SUICIDE AND SUICIDE ATTEMPTS IN THE FIRST 24 MONTHS OF THE COVID-19 PANDEMIC IN CHILE
Authors
-
Dagoberto Duarte Quapper
Profesional y Consultor independiente
https://orcid.org/0000-0002-3689-9666
Abstract
Introduction: this study investigates the evolution of mortality from suicide and suicide attempts in the context of the COVID-19 pandemic in Chile. Objective: to study the monthly evolution of suicide mortality and hospital discharges associated with self-inflicted injuries in the first 24 months of the COVID-19 pandemic in the general population and according to sex in Chile. Methods: the study is quantitative, population-based and retrospective. Data from the mortality registry and hospital discharge statistics from the Ministry of Health were used. Monthly rates of deaths by suicide and self-inflicted injuries were calculated from March 2015 to February 2020; monthly suicide rates from March 2020 to February 2022 and self-inflicted injuries for hospital discharges from March 2020 to December 2021. A 95% CI was calculated from the expected rates and compared with the observed rates. Results: there was a significant decrease in suicide mortality rates, particularly among men, which returned to their pre-pandemic level at the end of the period. Suicide attempts drop in the first year and have a significant increase in the second year, especially in the female population. Conclusion: the rates of suicide mortality and suicide attempts evolved differently from those observed in other countries. There were differences by sex in both indicators. The findings are relevant for Public Health and Primary Health Care.
Keywords:
COVID-19, pandemics, suicide, suicide attempt, sexReferences
Suicide worldwide in 2019: global health estimates. Geneva: World Health Organization; 2021. Licence: CC BY-NC-SA 3.0 IGO.
Zortea TC, Brenna CTA, Joyce M, McClelland H, Tippett M, Tran MM, et al. The impact of infectious disease-related public health emergencies on suicide, suicidal behavior, and suicidal thoughts: A systematic review. Crisis [Internet]. 2021;42(6):474–87. Available from: http://dx.doi.org/10.1027/0227-5910/a000753
McIntyre RS, Lee Y. Projected increases in suicide in Canada as a consequence of COVID-19. Psychiatry Research [Internet]. 2020 Aug 1;290:113104. Available from: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7236718/
McIntyre RS, Lee Y. Preventing suicide in the context of the COVID ‐19 pandemic. World Psychiatry. 2020 June;19(2):250-1.
Reger MA, Stanley IH, Joiner TE. Suicide Mortality and Coronavirus Disease 2019-A Perfect Storm? JAMA Psychiatry [Internet]. 2020 Apr 10;77(11). Available from: https://jamanetwork.com/journals/jamapsychiatry/fullarticle/2764584
Duarte F, Jiménez-Molina Á. Psychological distress during the COVID-19 epidemic in Chile: The role of economic uncertainty. Brenner MH, editor. PLOS ONE. 2021 Nov 3;16(11): e0251683.
Dubé JP, Smith MM, Sherry SB, Hewitt PL, Stewart SH. Suicide behaviors during the COVID-19 pandemic: A meta-analysis of 54 studies. Psychiatry Research. 2021 Jul; 301:113998.
Bhuiyan AKMI, Sakib N, Pakpour AH, Griffiths MD, Mamun MA. COVID-19-related suicides in Bangladesh due to lockdown and economic factors: Case study evidence from media reports. Int J Ment Health Addict [Internet]. 2021;19(6):2110–5. Available from: http://dx.doi.org/10.1007/s11469-020-00307-y
Gunnell D, Appleby L, Arensman E, Hawton K, John A, Kapur N, et al. Suicide risk and prevention during the COVID-19 pandemic. Lancet Psychiatry. 2020;7(6):468-471. doi:10.1016/S2215-0366(20) 30171-1
Galea S, Merchant RM, Lurie N. The mental health consequences of COVID-19 and physical distancing: the need for prevention and early intervention. JAMA Intern Med. 2020;180(6):817-818. doi:10.1001/jamainternmed.2020.1562
Pirkis J, John A, Shin S, DelPozo-Banos M, Arya V, Analuisa-Aguilar P, et al. Suicide trends in the early months of the COVID-19 pandemic: an interrupted time-series analysis of preliminary data from 21 countries. The Lancet Psychiatry [Internet]. 2021 Apr 13;0(0). Available from: https://www.thelancet.com/journals/lanpsy/article/PIIS2215-0366(21)00091-2/fulltext
Instituto Nacional de Estadística (INE). Censo 2017. Estimaciones y proyecciones de la población de Chile 1992-2050 total país. Accedido via internet el 07-12-2019.
Naghavi M; Global Burden of Disease Self-Harm Collaborators. Global, regional, and national burden of suicide mortality 1990 to 2016: systematic analysis for the Global Burden of Disease Study 2016. BMJ. 2019;364: l94. doi: 10.1136/bmj.l94
Ministerio de Salud. Gobierno de Chile. Programa nacional de prevención del suicidio. Orientaciones para su Implementación, 2013.
Arce, M., Vega, C., Moya, M., Muñoz, AM., Rubio, E., Nivelo, M., y cols. Ideación e intento suicida en adolescentes: factores personales, familiares y sociales. Revista Chilena de Atención Primaria y Salud Familiar. Vol. 1 (2022). DOI https://doi.org/10.5354/2735-7805.2022.67502
Ministerio de Salud. Gobierno de Chile. Herramientas de apoyo para la prevención del suicidio. Septiembre, 2021.
Duarte, D. El suicidio en Chile, estudio socio demográfico y aproximación microsocial y psicológica a la violencia ejercida contra sí mismo. Tesis presentada para la obtención del grado de Doctor en Psicología, Universidad Católica de Lovaina. 2007. Santiago de Chile. Ene 21 de 2014. Disponible en: https://www.dagobertoduarte.cl/el-suicidio-en-chile-estudio-socio-demografico-y-aproximacion-microsocial-y-psicologica-a-la-violencia-ejercida-contra-si-mismo/
Eguchi A, Nomura S, Gilmour S, Harada N, Sakamoto H, Ueda P, et al. Suicide by gender and 10-year age groups during the COVID-19 pandemic vs previous five years in Japan: An analysis of national vital statistics. Psychiatry Research [Internet]. 2021 Nov 1; 305:114173. Available from: https://www.sciencedirect.com/science/article/pii/S0165178121004698
Nomura S, Kawashima T, Harada N, Yoneoka D, Tanoue Y, Eguchi A, et al. Trends in suicide in Japan by gender during the COVID-19 pandemic, through December 2020. Psychiatry Research. 2021 Jun; 300:113913.
Sakamoto H, Ishikane M, Ghaznavi C, Ueda P. Assessment of suicide in Japan during the COVID-19 pandemic vs previous years. JAMA Netw Open [Internet]. 2021;4(2): e2037378. Available from: https://jamanetwork.com/journals/jamanetworkopen/fullarticle/2775740
Anzai T, Fukui K, Ito T, Ito Y, Takahashi K. Excess mortality from suicide during the early COVID-19 pandemic period in Japan: a time-series modeling before the pandemic. J Epidemiol. 2021;31(2):152-156. doi:10.2188/jea.JE20200443
Tanaka T, Okamoto S. Increase in suicide following an initial decline during the COVID-19 pandemic in Japan. Nat Hum Behav [Internet]. 2021;5(2):229–38. Available from: https://www.nature.com/articles/s41562-020-01042-z
Wasserman D, Iosue M, Wuestefeld A, Carli V. Adaptation of evidence-based suicide prevention strategies during and after the COVID-19 pandemic. World Psychiatry [Internet]. 2020;19(3):294–306. Available from: http://dx.doi.org/10.1002/wps.20801
Instituto Nacional de Estadística (INE). Género y empleo: impacto de la crisis económica por covid-19. Boletín estadístico. 8 de marzo de 2021. Internet, 17-09-2022.
Ueda M, Nordström R, Matsubayashi T. Suicide and mental health during the COVID-19 pandemic in Japan. J Public Health (Oxf). 2022 Aug 25;44(3):541-548. doi: 10.1093/pubmed/fdab113. PMID: 33855451; PMCID: PMC8083330.
Brooks SK, Webster RK, Smith LE, Woodland L, Wessely S, Greenberg N, et al. The psychological impact of quarantine and how to reduce it: rapid review of the evidence. Lancet [Internet]. 2020;395(10227):912–20. Available from: https://www.thelancet.com/journals/lancet/article/PIIS0140-6736(20)30460-8/fulltext)
Connor J, Madhavan S, Mokashi M, Amanuel H, Johnson NR, Pace LE, et al. Health risks and outcomes that disproportionately affect women during the Covid-19 pandemic: A review. Social Science & Medicine [Internet]. 2020;266(C). Available from: https://ideas.repec.org/a/eee/socmed/v266y2020ics0277953620305839.html
Lee SM, Kang WS, Cho A-R, Kim T, Park JK. Psychological impact of the 2015 MERS outbreak on hospital workers and quarantined hemodialysis patients. Compr Psychiatry [Internet]. 2018;87:123–7. Available from: https://pubmed.ncbi.nlm.nih.gov/30343247/
van Gelder N, Peterman A, Potts A, O’Donnell M, Thompson K, Shah N, et al. COVID-19: Reducing the risk of infection might increase the risk of intimate partner violence. E Clinical Medicine [Internet]. 2020;21(100348):100348. Available from: https://www.thelancet.com/journals/eclinm/article/PIIS2589-5370(20)30092-4/fulltext
Devries KM, Mak JY, Bacchus LJ, Child JC, Falder G, Petzold M, et al. Intimate partner violence and incident depressive symptoms and suicide attempts: a systematic review of longitudinal studies. PLoS Med [Internet]. 2013;10(5): e1001439. Available from: http://dx.doi.org/10.1371/journal.pmed.1001439
Charpignon ML, Ontiveros J, Sundaresan S, Puri A, Chandra J, Mandl KD, et al. Evaluation of Suicides Among US Adolescents During the COVID-19 Pandemic. JAMA Pediatr. 2022 Jul 1;176(7):724-726. doi: 10.1001/jamapediatrics.2022.0515. PMID: 35467724; PMCID: PMC9039827.
