Table 2.
Poisson models estimating effects of the first-wave and second-wave of Covid-19 on suicidal ideation (SI), suicide plans (SP) and suicide attempts (SA)
| Suicidal ideation (SI) | First-wave | p-value | Second-wave | p-value |
|---|---|---|---|---|
| RateRatio (95% CI) | RateRatio (95% CI) | |||
| Covid-19 (vs. control) | 1.614 (1.093–2.382) | 0.016 | 0.993 (0.781–1.262) | 0.953 |
| Interaction effects (time dependent) | ||||
| Borderline personality disorder by Covid-19 | 1.362 (0.815–2.276) | 0.239 | 0.822 (0.581–1.165) | 0.271 |
| Substance use disorders by Covid-19 | 0.753 (0.504–1.125) | 0.166 | 1.305 (1.008–1.689) | 0.043 |
| Depressive disorders by Covid-19 | 0.857 (0.541–1.358) | 0.512 | 1.011 (0.757–1.350) | 0.943 |
| Schizophrenia and psychotic disorders by Covid-19 | 1.031 (0.618–1.720) | 0.906 | 0.750 (0.544–1.034) | 0.079 |
| Diagnostic categories (time independent) | ||||
| Organic mental disorders | 0.761 (0.406–1.427) | 0.395 | 1.015 (0.706–1.460) | 0.936 |
| Substance use disorders | 1.482 (1.097–2.001) | 0.010 | 1.226 (1.017–1.478) | 0.033 |
| Schizophrenia and psychotic disorders | 0.851 (0.575–1.257) | 0.417 | 1.294 (1.023–1.636) | 0.032 |
| Bipolar and manic disorders | 1.015 (0.630–1.635) | 0.953 | 1.411 (1.044–1.907) | 0.025 |
| Depressive disorders | 2.187 (1.585–3.019) | < 0.001 | 2.138 (1.744–2.622) | < 0.001 |
| Neurotic, somatoform and stress related disorders | 1.379 (1.083–1.756) | 0.009 | 1.558 (1.338–1.813) | < 0.001 |
| Borderline personality disorder | 2.375 (1.616–3.491) | < 0.001 | 2.908 (2.262–3.738) | < 0.001 |
| Other personality disorders | 1.779 (1.222–2.590) | 0.003 | 2.016 (1.602–2.538) | < 0.001 |
| Sociodemographic risk factors (time independent) | ||||
| Male | 1.017 (0.825–1.252) | 0.877 | 1.145 (0.996–1.316) | 0.056 |
| Age | 0.991 (0.983–0.998) | 0.018 | 0.991 (0.986–0.997) | 0.001 |
| Living in residential therapeutic environment | 1.474 (0.960–2.264) | 0.076 | 1.350 (1.080–1.688) | 0.008 |
| Homeless | 1.431 (1.060–1.933) | 0.019 | 1.529 (1.270–1.840) | < 0.001 |
| Covid-19 risk group | 1.235 (0.959–1.590) | 0.102 | 1.437 (1.206–1.712) | < 0.001 |
| Suicide plans (SP) | ||||
| Covid-19 (vs. control) | 2.900 (1.415—5.943) | 0.004 | 0.881 (0.599—1.295) | 0.519 |
| Interaction effects (time dependent) | ||||
| Borderline personality disorder by Covid-19 | 1.628 (0.691–4.287) | 0.323 | 1.638 (0.896–2.994) | 0.109 |
| Substance use disorders by Covid-19 | 0.520 (0.249–1.087) | 0.082 | 1.645 (1.088–2.487) | 0.018 |
| Depressive disorders by Covid-19 | 0.769 (0.353–1.672) | 0.507 | 0.804 (0.509–1.272) | 0.351 |
| Schizophrenia and psychotic disorders by Covid-19 | 0.788 (0.286–2.174) | 0.646 | 1.034 (0.610–1.752) | 0.901 |
| Diagnostic categories (time independent) | ||||
| Organic mental disorders | 0.308 (0.073–1.300) | 0.109 | 0.990 (0.567–1.731) | 0.973 |
| Substance use disorders | 1.692 (0.943—3.036) | 0.078 | 1.168 (0.861–1.585) | 0.319 |
| Schizophrenia and psychotic disorders | 0.659 (0.297–1.460) | 0.304 | 0.928 (0.617–1.396) | 0.720 |
| Bipolar and manic disorders | 1.550 (0.783–3.072) | 0.209 | 1.286 (0.787–2.100) | 0.315 |
| Depressive disorders | 2.635 (1.445–4.805) | 0.002 | 2.386 (1.731–3.290) | < 0.001 |
| Neurotic, somatoform and stress related disorders | 1.019 (0.647–1.606) | 0.934 | 1.551 (1.217–1.977) | < 0.001 |
| Borderline personality disorder | 2.012 (0.914–4.428) | 0.083 | 1.706 (1.050–2.772) | 0.031 |
| Other personality disorders | 2.547 (1.434–4.522) | 0.001 | 1.911 (1.327–2.751) | < 0.001 |
| Sociodemographic risk factors (time independent) | ||||
| Male | 1.482 (1.011–2.170) | 0.044 | 1.392 (1.110–1.745) | 0.004 |
| Age | 0.995 (0.982–1.009) | 0.503 | 0.997 (0.988–1.005) | 0.424 |
| Living in residential therapeutic environment | 1.100 (0.477–2.536) | 0.824 | 1.084 (0.732–1.606) | 0.686 |
| Homeless | 1.597 (0.959–2.669) | 0.072 | 1.577 (1.187–2.096) | 0.002 |
| Covid-19 risk group | 1.507 (0.981–2.316) | 0.061 | 1.270 (0.962–1.677) | 0.092 |
| Suicide attempt (SA) | ||||
| Covid-19 (vs. control) | 9.862 (2.171–44.806) | 0.003 | 1.146 (0.590–2.223) | 0.688 |
| Interaction effects (time dependent) | ||||
| Borderline personality disorder by Covid-19 | 1.307 (0.304–5.616) | 0.719 | 7.128 (1.528–33.258) | 0.012 |
| Substance use disorders by Covid-19 | 0.391 (0.105–1.456) | 0.162 | 1.279 (0.624–2.619) | 0.501 |
| Depressive disorders by Covid-19 | 0.168 (0.038–0.739) | 0.018 | 0.663 (0.293–1.502) | 0.325 |
| Schizophrenia and psychotic disorders by Covid-19 | 0.488 (0.091–2.621) | 0.403 | 0.345 (0.124–0.961) | 0.042 |
| Diagnostic categories (time independent) | ||||
| Organic mental disorders | 0.805 (0.162–4.000) | 0.791 | 1.180 (0.483–2.881) | 0.716 |
| Substance use disorders | 1.694 (0.582–4.935) | 0.334 | 1.253 (0.728–2.156) | 0.415 |
| Schizophrenia and psychotic disorders | 1.690 (0.413–6.909) | 0.465 | 1.023 (0.528–1.981) | 0.947 |
| Bipolar and manic disorders | 0.491 (0.065–3.711) | 0.490 | 0.354 (0.086–1.460) | 0.151 |
| Depressive disorders | 9.171 (2.921–28.790) | < 0.001 | 1.999 (1.118–3.576) | 0.020 |
| Neurotic, somatoform and stress related disorders | 0.383 (0.131–1.115) | 0.078 | 1.186 (0.766–1.846) | 0.444 |
| Borderline personality disorder | 6.374 (1.879–21.620) | 0.003 | 0.401 (0.096–1.678) | 0.211 |
| Other personality disorders | 3.219 (1.202–8.618) | 0.020 | 1.420 (0.686–2.940) | 0.345 |
| Sociodemographic risk factors (time independent) | ||||
| Male | 2.443 (1.222–4.885) | 0.012 | 0.974 (0.663–1.433) | 0.895 |
| Age | 1.009 (0.985–1.034) | 0.473 | 0.994 (0.979–1.009) | 0.410 |
| Living in residential therapeutic environment | 0.554 (0.075–4.123) | 0.564 | 0.978 (0.473–2.023) | 0.952 |
| Homeless | 1.425 (0.574–3.536) | 0.445 | 1.157 (0.666–2.010) | 0.604 |
| Covid-19 risk group | 1.240 (0.583–2.638) | 0.576 | 1.105 (0.667–1.831) | 0.699 |
Results from the Poisson regression models estimating effects of "Covid-19 period" vs. "Control period" on the number of pED presentations with suicidality (SI, SP and SA) per patient. Rate ratios greater than 1 indicate that a factor is increasing the number of presentations per person with suicidality. Rate ratios below 1 indicate that a factor is decreasing the number of presentations per person with suicidality. bold = significant to a level of p ≤ 0.05; Covid-19 risk group is defined by a modified classification of the Robert-Koch-Institute, criteria can be found in supplementary material S2.3. "Living in a residential therapeutic environment" is composed of patients living in therapeutic residential groups and living alone with psychiatric and/or social assistance. Abbreviations used: 95% CI = 95% confidence interval; Covid-19 = coronavirus disease 2019