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Monthly suicide rates during the COVID-19 pandemic: Evidence from Japan.

ABSTRACT: This paper uses 2018-2020 prefecture-month-year, gender-month-year, and age group-month-year level data on suicide rates in Japan to document how suicide rates are evolving during the COVID-19 pandemic. I use a monthly event study design to study changes in suicide rates surrounding Japan's COVID-19 state of emergency and to trace out monthly changes in suicide rates during the first 11 months of 2020 relative to 2018-2019. I find that monthly suicide rates during the pandemic started increasing meaningfully in June-July 2020. I find that women experienced greater increases in suicide rates than men, relative to their 2018-2019 average suicide rate, and that women experienced the largest increase in suicide rates in October 2020. I also find descriptive evidence that in terms of suicide, individuals under 30 years old were faring worse during the pandemic.

SUBMITTER: Ruiz Sanchez G

PROVIDER: S-EPMC8446371 | biostudies-literature | 2021 Oct

REPOSITORIES: biostudies-literature

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Monthly suicide rates during the COVID-19 pandemic: Evidence from Japan.

Ruiz Sánchez Gerardo G

Economics letters 20210730

This paper uses 2018-2020 prefecture-month-year, gender-month-year, and age group-month-year level data on suicide rates in Japan to document how suicide rates are evolving during the COVID-19 pandemic. I use a monthly event study design to study changes in suicide rates surrounding Japan's COVID-19 state of emergency and to trace out monthly changes in suicide rates during the first 11 months of 2020 relative to 2018-2019. I find that monthly suicide rates during the pandemic started increasing ...[more]

PMID: 34548722

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Project description:ImportanceAlthough the suicide rate in Japan increased during the COVID-19 pandemic, the reasons for suicide have yet to be comprehensively investigated.ObjectiveTo assess which reasons for suicide had rates that exceeded the expected number of suicide deaths for that reason during the COVID-19 pandemic.Design, setting, and participantsThis national, population-based cross-sectional study of data on suicides gathered by the Ministry of Health, Labor, and Welfare from January 2020 to May 2021 used a times-series analysis on the numbers of reason-identified suicides. Data of decedents were recorded by the National Police Agency and compiled by the Ministry of Health, Labor, and Welfare.ExposureFor category analysis, we compared data from January 2020 to May 2021 with data from December 2014 to June 2020. For subcategory analysis, data from January 2020 to May 2021 were compared with data from January 2019 to June 2020.Main outcomes and measuresThe main outcome was the monthly excess suicide rate, ie, the difference between the observed number of monthly suicide deaths and the upper bound of the 1-sided 95% CI for the expected number of suicide deaths in that month. Reasons for suicide were categorized into family, health, economy, work, relationships, school, and others, which were further divided into 52 subcategories. A quasi-Poisson regression model was used to estimate the expected number of monthly suicides. Individual regression models were used for each of the 7 categories, 52 subcategories, men, women, and both genders.ResultsFrom the 29 938 suicides (9984 [33.3%] women; 1093 [3.7%] aged <20 years; 3147 [10.5%] aged >80 years), there were 21 027 reason-identified suicides (7415 [35.3%] women). For both genders, all categories indicated monthly excess suicide rates, except for school in men. October 2020 had the highest excess suicide rates for all cases (observed, 1577; upper bound of 95% CI for expected number of suicides, 1254; 25.8% greater). In men, the highest monthly excess suicide rate was 24.3% for the other category in August 2020 (observed, 87; upper bound of 95% CI for expected number, 70); in women, it was 85.7% for school in August 2020 (observed, 26; upper bound of 95% CI for expected number, 14).Conclusions and relevanceIn this study, observed suicides corresponding to all 7 categories of reasons exceeded the monthly estimates (based on data from before or during the COVID-19 pandemic), except for school-related reasons in men. This study can be used as a basis for developing intervention programs for suicide prevention.

Project description:BackgroundThe COVID-19 pandemic posed many mental health challenges to youth through unprecedented infection control measures such as nationwide school closures. Despite this, few studies have investigated trends in suicide among youth during the pandemic, let alone their reasons.MethodsPopulation-level data on crude monthly suicide rates (2016-2021) and reasons of suicide (2018-2020) among youth aged 10-19 years were obtained from the Japanese Ministry of Health, Labour and Welfare and the National Police Agency, respectively. Using an event study design (with a Poisson regression model to calculate changes-in-changes (CiC) estimates) and interrupted time series analysis, we investigated changes in monthly suicide rates during the first 12 months of the pandemic (May 2020 to April 2021) compared to pre-pandemic levels (May 2016 to March 2020). Additionally, we investigated the changes in reasons of suicide (family-related, mental illness, social concerns, and academic concerns).FindingsIn the event study analysis, suicide rates among youth increased during the pandemic relative to pre-pandemic levels, especially between August-November 2020 (e.g., ratio of the suicide rate in November 2020 relative to previous years, 1.86; 95% confidence interval (CI), 1.30 to 2.66). Though suicide levels returned closer to pre-pandemic levels by December 2020, they remained slightly elevated into 2021. In the interrupted time series analysis, suicide rates increased from May to August 2020 (0.099 cases per 100,000 youth per month; 95% CI, 0.022 to 0.176), followed by a decrease from September to December 2020 (-0.086 cases per 100,000 youth per month; 95% CI, -0.164 to -0.009). We observed elevated suicide rates for all major reasons from summer to autumn 2020, especially suicides attributed to family-related problems and social concerns. Furthermore, rates of suicides attributed to mental illness remained higher than pre-pandemic levels into December 2020.InterpretationSuicide rates among youth remained slightly elevated compared to pre-pandemic levels into 2021. The reasons of the increase in suicide rates were multifactorial, including mental health issues and disruptions in social relationships. During a pandemic, interventions that provide mental support as well as opportunities for regular social interactions to youth may be beneficial.FundingNorwegian Agency for International Cooperation and Quality Enhancement in Higher Education.

Project description:ImportanceThere are concerns that suicide rates may have increased during the coronavirus disease 2019 (COVID-19) pandemic.ObjectiveTo assess whether suicide rates in Japan increased in April through November 2020 compared with previous years.Design, setting, and participantsThis cross-sectional study used national data obtained from the Ministry of Health, Labor and Welfare from 2016 to 2020 on the monthly number of individuals who died of suicide in Japan from January to November of 2016 to 2020.Exposure2020 vs previous years.Main outcomes and measuresThe main outcome was monthly suicide rates, calculated as the number of individuals who died of suicide divided by the total population. A difference-in-difference regression model was used to estimate the change in monthly suicide rates in April to November 2020 vs these months in 2016 to 2019.ResultsAnalyses included 90 048 individuals (61 366 [68.1%] men) who died of suicide from 2016 to 2020. The difference-in-difference analysis of men showed that there was no increase in suicide rates from April through September 2020 compared with these months in 2016 to 2019, but that suicide rates were increased in October (difference-in-difference, 0.40 [95% CI, 0.14 to 0.67] suicide deaths per 100 000 population) and November (difference-in-difference, 0.34 [95% CI, 0.07 to 0.60] suicide deaths per 100 000 population). Among women, suicide rates in 2020 compared with 2016 to 2019 increased in July (difference-in-difference, 0.24 [95% CI, 0.09 to 0.38] suicide deaths per 100 000 population), August (difference-in-difference, 0.30 [95% CI, 0.16 to 0.45] suicide deaths per 100 000 population), September (difference-in-difference, 0.29 [95% CI, 0.15 to 0.44] suicide deaths per 100 000 population), October (difference-in-difference, 0.62 [95% CI, 0.48 to 0.77] suicide deaths per 100 000 population), and November (difference-in-difference, 0.29 [95% CI, 0.15 to 0.44] suicide deaths per 100 000 population). In secondary analyses in which the suicide rates of 2020 were compared with the expected rates based on trends from 2011 to 2019, the increases in suicide rates were most pronounced among men aged younger than 30 years (eg, November: observed vs expected rate ratio [RR], 1.48 [95% CI, 1.26-1.71]) and women aged younger than 30 years (eg, October: observed vs expected RR, 2.14 [95% CI, 1.76 to 2.52]) and 30 to 49 years (eg, October: observed vs expected RR, 2.30 [95% CI, 2.01 to 2.58]).Conclusions and relevanceThese findings suggest that compared with previous years, suicide rates in Japan in 2020 increased in October and November for men and in July through November for women.

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Monthly suicide rates during the COVID-19 pandemic: Evidence from Japan.

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Monthly suicide rates during the COVID-19 pandemic: Evidence from Japan.

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