Despair in the time of COVID: A look at suicidal ingestions reported to the California Poison Control System during the pandemic

Abstract

Background Despite concern that the global pandemic will worsen depression and suicide rates, there remain little data on its actual effect. The purpose of this study was to determine the effect of the COVID‐19 pandemic on suicidal ingestions reported to the California Poison Control System (CPCS). Methods This was a cross‐sectional comparison of suicidal ingestions reported to the CPCS during the 2020 COVID‐19 pandemic compared to suicidal ingestions reported during the same period in 2018 and 2019. Results The CPCS received 19,607 call for suicidal ingestions during the study periods, of which 13,800 were in the pre‐COVID era (2018 and 2019) and 5,807 were in the COVID era. The median (IQR) number of suicidal ingestions per month decreased from 2,286 (2,240–2,364) to 1,940 (1,855–2,045; p = 0.02). This decrease was consistent and significant across all age groups except those age 70 or older. Ingestions without adverse events decreased by 101 cases/month (95% confidence interval [CI] = 136.8 to 65; p = 0.0003), minor outcomes decreased by 156.6 cases/month (95% CI = 226.2 to 87.1; p = 0.001), and moderate outcomes decreased by 96 cases/month (95% CI = 143.9 to 48.1; p = 0.00021). Major outcomes decreased from 793 (4.99%) cases in the pre‐COVID era to 315 (4.60%) cases in the COVID era (risk ratio = 0.92, 95% CI = 0.81 to 1.05). The number of deaths decreased by 3.7 cases/month (95% CI = –8.3 to 0.92, p = 0.10). Conclusions Despite concern for worsening suicidality, calls regarding suicidal ingestions to the nation's largest poison control center decreased during the COVID era compared to the pre‐COVID era. This study provides evidence that the pandemic's effects on modern society remain difficult to predict. Further effort is needed to understand how pandemic will affect American's mental health.

Impact of the COVID-19 pandemic on suicidal attempts and death rates: a systematic review

“…Sixteen (16) studies (88.9%) had a cross-sectional design and two studies [ 24 , 26 ] have followed cohort design. Out of 18 studies included, 8 (44.4%) were from the United State of America [ 22 , 24 , 26 , 30 , 32 , 34 , 36 , 38 ], 4 (22.2%) from Japan [ 25 , 27 , 29 , 35 ], 2 (11.1%) from India [ 23 , 37 ] and 1 (5.6%) each from Austria [ 31 ], Canada [ 33 ], German [ 28 ] and Nepal [ 39 ].…”

“…The main characteristics of the included studies are listed in Table 1. Some of the studies' studied samples were composed only of suicidal attempts or suicidal deaths [22][23][24][25][26][27][28][29], while some of the studies included a wider sample to see the incidence of suicidal deaths and suicidal attempts [30][31][32][33][34][35][36][37][38]. The sample sizes of the studies that included only the suicidal deaths or suicidal attempts were ranged from 53 to 17,794.…”

Temporal trends in calls for suicide attempts to poison control centers in France during the COVID-19 pandemic: a nationwide study

“…Of note, ingestions are involved in approximately 80% of all suicide attempts presenting to hospitals [ 26 ]. To our knowledge, only one study has used PCC data to assess the impact of the pandemic, this showing decreased numbers of calls in California in 2020 compared to 2019 and 2018 [ 27 ].…”

“…Our first objective was to assess trends in calls for suicide attempts during the COVID-19 pandemic (until May 31 st , 2022) as compared to pre-pandemic years, using national data on calls to PCCs with regard to intentional ingestion of drugs or other toxic substances. We also aimed to investigate the relevance of using calls to PCCs as a means of monitoring suicide attempts at the national level [ 27 ]. Based on available data, we hypothesized an initial decrease in calls to PCCs mirroring data on self-harm hospitalizations, followed by a rebound in young people during the subsequent stage of the pandemic.…”

Have deaths of despair risen during the COVID-19 pandemic? A rapid systematic review

“…Findings varied depending on the outcomes. The rate of suicides was not observed to increase during the pandemic 32,38,45,59,61,90 , though some studies indicated a potential drop in comparison to pre-pandemic years [26][27][28]33,46,49,51,52,58,62,89,91 . There were only a few countries, such as Japan, reported contradictory results for suicide.…”