Accepted for/Published in: JMIR Public Health and Surveillance
Date Submitted: Sep 14, 2023
Open Peer Review Period: Sep 14, 2023 - Sep 28, 2023
Date Accepted: May 12, 2024
(closed for review but you can still tweet)
Association between COVID-19 and self-harm: a nationwide retrospective ecological spatiotemporal study in metropolitan France
ABSTRACT
Background:
The COVID-19 pandemic has not been associated with increases in suicidal behaviour at the national, regional, or county level. However, previous studies were not conducted on a finer scale or adjusted for ecological factors. Our objective was to assess the fine-scale spatiotemporal association between self-harm and COVID-19 hospitalizations, while considering ecological factors.
Objective:
Our objective was to assess the fine-scale spatiotemporal association between self-harm and COVID-19 hospitalizations, while considering ecological factors.
Methods:
Using the French national hospital discharge database, we extracted data on hospitalizations of patients aged over 10 years old for self-harm (from 2019 to 2021) or for COVID-19 (from 2020 to 2021) in metropolitan France. We first calculated monthly standardized incidence ratios (SIRs) for COVID-19 between March 2020 and December 2021, using a Besag, York, and Mollié spatiotemporal model. Next, we entered the SIRs into an ecological regression, in order to test the association between hospital admissions for self-harm and those for COVID-19. Lastly, we adjusted for ecological variables with time lags of 0 to 6 months.
Results:
Compared with a smoothed SIR of ≤1, smoothed SIRs from 1 to 3, from 3 to 4 and greater than 4 for COVID-19 hospital admissions were associated with a subsequent increase in hospital admissions for self-harm, with a time lag of 2 to 4 months, 4 months, and 6 months, respectively.
Conclusions:
A high SIR for hospital admissions for COVID-19 was a risk factor for hospital admission for self-harm some months after the epidemic peaks. This finding emphasizes the importance of monitoring and seeking to prevent suicide attempts outside the epidemic peak periods.
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Copyright
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