Abstract
Background
There are widespread concerns that the COVID-19 pandemic may increase suicides. Few studies have analysed effects beyond the pandemic's early months or examined changes in known suicide risk factors.
Methods
Using time series models fit with Poisson regression, we analysed monthly police-reported suicides in Ecuador from January 2015 to June 2021. Treating March 2020 as the start of the pandemic, we calculated rate ratios (RRs) comparing the observed to the expected number of suicides for the total population and by age and sex groups. We investigated changes in risk factors, precipitants, geographic distribution, and suicide methods.
Findings
There was no evidence that suicide rates were higher than expected during the pandemic (RR 0·97 [95% CI 0·92–1·02]). There was some evidence of fewer than expected male suicides (RR 0·95 [95% CI 0·90–1·00]). The proportion of suicides occurring in urban and coastal areas increased but decreased amongst indigenous and other minorities. The proportions of suicides with evidence of alcohol consumption, disability, and amongst married and cohabiting individuals decreased, whereas suicides where mental health problems were considered contributory increased. There were relative increases in the proportion of suicides by hanging but decreases in self-poisoning and other suicide methods.
Interpretation
The pandemic did not appear to adversely impact overall suicide numbers nationwide during the first 16 months of the pandemic. Reduced alcohol consumption may have contributed to the decline in male suicides.
There are widespread concerns that the COVID-19 pandemic may increase suicides. Few studies have analysed effects beyond the pandemic's early months or examined changes in known suicide risk factors.
Methods
Using time series models fit with Poisson regression, we analysed monthly police-reported suicides in Ecuador from January 2015 to June 2021. Treating March 2020 as the start of the pandemic, we calculated rate ratios (RRs) comparing the observed to the expected number of suicides for the total population and by age and sex groups. We investigated changes in risk factors, precipitants, geographic distribution, and suicide methods.
Findings
There was no evidence that suicide rates were higher than expected during the pandemic (RR 0·97 [95% CI 0·92–1·02]). There was some evidence of fewer than expected male suicides (RR 0·95 [95% CI 0·90–1·00]). The proportion of suicides occurring in urban and coastal areas increased but decreased amongst indigenous and other minorities. The proportions of suicides with evidence of alcohol consumption, disability, and amongst married and cohabiting individuals decreased, whereas suicides where mental health problems were considered contributory increased. There were relative increases in the proportion of suicides by hanging but decreases in self-poisoning and other suicide methods.
Interpretation
The pandemic did not appear to adversely impact overall suicide numbers nationwide during the first 16 months of the pandemic. Reduced alcohol consumption may have contributed to the decline in male suicides.
| Original language | English |
|---|---|
| Article number | 100324 |
| Number of pages | 10 |
| Journal | The Lancet Regional Health - Americas |
| Volume | 14 |
| Early online date | 25 Jul 2022 |
| DOIs | |
| Publication status | Published - 1 Oct 2022 |
Bibliographical note
Funding Information:We acknowledge the National Police of Ecuador, specifically the National Directorate of Crimes Against Life, Violent Deaths, Disappearances, Extortion and Kidnapping (DINASED) for sharing requested information about suicides in police reports and providing relevant information relating to the methodology of the data collection. DG is supported by the NIHR Biomedical Research Centre at University Hospitals Bristol and Weston NHS Foundation Trust and the University of Bristol, England. The views expressed in this publication are those of the author(s) and not necessarily those of the NHS, the National Institute for Health Research or the Department of Health and Social Care.
Funding Information:
We acknowledge the National Police of Ecuador, specifically the National Directorate of Crimes Against Life, Violent Deaths, Disappearances, Extortion and Kidnapping (DINASED) for sharing requested information about suicides in police reports and providing relevant information relating to the methodology of the data collection. DG is supported by the NIHR Biomedical Research Centre at University Hospitals Bristol and Weston NHS Foundation Trust and the University of Bristol, England. The views expressed in this publication are those of the author(s) and not necessarily those of the NHS, the National Institute for Health Research or the Department of Health and Social Care.
Funding Information:
Matthew Spittal is a recipient of an Australian Research Council Future Fellowship (project number FT180100075) funded by the Australian Government. David Gunnell receives funding support from the NIHR Biomedical Research Centre at University Hospitals Bristol and Weston NHS Foundation Trust. Stuart Leske is a recipient of a grant from Queensland Health. The other authors declare no competing interests.
Publisher Copyright:
© 2022 The Authors
Structured keywords
- SASH
Keywords
- suicide
- COVID-19
- risk factors
- Ecuador
Access to Document
- Full-text PDF (final published version)
This is the final published version of the article (version of record). It first appeared online via The Lancet Group at https://doi.org/10.1016/j.lana.2022.100324. Please refer to any applicable terms of use of the publisher.
Handle.net
Full-text PDF (author accepted manuscript)
Accepted author manuscript, 228 KB
Supplementary information PDF
Accepted author manuscript, 223 KB