Suicide Presentations to an Emergency Department Pre and During the COVID Lockdown, March–May 2020, in Spain

Abstract

The impact of the COVID-19 pandemic and lockdown may affect suicide risk and behavior. We compared suicide-related presentations during the national quarantine with pre-COVID data. This observational incidence study compared all suicide-related presentations at the University Hospital Reina Sofia emergency department (ED) in Cordoba, Spain, for the lockdown period from 15 March to 15 May 2020, with the same period in 2019. Descriptive and inferential analyses of case characteristics between 2019 and 2020 periods were conducted, and a multivariable logistic regression model developed. Results: Despite a decrease in overall ED cases during the lockdown, the number of suicide-related presentations stayed the same and represented a significantly larger proportion of cases in comparison to the pre-COVID period (0.42 vs. 0.87%, in 2019 and 2020, respectively; p < .001). The number presenting alone more than doubled during the COVID lockdown, increasing to 42.9% compared with 19.4% in 2019 (p = .002). An increase in presentations with a family history of suicide was also found. Conclusions: Suicide cases represented an increased proportion of ED cases during the lockdown. Presenting to ED alone, having a family history of suicide, habitual drug consumption, and hospital admission to ICU differentiated cases between pre and during COVID periods. These findings should be considered in light of the second wave and further implementation of lockdown measures.

Keywords:

• COVID-19
• emergency department
• pandemic
• quarantine
• suicide

ACKNOWLEDGMENTS

The authors wish to thank Ingrid de Ruiter, MBChB, PhD, for medical writing support in accordance with Good Publication Practice (GPP3). This funding source had no role in the planning, design, analysis, interpretation, or publication of this study.

DISCLOSURE STATEMENT

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

AUTHOR NOTES

Juan L. Prados-Ojeda, Unidad de Gestión Clínica de Salud Mental, Hospital Universitario Reina Sofía, Córdoba, Spain; Instituto Maimónides de Investigación Biomédica de Córdoba (IMIBIC), Córdoba, Spain; Departamento de Ciencias Morfológicas y Sociosanitarias, Universidad de Córdoba, Córdoba, Spain.

Rafael M. Gordillo-Urbano, Teresa Carrillo-Pérez, Alba Vázquez-Calvo, Mario A. Herrera-Cortés, and M. Ángeles Carreño-Ruiz, Unidad de Gestión Clínica de Salud Mental, Hospital Universitario Reina Sofía, Córdoba, Spain.

Pilar Font-Ugalde, Instituto Maimónides de Investigación Biomédica de Córdoba (IMIBIC), Córdoba, Spain; Departamento de Ciencias Médicas y Quirúrgicas, Universidad de Córdoba, Córdoba, Spain; Unidad de Gestión Clínica de Reumatología, Hospital Universitario Reina Sofía, Córdoba, Spain.

AUTHOR CONTRIBUTIONS

JLPO and RMGU designed the study concept. JLPO, RMGU, MAHC, AVC, MACR, and TCP were involved in data collection. JLPO, RMGO, and PFU carried out data analysis and the interpretation of results. JLPO and RMGU wrote the first draft. All authors were involved in editing, commenting on the manuscript, and approved the final version.

DATA AVAILABILITY

Anonymized data is available from the authors on reasonable request.

Additional information

Funding

Medical writing support was funded by FIBICO (Fundación para la Investigación Biomédica de Córdoba). This funding source had no role in the planning, design, analysis, interpretation, or publication of this study.