Suicide Risk in Individuals With and Without Mental Disorders Before and During the COVID-19 Pandemic: An Analysis of Three Nationwide Cross-Sectional Surveys in Czechia

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 , …”

“…Sensitivity analysis using leave-one-out method showed that most of the included samples did not affect the outcome substantially. However, when Ettman et al [ 10 ] and Kasal et al [ 9 ] were excluded separately, the respective pooled ratio (1.007–1.112) indicated a slight but non-significant increase in the peri-pandemic prevalence of suicidal ideation compared with pre-pandemic periods ( Figure S1 ). No publication bias was observed among the non-clinical samples according to the funnel plot ( Figure S2 ) and the non-significant results from Egger’s tests ( intercept = 2.61, t = 1.48, p = 0.151).…”

“…There were 37 studies with 55 samples (30 non-clinical and 25 clinical samples, respectively) included for the analysis of suicidal ideation. Specifically, several studies contributed more than one sample due to multiple peri-pandemic data collection [ 9 , 65 , 70 , 75 , 106 , 108 ] or subsets of participants [ 75 , 103 , 111 ]. With an average risk of bias score of 7.5 (range = 4–9), the majority of included studies had adequate size and information for their sample, and they employed appropriate sampling and statistical methods.…”

“…The results for suicidal ideation and attempt were mostly robust, based on the sensitivity analysis. The only exception was found by excluding several non-clinical samples one by one [ 9 , 10 ], the pooled estimates which changed substantially, and the fact that the increases in suicidal ideation became smaller and nonsignificant, indicating the peculiarly large increases in these studies. Both studies employed a repeated cross-sectional design; therefore, those who responded to the survey in two periods may have differed in characteristics.…”

“…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 ].…”