Excess suicides in Brazil: Inequalities according to age groups and regions during the COVID-19 pandemic

Abstract

Background: The COVID-19 pandemic has already claimed more than six million direct deaths. Low-and middle-income countries, such Brazil, were severely hit, not only due to direct effects on mortality, but also for its indirect effects on other causes of deaths. Aims: The objective of this study was to estimate the excess suicides in Brazil and evaluate patterns within and between its regions during the COVID-19 pandemic in 2020. Method: The observed suicides are gathered from the mortality information system of the Brazilian Ministry of Health. The estimates of expected suicides, according to sex, age group, bimonthly period and region, were reached through quasi-Poisson generalized additive models, with adjustment for overdispersion. The analyses were performed in R software, version 3.6.1 and RStudio, version 1.2.1335. Results: From March 2020 to December 2020, 10,409 suicides were observed in Brazil, resulting in an overall decrease of 13%, in comparison to the expected rate for the period. There were excess suicides of 26% in men from the Northern region in the 60 years and more age group, as well as in women from the Northern region in the 30 to 59 years age group in two consecutive bimonthly periods. Excess suicides of 40% was also observed in women in the 60 years and more age group from the Northeastern region. Conclusions: Despite the overall decrease in suicides in Brazil over the period assessed, substantial excess suicides were observed in different age groups and sexes from the Northern and Northeastern regions of the country, which are regions that are historically more prone to health and socioeconomic inequalities.

Covid-19: Suicide rates fell during Brazil’s first wave but increased in older people

“…Their findings, published in the International Journal of Social Psychiatry ,1 follow studies in other countries that also found decreased suicide rates during the height of the pandemic. In the UK the number of suicides in 2020 was lower than in 2019 despite strict lockdowns being implemented to slow the transmission of SARS-CoV-2 2…”

“…The number of people who died by suicide in Brazil in 2020 declined overall despite the country being one of the worst affected in the world by the covid-19 pandemic, a study by the country’s leading public health institute has found 1…”

The impact of the SARS-CoV-2 pandemic on cause-specific mortality patterns: a systematic literature review

“…Of these, 56 were excluded after the full-text screening. We extracted relevant data from the final set of 22 articles (Brant et al 2020 ; Fernandes et al 2021 ; Décarie and Michaud 2021 ; Liu et al 2021 ; Li et al 2021 ; Shoaib et al 2021 ; Wu et al 2021a , b ; Al Wahaibi et al 2021 ; Wang et al 2021 ; Wu et al 2021a , b ; Kontopantelis et al 2021 ; Sharma et al 2021 ; Faust et al 2021 ; Grande et al 2022 ; Palacio-Mejía et al 2022 ; Gobiņa et al 2022 ; Perotti et al 2022 ; Jardim et al 2022 ; Glei 2022 ; Orellana and de Souza 2022 ; Odd et al 2022 ; Chen et al 2022 ).

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“…Among the 22 articles selected for data extraction, one was published in 2020 (Brant et al 2020 ), 12 were published in 2021 (Fernandes et al 2021 ; Décarie and Michaud 2021 ; Liu et al 2021 ; Li et al 2021 ; Shoaib et al 2021 ; Wu et al 2021a , b ; Al Wahaibi et al 2021 ; Wang et al 2021 ; Wu et al 2021a , b ; Kontopantelis et al 2021 ; Sharma et al 2021 ; Faust et al 2021 ) and nine were published in 2022 (Grande et al 2022 ; Palacio-Mejía et al 2022 ; Gobiņa et al 2022 ; Perotti et al 2022 ; Jardim et al 2022 ; Glei 2022 ; Orellana and de Souza 2022 ; Odd et al 2022 ; Chen et al 2022 ). All the included studies used data from official governmental sources to perform their analysis.…”

Suicide risk among undergraduate students in Brazil in the periods before and during the COVID-19 pandemic: results of the SABES-Grad national survey

“…Data from 21 high- and upper-middle-income countries indicate that suicide numbers remained largely unchanged or declined (Pirkis et al, 2021 ). There was also a decrease in suicide rates in Brazil, but with an excess of suicide mortality among different age groups and sexes from the north and northeast region of the country (Orellana & Souza, 2022 ). Regarding university students, there were increases in suicide rates in Japan (Fuse-Nagase et al, 2021 ) and in suicide ideation in Germany (Brailovskaia, Teismann, Friedrich, Schneider, & Margraf, 2021 ).…”