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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)

The final, peer-reviewed published version of this preprint can be found here:

Association Between COVID-19 and Self-Harm: Nationwide Retrospective Ecological Spatiotemporal Study in Metropolitan France

Baillet M, Wathelet M, Lamer A, Frévent C, Fovet T, D'Hondt F, Notredame CE, Vaiva G, Génin M

Association Between COVID-19 and Self-Harm: Nationwide Retrospective Ecological Spatiotemporal Study in Metropolitan France

JMIR Public Health Surveill 2024;10:e52759

DOI: 10.2196/52759

PMID: 39189893

PMCID: 11370185

Association between COVID-19 and self-harm: a nationwide retrospective ecological spatiotemporal study in metropolitan France

  • Maëlle Baillet; 
  • Marielle Wathelet; 
  • Antoine Lamer; 
  • Camille Frévent; 
  • Thomas Fovet; 
  • Fabien D'Hondt; 
  • Charles-Edouard Notredame; 
  • Guillaume Vaiva; 
  • Michael Génin

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.


 Citation

Please cite as:

Baillet M, Wathelet M, Lamer A, Frévent C, Fovet T, D'Hondt F, Notredame CE, Vaiva G, Génin M

Association Between COVID-19 and Self-Harm: Nationwide Retrospective Ecological Spatiotemporal Study in Metropolitan France

JMIR Public Health Surveill 2024;10:e52759

DOI: 10.2196/52759

PMID: 39189893

PMCID: 11370185

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