Impact of COVID-19 restrictions on self-poisoning behaviour with mild analgesics in Danish youth

Abstract

Background

The COVID-19 pandemic prompted the implementation of precautions to contain the disease, including lockdowns and social isolation. Previous studies have investigated suicide rates among children and adolescents during the pandemic and have found varying results. We speculated how the two lockdowns influenced suicidal behaviour in children and adolescents in Denmark.

Objective

This study aimed to investigate the effect of lockdowns during the COVID-19 pandemic on suicide attempts, as measured by the incidence rate in all self-poisonings with mild analgesics among children and adolescents.

Methods

This national Danish registry-based study on children and adolescents used Poisson regression and interrupted time series analysis to examine the incidence rates and trends of self-poisonings with mild analgesics from 2019 to mid-2021.

Results

For the period of this study, 1655 self-poisonings were registered. During the first lockdown, there was a slight, not statistically significant, decrease in self-poisoning rates (incidence rate ratio [IRR]) 0.98) compared to no lockdown. During the second lockdown, there was a significant increase in self-poisonings for the whole Danish population (IRR 1.85) with girls being slightly higher at risk (IRR 1.87). Being a girl or between the ages of 13–17 years old were risk factors for self-poisoning.

Conclusion

These findings indicate that the restrictions enforced during the second lockdown greatly impacted youth mental health, especially girls, leading to an 85% increase in self-poisonings. We hope for increased awareness of mental health in children and adolescents during possible future lockdowns.

Keywords:

• Self-harm
• youth
• COVID-19
• suicide attempts
• self-poisonings

Ethical statement

According to Danish law, studies based entirely on registry data do not require approval from an ethics review board or informed consent from individuals used in the study.

Disclosure statement

No potential conflict of interest was reported by the author(s).

Data availability statement

The study was registered at Open Patient data Explorative Network (OPEN), The Region of Southern Denmark and anonymised data were hosted at Statistics Denmark. Due to legal reasons, anonymised individual-level data cannot be shared by the authors.

Additional information

Funding

This work was funded by the Research Council at Lillebaelt Hospital, Denmark. Grant number [K22-10K].

Notes on contributors

Gurbhej Singh

Gurbhej Singh, Junior doctor with a keen interest in child psychiatry and mental health. GS just started his residency, and plans to go to into paediatrics or child psychiatry after his residency.

Jonathan Pommer Hansen

Jonathan Pommer Hansen, Junior doctor with a great passion for infectious medicine, paediactrics and mental health. Recently started his residency in general surgery, and plans to go into the paedaitrics after completion of residency.

Ditte Hulgaard

Ditte Hulgaard is an Associate Professor at the Child and Adolescent Psychiatric Centre, Institute for Regional Health Research, University of Southern Denmark and is a Consultant at the Pediatric Department at Lillebaelt Hospital. Her main research focus is functional disorders in early life.

Mads Damkjær

Mads Damkjær, A specialist in paediatric cardiology, certified by EACVI and AEPC, with a robust research portfolio, including leadership in groundbreaking studies on cardiovascular function. Currently an Associate Professor at the University of Southern Denmark, dedicated to advancing paediatric medical education and research.

Erik Christiansen

Erik Christiansen is an associate professor at University of Southern Denmark and head of research at Center for Suicide Research. He has been using Danish register data to model risk factors and periods for suicide, but his work also includes testing and using suicide ideation-to-action models in suicide prevention.