Table 1.
Suicide and/or Self-Harm Behavior in People With SARS-CoV-2 in Studies With a SARS-CoV-2-Negative Comparator Group.
| Authors | Population and setting | Study design | Exposure measure | Sample size of SARS-CoV-2 infected individuals | COVID-19 status (A = Active, R = Recovered, U = Unclear) | Outcome questionnaire used | Outcome time span | Estimates/Findings | Quality assessment overall rating |
|---|---|---|---|---|---|---|---|---|---|
| Iob et al., 2020 12 | Adults (General Population) in UK March 21–April 20, 2020 |
Cross-sectional | Self-report | 198 | U | Ad hoc question asking about “self-harming or deliberately hurting” | Past week | The proportion of people engaging in self-harm behaviours was
greater in people who reported a COVID-19 diagnosis n = 28(14.2%) compared to those who did not n = 2,146(4.8%) (PR 2.94, 95%CI 2.08–4.15) |
Fair |
| Paul & Fancourt 2021 13 | Adults (General Population) in UK April 1, 2020–May 17, 2021 |
Cohort | Self-report | Not stated (overall study n = 49,324 participants) | U | Ad hoc question asking about “self-harming or deliberately hurting” | Past week | Having had COVID-19 illness increased risk of self-harm
behaviours in the total sample and ages 18–29, 45–59. For all ages/overall sample: unadjusted (OR 1.36, 95%CI 1.21–1.53) adjusted for anxiety symptoms (OR 1.35, 95%CI 1.20–1.53) adjusted for depressive symptoms (OR 1.32, 95%CI 1.17–1.50) adjusted for physical abuse and psychological abuse (OR 1.33, 95%CI 1.17–1.50) |
Good |
| Abel et al., 2021 14 | Primary care patients (aged >16) in UK February 1–December 8, 2020 |
Cohort | PCR test | Total n = 11,923,105 of whom 2.0% (232780) were recorded as having a positive PCR test | U | Clinical codes from charts for self-harm (including self-poisoning and self-injury episodes of varying suicidal intent) | Not stated | COVID-19 positive patients had higher self-harm incident
outcomes: unadjusted HR = 2.09, 95%CI = 1.20–3.64 adjusted HR = 2.21, 95%CI = 1.11–4.39 |
Good |
| Mortier et al., 2021 a 15 | Healthcare workers (from ten hospitals in four autonomous
communities in Spain: the Basque Country, Castile and Leon,
Catalonia, and the Community of Madrid) May 5–July 23, 2020 |
Cross-sectional | Self-report (subcategorized as having been hospitalized for COVID-19, having had a positive COVID-19 test or medical diagnosis not requiring hospitalization, and all others) | Having been hospitalized for COVID-19 (n = 55); Positive SARS-CoV-2 test or medical COVID-19 diagnosis (n = 845); No COVID-19 diagnosis (n = 4,264) | U | Modified self-report version of selected items from the Columbia Suicide Severity Rating Scale measuring suicide attempt (“make a suicide attempt [i.e., purposefully hurt yourself with at least some intent to die]”). | Past 30 days | The proportion of suicide attempts was greater in those
hospitalized with COVID-19 Diagnosis compared to those with no diagnosis: n = 1(1.8%) vs. 3(0.07%) (PR 25.84, 95%CI 2.73–244.58 b ) There was no difference in proportion of suicide attempts between those with a positive test and/or a medical diagnosis compared to with no diagnosis: n = 2(0.24%) vs. 3(0.07%) (PR 3.36, 95%CI 0.56–20.12 b ) |
Good |
a
This paper combined suicidal thoughts with a plan and suicide attempts. The data presented here on attempts only were provided through correspondence with the authors.
b
Calculations conducted using raw data.