Changes in the pattern of suicide attempters visiting the emergency room after COVID-19 pandemic: an observational cross sectional study

Abstract

Background This study aimed to find out the change in the rate and pattern of suicide attempts during severe acute respiratory syndrome COVID-19 pandemic period. Methods This study was a retrospective analysis of data collected as a part of an emergency room-based post-suicide management program. The data were collected through interviews and from medical records of suicide attempts, maintained in the emergency room, from January 19 to October 31, 2020, during the “COVID-19 period,” and those who attempted suicide from January 19 to October 31, 2019 “pre-COVID-19 period.” We extracted educational background, marital status, occupation, presence of domestic partner, history of mental illness, alcohol consumption, history of previous suicide attempts; suicide attempt method and location (i.e., at home or a place other than home) at the time of attempt, and whether the attempt was a mass suicide. In addition, we compared patient severity between “COVID-19 period” and “pre-COVID-19 period” using the initial KTAS (South Korean triage and acuity scale) level, consciousness level, and systolic blood pressure. In 2012, KTAS was developed through the Ministry of Health and Welfare’s research project to establish triage system in South Korea. Results The analysis of the number of suicide attempts during “pre-COVID-19 period” and “ COVID-19 period” showed that the number of suicide attempts during “COVID-19 period” (n = 440) increased compared to the “pre-COVID-19 period” (n = 400). Moreover, the method of suicide attempts during “COVID-19 period” included overdose of drugs such as hypnotics, antipsychotics, and pesticides that were already possessed by the patient increased compared to the “pre-COVID-19 period” (P < 0.05). At the time of the visit to the emergency room, high KTAS level, low level of consciousness, and low systolic blood pressure, were observed, which were significantly different between “COVID-19 period” and “pre-COVID-19 period” (P < 0.05). Conclusion With the worldwide COVID-19 virus spread, suicide rate and suicide attempts at home have significantly increased. In addition, patient severity was higher in the “COVID-19 period” than that in the “pre-COVID-19 period.” The increasing suicide attempt rate should be controlled by cooperation between the emergency room and regional organizations.

Changes in Suicide Rate and Characteristics According to Age of Suicide Attempters before and after COVID-19

“…After COVID-19, poisoning (52.4%) and cutting (40.5%) increased and general hospitalization increased (33.3%) in adolescents. This is consistent with the results of other study that post-COVID-19 poisoning and the severity increased [ 43 ]. Next, the elderly used falling (12.5%) and hanging (21.9%) methods of suicide more, and as a result, ICU admissions (15.6%) and deaths (31.3%) increased.…”

“…Next, the elderly used falling (12.5%) and hanging (21.9%) methods of suicide more, and as a result, ICU admissions (15.6%) and deaths (31.3%) increased. One study shows that the elderly use a harder method compared to other age groups [ 44 ], while another study indicates that the severity of suicide patients after COVID-19 increased [ 43 ]. In this study, harder methods such as falling and hanging were used more after COVID-19 even in the same elderly age group, which suggests the increase in deaths from this.…”

Interventions for attempted suicide

“…Emerging data from multiple settings suggests a significant increase in the rate of suicide attempts following the onset of the pandemic [32,33]. There is a need for indicated suicide prevention approaches that target high-risk groups, such as those with active Psychiatry, medicine and the behavioural sciences suicidal thoughts and behaviors.…”

Heidegger and the Technocratic Warping of the COVID-19 Pandemic

“…Kang et al (2021) investigate a rich data set out of South Korean emergency rooms in which individuals were admitted to hospitals after attempted suicides from January 19 to October 31, 2020, during the "COVID-19 period," and compare these data to cases of people that attempted suicide from January 19 to October 31, 2019. The analysis findsthat 2020 saw an increase in suicide attempts and the most common method of taking one's life were via hypnotics, antipsychotics, and pesticides-all of which were used to a greater extent than the pre-COVID-19 period (Kang et al, 2021). An analysis of a 3-month period from April to June 2020 in the United States revealed similar findings-the degree of individuals (from a sample of lockdowned population) that reported they had suicidal intentions increased (April 17.6% to 30.7% in June) (Killgore et al, 2020).…”

“…Many of the cases that experiences substantial increases in suicide also were correlated with economic decline and ruin. Kang et al (2021) investigate a rich data set out of South Korean emergency rooms in which individuals were admitted to hospitals after attempted suicides from January 19 to October 31, 2020, during the "COVID-19 period," and compare these data to cases of people that attempted suicide from January 19 to October 31, 2019. The analysis findsthat 2020 saw an increase in suicide attempts and the most common method of taking one's life were via hypnotics, antipsychotics, and pesticides-all of which were used to a greater extent than the pre-COVID-19 period (Kang et al, 2021).…”