Characteristics of suicidal emergency room patients before and during the COVID-19 pandemic in Japan

Abstract Background : Owing to the stress caused by the behavioral restrictions and lifestyle changes during the coronavirus disease 2019 pandemic, suicide rates have increased in Japan, especially among young people. This study identified the differences in the characteristics of patients hospitalized for suicide attempts in the Kobe City Medical Center General Hospital’s emergency room, requiring inpatient care before and during the pandemic over two years. Methods : This study was a retrospective analysis. Data were collected from 201 patients’ medical records. Patient interviews were conducted bedside or in an interview room in the emergency ward. Data collected from the electronic medical records included sex, age, COVID-19 infection status, admission to a ward with physical complications, psychiatric liaison team intervention, presence or absence of a previous department of psychiatry visit and diagnosis, prescription history of antipsychotic, antidepressant, and anxiolytic or sleeping medication, presence of physical complications, and Charlson Comorbidity Index score to compare the severity of comorbidities. A descriptive survey was conducted to examine changes in the pattern of suicide attempts during the COVID-19 outbreak. Two-sample independent t -tests, chi-square tests, and Fisher’s exact test were used for data analysis. Results : No significant differences were found in the number of patients hospitalized for suicide attempts, average age, or sex ratio between the pre- and post-pandemic periods. Acute drug intoxication and overmedication in patients increased significantly during the pandemic. The self-inflicted means of injury with high fatality rates were non-significantly different in the two periods. The rate of physical complications significantly increased during the pandemic, while the proportion of unemployed individuals significantly decreased. Conclusion : Despite studies predicting an increase in suicides based on past statistics of young people and of women, no significant changes were observed. This may have been owing to the effect of suicide prevention measures and mental health measures implemented by the Japanese government after an increase in suicides and after past natural disasters as well as infectious disease pandemics such as the H1N1 influenza.