Luk Luke Y F, Ching Christie J Y, Yip Tsz Fung, Chan Sunny C L, Lam Catherine Y T, Lam Elizabeth T C, Yue Serena R B, Pang Hoi Ching, Wong Janet Y H, Wong Carlos K H, Tong Chak Kwan, Yamamoto Tafu, Rainer Timothy H, Wai Abraham K C, Ho Joshua W K
School of Biomedical Sciences, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Hong Kong SAR, China (Hong Kong).
Laboratory of Data Discovery for Health Limited (D24H), Hong Kong Science Park, Hong Kong SAR, China (Hong Kong).
JMIR Public Health Surveill. 2025 Feb 10;11:e57500. doi: 10.2196/57500.
COVID-19 ended on May 5, 2023, and since then Hong Kong reported increased mental distress, which was speculated to be from the policies implemented during the pandemic. Despite this, longitudinal surveillance of deliberate self-harm (DSH) incidences throughout the pandemic in Hong Kong remained insufficient.
The objective of this study was to outline the changes in DSH incidences before and during the COVID-19 pandemic in Hong Kong, with respect to sex, age, and co-occurring mental health issues.
A quasi-experiment was conducted using an interrupted time series design to estimate the impact of the pandemic on DSH-related emergency department (ED) visits. This design enabled the estimation of DSH-related ED visits based on prepandemic data from 2016 to 2019, assuming the pandemic had not occurred, and allowed for a comparison with observed DSH-related ED visits during the pandemic. The descriptive results were reported as the observed monthly DSH-related ED visits and observed incidence ratios during the pandemic. Afterwards, a negative binomial model was fitted to the prepandemic data (2016-2019) and adjusted for temporal trends, seasonality, and population variation to estimate the expected monthly DSH-related ED visits and adjusted incidence ratios (aIRs).
Between January 2016 and December 2022, a total of 31,893 DSH episodes were identified. Initial descriptive analysis showed a significant difference in demographic characteristics (sex) and clinical characteristics (death within 28 d, diagnoses of co-occurring mental health issues, public assistance pay code, and triage level). Subsequent interrupted time-series analysis demonstrated significantly increasing trends in comparison with the prepandemic period. As reported in the aIRs among young adult males (aIR in 2020=1.34, P=.002; 2021: aIR=1.94, P<.001; and 2022: aIR=2.53, P<.001), adult males (aIR in 2020=1.58, P<.001; 2021: aIR=2.64, P<.001; and 2022: aIR=3.13, P<.001), adult females (aIR in 2020=1.13, P=.01; 2021: aIR=1.52, P<.001; and 2022: aIR=1.64, P<.001), and older male adults (aIR in 2020=1.53, P<.001; 2021: aIR=2.37, P<.001; and 2022: aIR=3.01, P<.001).
The average annual DSH-related ED visits increased during the pandemic period. Therefore, there is a need to raise awareness for such vulnerable groups in Hong Kong to prepare for postpandemic spillover.
2023年5月5日新冠疫情结束，自那时起，香港报告称心理困扰有所增加，据推测这源于疫情期间实施的政策。尽管如此，香港在整个疫情期间对蓄意自伤（DSH）发生率的纵向监测仍然不足。
本研究的目的是概述香港在新冠疫情之前和期间DSH发生率在性别、年龄和并发心理健康问题方面的变化。
采用中断时间序列设计进行了一项准实验，以评估疫情对与DSH相关的急诊科（ED）就诊的影响。这种设计能够根据2016年至2019年疫情前的数据估计与DSH相关的ED就诊情况（假设未发生疫情），并与疫情期间观察到的与DSH相关的ED就诊情况进行比较。描述性结果报告为疫情期间观察到的每月与DSH相关的ED就诊次数和观察到的发病率。之后，对疫情前的数据（2016 - 2019年）拟合负二项模型，并对时间趋势、季节性和人口变化进行调整，以估计预期的每月与DSH相关的ED就诊次数和调整后的发病率（aIRs）。
2016年1月至2022年12月期间，共识别出31,893例DSH事件。初步描述性分析显示，在人口统计学特征（性别）和临床特征（28天内死亡、并发心理健康问题的诊断、公共援助支付代码和分诊级别）方面存在显著差异。随后的中断时间序列分析表明，与疫情前相比，呈显著上升趋势。如年轻成年男性的aIRs所示（2020年：aIR = 1.34，P = 0.002；2021年：aIR = 1.94，P < 0.001；2022年：aIR = 2.53，P < 0.001），成年男性（2020年：aIR = 1.58，P < 0.001；2021年：aIR = 2.64，P < 0.001；2022年：aIR = 3.13，P < 0.001），成年女性（2020年：aIR = 1.13，P = 0.01；2021年：aIR = 1.52，P < 0.001；2022年：aIR = 1.64，P < 0.001），以及老年男性成年人（2020年：aIR = 1.53，P < 0.001；2021年：aIR = 2.37，P < 0.001；2022年：aIR = 3.01，P < 0.001）。
疫情期间，与DSH相关的急诊科平均年度就诊次数增加。因此，有必要提高对香港此类弱势群体的认识，为疫情后影响做好准备。
