间，物质滥用者每季度自杀和自杀未遂IR的变化分别为11.2%和3.6%。ASD/ADHD患者的这些变化为10.7%和3.6%。
该研究表明，在疫情期间患有SMD的个体自杀率显著下降。有必要进行进一步研究以了解这些趋势背后的机制，为未来的自杀预防策略提供参考。
