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. 2020 Oct 16;42(6):474–487. doi: 10.1027/0227-5910/a000753

Table 1. Critical gaps in the literature regarding the impact of infectious disease-related public health emergencies (epidemics) on suicide or suicide-related outcomes.

Critical gaps in literature
1 What is the association between COVID-19 and rates of suicide and related outcomes across regions and cultures both in the short and long term?
2 What is the trajectory of any observed changes (e.g., an initial decrease in suicide outcomes due to a "pulling together" phenomenon followed by a steady increase vs. an initial increase that slowly dissipates)?
3 Are there particular populations (e.g., older adults, frontline healthcare workers, high population density/urban dwellers, men) who are at elevated risk of suicide outcomes during pandemics compared with baseline rates? And, if so, are they amenable to targeted interventions?
4 Are those directly exposed to the virus or their families/caregivers at elevated risk of suicide outcomes, whether immediately or over the longer term?
5 What is the population-attributable risk of suicide outcomes that arises from factors unique to pandemics (e.g., social distancing; mass exposure to a virus with neuropsychiatric health sequelae) versus more general, ongoing risk factors (psychiatric illness, medical illness, access to means)?
6 Which suicide-specific (e.g., media campaigns, means restriction) and nonspecific (social safety net, efforts to reduce social isolation) population-level interventions have the greatest impact on suicide outcomes?
7 Which surveillance strategies are most effective in detecting and intervening to prevent suicide during the pandemic?
8 Can remote or virtual suicide risk assessments be conducted in a sensitive, safe, and effective fashion?
9 If rates of suicide outcomes change, what are the mechanisms or processes (neurobiological, psychological, social) that drive those changes?