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Suicide before and during the COVID-19 Pandemic: A Systematic Review with Meta-Analysis

Author

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  • Yifei Yan

    (Department of Social and Behavioural Sciences, City University of Hong Kong, Tat Chee Avenue, Kowloon, Hong Kong SAR, China)

  • Jianhua Hou

    (Department of Social and Behavioural Sciences, City University of Hong Kong, Tat Chee Avenue, Kowloon, Hong Kong SAR, China)

  • Qing Li

    (Department of Computing, The Hong Kong Polytechnic University, Hong Kong SAR, China)

  • Nancy Xiaonan Yu

    (Department of Social and Behavioural Sciences, City University of Hong Kong, Tat Chee Avenue, Kowloon, Hong Kong SAR, China)

Abstract

Synthesizing evidence to examine changes in suicide-related outcomes before and during the pandemic can inform suicide management during the COVID-19 crisis. We searched 13 databases as of December 2022 for studies reporting both the pre- and peri-pandemic prevalence of suicidal ideation, suicide attempts, or rate of death by suicide. A random-effects model was used to pool the ratio of peri- and pre-pandemic prevalence of suicidal ideation and attempt (Prevalence Ratio—PR) and rate of death by suicide (Rate Ratio; RR). We identified 51, 55, and 25 samples for suicidal ideation, attempt, and death by suicide. The prevalence of suicidal ideation increased significantly among non-clinical (PR = 1.142; 95% CI: 1.018–1.282; p = 0.024; k = 28) and clinical (PR = 1.134; 95% CI: 1.048–1.227; p = 0.002; k = 23) samples, and pooled estimates differed by population and study design. Suicide attempts were more prevalent during the pandemic among non-clinical (PR = 1.14; 95% CI: 1.053–1.233; p = 0.001; k = 30) and clinical (PR = 1.32; 95% CI: 1.17–1.489; p = 0.000; k = 25) participants. The pooled RR for death by suicide was 0.923 (95% CI: 0.84–1.01; p = 0.092; k = 25), indicating a nonsignificant downward trend. An upward trend of suicidal ideation and suicide attempts was observed during the COVID-19 pandemic, despite suicide rate remaining stable. Our findings suggest that timely prevention and intervention programs are highly needed for non-clinical adult population and clinical patients. Monitoring the real-time and long-run suicide risk as the pandemic evolves is warranted.

Suggested Citation

  • Yifei Yan & Jianhua Hou & Qing Li & Nancy Xiaonan Yu, 2023. "Suicide before and during the COVID-19 Pandemic: A Systematic Review with Meta-Analysis," IJERPH, MDPI, vol. 20(4), pages 1-30, February.
    • Handle: RePEc:gam:jijerp:v:20:y:2023:i:4:p:3346-:d:1068125
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    References listed on IDEAS

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    1. Takanao Tanaka & Shohei Okamoto, 2021. "Increase in suicide following an initial decline during the COVID-19 pandemic in Japan," Nature Human Behaviour, Nature, vol. 5(2), pages 229-238, February.
    2. Dian-Jeng Li & Nai-Ying Ko & Yi-Lung Chen & Peng-Wei Wang & Yu-Ping Chang & Cheng-Fang Yen & Wei-Hsin Lu, 2020. "COVID-19-Related Factors Associated with Sleep Disturbance and Suicidal Thoughts among the Taiwanese Public: A Facebook Survey," IJERPH, MDPI, vol. 17(12), pages 1-12, June.
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    1. Ryusuke Matsumoto & Eishi Motomura & Motohiro Okada, 2024. "Impacts of Working Hours, Wages, and Regular Employment Opportunity on Suicide Mortalities of Employed and Unemployed Individuals before and during the COVID-19 Pandemic in Japan," IJERPH, MDPI, vol. 21(4), pages 1-17, April.

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