Self-injury, suicidal ideation and -attempt and eating disorders in young people following the initial and second COVID-19 lockdown

Abstract

Summary Background: The initial COVID-19 lockdowns have had negative effect on different mental health measures, especially in young women. However, the impact on self-injury, suicidality and eating disorder (ED) are less elucidated and remains inconsistent. We compare self-reported self-injury, suicide ideation and -attempt and symptoms of EDs from before through different pandemic periods until spring 2021. Methods: Young participants in the Danish National Birth Cohort reported these measures in an 18-year follow-up in 2015-2021 and in a COVID-19 survey in spring 2021 when participants were aged 19-24 years. Changes in measures from pre to post lockdown were estimated with longitudinal data (N=7,597) and with repeated cross-sectional data (N=24,625) by linear regression. Findings: In the longitudinal comparisons 14% of women and 7% of men reported self-injury pre lockdown, which decreased 6%-points (95% CI:-7%;-5%) for women and 3%-points (95% CI:-4%;-2%) for men during lockdown. For suicide ideation, the pre lockdown proportions were 25% and 18% for women and men respectively, and decreased 7%-points (95% CI:-8%;-6%) for women and 3%-points (95% CI:-5%;-1%) for men. For suicide attempt no change was observed. Pre lockdown 15% and 3% of women and men, respectively, had symptoms of EDs, which decreased 2%-points (95% CI:-3%;-1%) for women. We observed no changes in proportions of self-injury, suicide ideation or EDs in the repeated cross-sectional data. Interpretation: Our findings provide no support for increase in self-injury, suicidality and EDs following the lockdowns, and if anything, indicate a reduction in self-injury and suicide ideation as well as EDs in women.

Suicide before and during the COVID-19 Pandemic: A Systematic Review with Meta-Analysis

“…A total of 8642 studies were screened, with 72 studies (131 samples) meeting the inclusion criteria. Among them, 16 [ 10 , 11 , 51 , 52 , 53 , 54 , 55 , 56 , 57 , 58 , 59 , 60 , 61 , 62 , 63 , 64 ], 11 [ 65 , 66 , 67 , 68 , 69 , 70 , 71 , 72 , 73 , 74 , 75 ], and 19 [ 8 , 13 , 14 , 76 , 77 , 78 , 79 , 80 , 81 , 82 , 83 , 84 , 85 , 86 , 87 , 88 , 89 , 90 , 91 ] only addressed changes in suicidal ideation, suicide attempt, and death by suicide, respectively; 25 [ 9 , 12 , 15 , 16 , 92 , 93 , 94 , …”

“… Forest plot for suicidal ideation of studies [ 9 , 10 , 11 , 12 , 15 , 51 , 52 , 53 , 54 , 55 , 56 , 57 , 58 , 61 , 64 , 93 , 97 , 98 , 99 , 100 , 102 , 108 , 112 ] conducting in the non-clinical setting (Prismatic colored as red refers to the pooled estimate). …”

“…The suicide risk was expected to be alarmingly severe over the short or long run following the outbreak of the COVID-19 pandemic, due to widespread and prolonged economic, social, health, and psychological vulnerability [ 6 , 7 ]. A few primary studies found an overall increase in the prevalence of suicidal ideation and attempts, and in the rate of death by suicide during the pandemic period compared with the pre-pandemic period [ 8 , 9 , 10 ], while other studies found a decreased trend [ 11 , 12 , 13 ], and some reported an overall stable trend [ 14 , 15 , 16 ]. Suicide studies during the pandemic tend to be methodologically poor [ 17 ], and high-quality evidence from an interrupted time-series study covering 33 countries showed no significant increases in suicide death in most countries/regions [ 18 ].…”

The impact of the initial and second national COVID-19 lockdowns on mental health in young people with and without pre-existing self-injury, suicide ideation, and ED symptoms

“…Pre-existing self-injury and suicide ideation were binary variables de ned as being at least one time within the last year. ED symptoms were de ned as having at least monthly symptoms based on multiple variables as described in Danielsen et al [2].…”

“…The mental health burden induced by COVID-19 pandemic and the lockdowns was suggested early on to have a disproportional impact on vulnerable subgroups, including people with a pre-existing mental health problem [1] In a previous study, we demonstrated no increase in the proportions of young people with self-injury, suicide ideation, and eating disorder symptoms (ED), respectively, following the two national lockdowns in Denmark [2]. The evidence is however inconsistent, as the impact of lockdowns on young people with pre-existing mental health problems have been suggested to be positive and negative [3][4][5][6][7].…”