Vardi Ilor, Hamdan Sami, Zalsman Gil, Stukalin Yelena
School of Behavioral Sciences, Tel Aviv-Yaffo Academic College, Tel Aviv, Israel.
Geha Mental Health Center of the Clalit HMO, Petah Tiqwa, Israel.
Suicide Life Threat Behav. 2025 Feb;55(1):e13156. doi: 10.1111/sltb.13156.
The COVID-19 pandemic has significantly affected adolescents' mental health, raising concerns about the potential increase in self-harming and suicidal behaviors (SIB). This study aimed to evaluate the pandemic's impact on SIB among adolescents and explore the effects of school closures and psychiatric vulnerabilities to inform future interventions.
A systematic review and meta-analysis were conducted using PubMed, resulting in 420 studies, of which 36 studies (comprising 53 samples) met the inclusion criteria, encompassing 1,754,106 adolescents. Effect sizes were calculated using proportion effect size. Heterogeneity across studies was assessed using Q-statistics and I², while Egger's test was applied to evaluate publication bias. Differences between clinical and community samples, as well as the influence of psychiatric symptoms or disorders, were examined.
Clinical samples demonstrated higher rates of SIB compared to community samples, with adolescents having psychiatric symptoms or disorders being more vulnerable. Overall, the pandemic was associated with a decline in SIB rates compared to pre-pandemic levels. Suicidal ideation decreased by 4.14% in combined samples and by 7.13% in community samples. Self-harm rates fell by 5.38% and 6.62% in combined and community samples, respectively. In contrast, clinical samples showed a distinct trend, with suicidal ideation decreasing by 29.39%, while self-harm rates increased by 32.51% and suicide attempts rose by 22.41%.
The COVID-19 pandemic's impact on adolescents' SIB varied significantly across population types and levels of psychiatric vulnerability. While general declines were observed, the pronounced increases in self-harm and suicide attempts among clinical samples highlight the need for tailored mental health interventions. Addressing these disparities is essential for future mental health strategies and crisis preparedness.
新冠疫情对青少年的心理健康产生了重大影响，引发了人们对自我伤害和自杀行为（SIB）潜在增加的担忧。本研究旨在评估疫情对青少年SIB的影响，并探讨学校停课和精神疾病易感性的影响，以为未来的干预措施提供参考。
使用PubMed进行了系统综述和荟萃分析，共检索到420项研究，其中36项研究（包含53个样本）符合纳入标准，涵盖1,754,106名青少年。使用比例效应量计算效应大小。采用Q统计量和I²评估研究间的异质性，同时应用Egger检验评估发表偏倚。研究了临床样本和社区样本之间的差异，以及精神症状或疾病的影响。
与社区样本相比，临床样本的SIB发生率更高，有精神症状或疾病的青少年更容易出现SIB。总体而言，与疫情前水平相比，疫情期间SIB发生率有所下降。综合样本中的自杀意念下降了4.14%，社区样本中下降了7.13%。综合样本和社区样本中的自我伤害率分别下降了5.38%和6.62%。相比之下，临床样本呈现出不同的趋势，自杀意念下降了29.39%，而自我伤害率上升了32.51%，自杀未遂率上升了22.41%。
新冠疫情对青少年SIB的影响因人群类型和精神疾病易感性水平的不同而有显著差异。虽然总体上有所下降，但临床样本中自我伤害和自杀未遂的显著增加凸显了针对性心理健康干预措施的必要性。解决这些差异对于未来的心理健康策略和危机准备至关重要。
