Hospitalization for self-harm during the early months of the Covid-19 pandemic in France: a nationwide study

Jollant, Fabrice; Roussot, Adrien; Chauvet-Gélinier, Jean-Christophe; Falissard, Bruno; Mikaeloff, Yann; Quantin, Catherine

doi:10.1101/2020.12.18.20248480

Cited by 7 publications

(12 citation statements)

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“…Nevertheless, the current national study by Jollant F et al. [5] showed a significantly increased number of self-harm hospitalizations in older people aged 75 and over in France, which would be mostly hit by COVID-19 hospitalizations and mortality. Unlike younger people, elderly suffer from increased social isolation and are more vulnerable to any pandemic and other crises (e.g., political movement) in terms of mental health.…”

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confidence: 64%

“… [5] also showed that the decrease was more obvious in younger age groups (<19 years old) and in women. Among those with self-harm admitted to hospital, however, there were increased numbers of severe cases (including self-harm by firearm, jumping from height, drowning), intensive care stay, and self-harm mortality [5] . The study has provided new evidence on the presentation of self-harm as a result of the policy effects of COVID-19, and will have important implications on the management of self-harm across populations during the COVID-19 pandemic.…”

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confidence: 87%

“…Jollant F et al. [5] also showed that the decrease was more obvious in younger age groups (<19 years old) and in women. Among those with self-harm admitted to hospital, however, there were increased numbers of severe cases (including self-harm by firearm, jumping from height, drowning), intensive care stay, and self-harm mortality [5] .…”

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confidence: 91%

“…In The Lancet Regional Health - Europe , Jollant F et al. [5] examined the impact of COVID-19 on self-harm hospitalisations in France through comprehensive analysis of the French national database Programme de Médicalisation des Systèmes d'Information (PMSI). They identified 53,583 self-harm hospitalisations during January to August 2020, and found an overall 8.5% decrease in self-harm hospital admission compared to the same period in 2019.…”

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confidence: 99%

“…There are some theories to explain the decrease in self-harm during the COVID-19 pandemic and lockdown periods, particularly in younger age groups, including so-called “pulling-together effect or honeymoon effect” [8] , less academic pressure and peer bullying due to the school closedown, more parental care and attention given to children, and increased hospital attendance due to emerged COVID-19 [5] . However, one should bear in mind that the reduction in the recorded incidence of self-harm or in presenting to hospital could be, at least partially, due to a report bias.…”

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confidence: 99%

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The complex picture of self-harm during the COVID-19 pandemic

Chen

2021

The Lancet Regional Health - Europe

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confidence: 64%

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confidence: 87%

mentioning

confidence: 91%

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confidence: 99%

mentioning

confidence: 99%

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The complex picture of self-harm during the COVID-19 pandemic

Chen

2021

The Lancet Regional Health - Europe

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Self-harm and the COVID-19 pandemic: A study of factors contributing to self-harm during lockdown restrictions

Hawton

Lascelles

Brand

et al. 2021

Journal of Psychiatric Research

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Introduction The COVID-19 pandemic and resulting public health measures may have major impacts on mental health, including on self-harm. We have investigated what factors related to the pandemic influenced hospital presentations following self-harm during lockdown in England. Method Mental health clinicians assessing individuals aged 18 years and over presenting to hospitals in Oxford and Derby following self-harm during the period March 23rd to May 17, 2020 recorded whether the self-harm was related to the impact of COVID-19 and, if so, what specific factors were relevant. These factors were organized into a classification scheme. Information was also collected on patients’ demographic characteristics, method of self-harm and suicide intent. Results Of 228 patients assessed, in 46.9% (N = 107) COVID-19 and lockdown restrictions were identified as influencing self-harm. This applied more to females than males (53.5%, N = 68/127 v 38.6%, N = 39/101, χ 2 = 5.03, p = 0.025), but there were no differences in age, methods of self-harm or suicide intent between the two groups. The most frequent COVID-related factors were mental health issues, including new and worsening disorders, and cessation or reduction of services (including absence of face-to-face support), isolation and loneliness, reduced contact with key individuals, disruption to normal routine, and entrapment. Multiple, often inter-connected COVID-related factors were identified in many patients. Conclusions COVID-related factors were identified as influences in nearly half of individuals presenting to hospitals following self-harm in the period following introduction of lockdown restrictions. Females were particularly affected. The fact that mental health problems, including issues with delivery of care, predominated has implications for organisation of services during such periods. The contribution of isolation, loneliness and sense of entrapment highlight the need for relatives, friends and neighbours to be encouraged to reach out to others, especially those living alone. The classification of COVID-related factors can be used as an aide-memoire for clinicians.

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

et al. 2021

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Background To characterize the association between the protracted biopsychosocial coronavirus disease 2019 (COVID-19) pandemic exposures and incident suicide attempt rates. Methods Data were from a nationally representative cohort based on electronic health records from January 2013 to February 2021 (N = 852 233), with an interrupted time series study design. For the primary analysis, the effect of COVID-19 pandemic on incident suicide attempts warranting in-patient hospital treatment was quantified by fitting a Poisson regression and modeling the relative risk (RR) and the corresponding 95% confidence intervals (CIs). Scenarios were forecast to predict attempted suicide rates at 10 months after social mitigation strategies. Fourteen sensitivity analyses were performed to test the robustness of the results. Results Despite the increasing trend in the unexposed interval, the interval exposed to the COVID-19 pandemic was statistically significant (p < 0.001) associated with a reduced RR of incident attempted suicide (RR = 0.63, 95% CI 0.52–0.78). Consistent with the primary analysis, sensitivity analysis of sociodemographic groups and methodological factors were statistically significant (p < 0.05). No effect modification was identified for COVID-19 lockdown intervals or COVID-19 illness status. All three forecast scenarios at 10 months projected a suicide attempt rate increase from 12.49 (7.42–21.01) to 21.38 (12.71–35.99). Conclusions The interval exposed to the protracted mass social trauma of the COVID-19 pandemic was associated with a lower suicide attempt rate compared to the unexposed interval. However, this trend is likely to reverse 10 months after lifting social mitigation policies, underscoring the need for enhanced implementation of public health policy for suicide prevention.

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Hospitalization for self-harm during the early months of the Covid-19 pandemic in France: a nationwide study

Cited by 7 publications

References 31 publications

The complex picture of self-harm during the COVID-19 pandemic

The complex picture of self-harm during the COVID-19 pandemic

Self-harm and the COVID-19 pandemic: A study of factors contributing to self-harm during lockdown restrictions

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

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