Excess Mortality From Suicide During the Early COVID-19 Pandemic Period in Japan: A Time-Series Modeling Before the Pandemic

Abstract

Background Suicide amidst the coronavirus disease (COVID-19) pandemic is an important issue. In Japan, the number of suicides in April 2020 decreased by nearly 20% from that in 2019. To assess the impact of an infectious disease pandemic, excess mortality is often discussed. Our main purpose was evaluating excess mortality from suicide in Japan during the early pandemic period. Methods We used data on suicides collected by the National Police Agency of Japan until June 2020. We estimated excess mortality during the early pandemic period (March–June 2020) using a time-series model of the number of suicides before the pandemic. A quasi-Poisson model was employed for the estimation. We evaluated excess mortalities by the categories of age and sex, and by prefecture. Results No significant excess mortality was observed throughout the early pandemic; instead, a downward trend in the number of suicides for both sexes was noted. For males, negative values of excess mortalities below the lower bound of the 95% prediction interval were observed in April and May. All numbers of females during the period were included in the interval, and the excess mortalities in June were positive and higher than those in April and May. In Tokyo, the number of suicides was below the lower bound throughout the period. Conclusion Our results suggest that various changes, such as communication, and social conditions amid the early COVID-19 pandemic induced a decrease in suicides in Japan. However, continuous monitoring is needed to evaluate the long-term effects of the pandemic on suicides.

Attempted suicide rates before and during the COVID-19 pandemic: interrupted time series analysis of a nationally representative sample

“…1; Bernal, Cummins, & Gasparrini, 2017 , 2020 ; Bhaskaran, Gasparrini, Hajat, Smeeth, & Armstrong, 2013 ), a quasi-experimental study design (Shadish, Cook, & Campbell, 2002 ), widely used in COVID-19 suicide research (Leske et al, 2021 ; Pirkis et al, 2021 ), to compare monthly incident suicide attempt rates before and during the COVID-19 pandemic. Data collection covered the period from 1 January 2013 to 1 February 2021, thus included three waves of severe restrictions and extended existing studies of the first wave (Anzai, Fukui, Ito, Ito, & Takahashi, 2021 ; Calderon-Anyosa & Kaufman, 2021 ; Vandoros et al, 2020 ). The ITS study design used electronic health registry data that are continuously collected over time.…”

Suicide and Health Crisis in Extremadura: Impact of Confinement during COVID-19

“…Given the antecedents of observations in previous crises on their consequences for people's mental health and the increase in suicides [4][5][6][7][8][10][11][12], a similar impact could be expected during the course of the COVID-19 pandemic. Some studies have already shown the negative consequences of this crisis on mental health [2,3,[27][28][29], but there as yet seems to be no evidence for any increase in DBS during the confinement period-rather there seems to be stability [32][33][34] or a decline [35][36][37][38][39][40]-and there are still insufficient data to indicate otherwise. Nonetheless, the possible immediate impact in the months following confinement and the general medium and long term impacts remain to be explored in greater depth.…”

“…Finally, following the recommendations of the WHO [46], in order to implement preventive programs that stop or reduce such suicidal behaviors, as for example, the existing plans of prevention of Spain's various Autonomous Communities [47][48][49], it would be necessary to monitor the epidemiological trends of suicide in specific geographic areas through studies that help determine which population groups are at greatest risk, as some affected groups (such as women, adolescents, the elderly, or people with depression and post-traumatic stress disorder) suffer more and are more vulnerable to disasters [45]. The aforecited reference studies [32][33][34][35][36][37][38][39][40] respond implicitly to the need for this type of research at a local level, and their findings will be of relevance for the design of suicide prevention strategies in their specific zones of study. In this sense, a comparative analysis of the DBS registered by the IMLyCFs of Spain's various Autonomous Communities would show whether the results of this present study done at a local level are generalizable nationally.…”

“…In Leipzig (Germany), there was an intra-annual reduction in DBS registered between the confinement and nonconfinement months of 2020, although no significant differences were found when the comparison was with the years 2015-2019 (RR = 1.084; CI: 0.665-1.766) [34]. In the same line, research in Japan [35] found a 14% decline during the months of February to June (RR = 0.86; CI: 0.82-0.90) and a 16% increase during the months of July to October (RR = 1.16; CI: 1.11-1.21) relative to the preceding 5 years, although another study in Japan, which compared the period from March to June 2020 with the same period of the preceding 10 years [36], did not find any significant differences, but it did find an overall decrease in cases. Norway [37] and Korea [38] have published DBS statistics for the first months of the pandemic.…”

“…Early studies during the first months of the pandemic found no significant increase in DBS. Indeed, while some indicated absence of significant differences in any direction [32][33][34], others found a decrease in suicides during confinement in the first months of the pandemic [35][36][37][38][39][40].…”