Suicide Risk in Individuals With and Without Mental Disorders Before and During the COVID-19 Pandemic: An Analysis of Three Nationwide Cross-Sectional Surveys in Czechia

Figures & data

TABLE 1. Unweighted descriptive statistics of participants across surveys.

	2017 May n (%)	2020 May n (%)	2020 November n (%)
Being female	1,774 (53.66)	1,581 (52.33)	1,534 (51.13)
Median age (IQR)	48 (29)	46 (26)	46 (29)
Education
Basic	278 (8.41)	180 (5.96)	222 (7.40)
Vocational	1,292 (39.08)	1,159 (38.36)	1,078 (35.93)
High school graduation	1,178 (35.63)	1,046 (34.62)	1,078 (35.93)
University	558 (16.88)	636 (21.05)	622 (20.73)
Work status
Employed	1,560 (47.19)	1,692 (56.01)	1,445 (48.17)
Self-employed	367 (11.10)	193 (6.39)	177 (5.90)
Unemployed	112 (3.39)	104 (3.44)	102 (3.40)
Retired	872 (26.38)	678 (22.44)	697 (23.23)
Student	128 (3.87)	156 (5.16)	185 (6.17)
Parental leave	120 (3.63)	166 (5.49)	180 (6.00)
Other	147 (4.45)	32 (1.06)	214 (7.13)
Population of area of residence
<5,000 inhabitants	1,264 (38.23)	1,064 (35.22)	1,068 (35.60)
5,000–19,999 inhabitants	609 (18.42)	573 (18.97)	575 (19.17)
20,000–99,999 inhabitants	725 (21.93)	671 (22.21)	666 (22.20)
100,000+ inhabitants	708 (21.42)	713 (23.60)	691 (23.03)
Family status
Married	1,495 (45.22)	1,308 (43.30)	1,272 (42.40)
Co-habiting	497 (15.03)	470 (15.56)	460 (15.33)
Widowed	372 (11.25)	134 (4.44)	143 (4.77)
Divorced	422 (12.76)	421 (13.94)	424 (14.13)
Separated	30 (0.91)	51 (1.69)	34 (1.13)
Single	490 (14.82)	637 (21.09)	667 (22.23)
Prescription drugs use	173 (5.23)	187 (6.19)	179 (5.97)
Current binge drinking	129 (3.90)	193 (6.39)	202 (6.73)
Lifetime help-seeking behavior	316 (9.56)	800 (26.48)	869 (28.97)
Suicide risk	127 (3.84)	371 (12.28)	425 (14.17)
Major depressive episode	132 (3.99)	359 (11.88)	382 (12.73)
Anxiety disorders
Any	261 (7.89)	408 (13.51)	398 (13.27)
Panic disorder	7 (0.21)	30 (0.99)	35 (1.17)
Social phobia	57 (1.72)	85 (2.81)	105 (3.50)
Agoraphobia	172 (5.20)	251 (8.31)	256 (8.53)
Post-traumatic stress disorder	32 (0.97)	55 (1.82)	75 (2.50)
Generalized anxiety disorder	104 (3.15)	165 (5.46)	171 (5.70)

The results are presented as counts and unweighted proportions; IQR: inter-quartile range.

TABLE 2. Prevalence of suicide risk in people with and without mental disorders across surveys.

	2017 May	2020 May	2020 November
General population	3.88 (3.22; 4.55)	11.88 (10.66; 13.09)	14.26 (12.87; 15.64)
Without major depressive episode or anxiety disorder	1.95 (1.45; 2.44)	6.29 (5.28; 7.30)	8.42 (7.19; 9.65)
Major depressive episode	32.24 (24.02; 40.47)	43.08 (37.54; 48.61)	43.21 (37.87; 48.55)
Anxiety disorders	23.37 (18.07; 28.67)	36.88 (31.96; 41.80)	44.40 (39.01; 49.80)
Panic disorder	56.90 (18.41; 90.10)	58.01 (38.03; 78.00)	74.37 (58.43; 90.32)
Social phobia	34.73 (21.78; 47.68)	53.96 (42.50; 65.41)	52.72 (42.21; 63.23)
Agoraphobia	24.69 (18.05; 31.33)	34.43 (28.28; 40.58)	42.41 (35.62; 49.20)
Post-traumatic stress disorder	53.92 (35.65; 72.20)	50.17 (36.09; 64.26)	65.00 (53.20; 76.79)
Generalized anxiety disorder	35.60 (26.06; 45.15)	52.05 (43.91; 60.19)	57.83 (49.93; 65.73)
Any above-mentioned diagnosis	22.35 (17.64; 27.06)	36.68 (32.45; 40.91)	38.88 (34.51; 43.25)
Both major depressive episode and anxiety disorder	43.23 (31.54; 54.93)	49.18 (41.70; 56.67)	59.41 (52.10; 66.73)

The results are presented as weighted proportions (%) with 95% confidence intervals.

TABLE 3. Prevalence of suicidal thoughts and behavior in people with and without mental disorders across surveys.

	2017 November				2020 May				2020 November
	Suicidal thoughts		Suicidal behavior		Suicidal thoughts		Suicidal behavior		Suicidal thoughts		Suicidal behavior
	n	%	n	%	n	%	n	%	n	%	n	%
General population	94	2.90 (2.32; 3.49)	48	1.42 (1.02; 10.82)	218	6.80 (5.87; 7.73)	214	6.91 (5.96; 7.86)	256	8.47 (7.38; 9.56)	260	8.89 (7.75; 10.02)
Without major depressive episode or anxiety disorder	38	1.26 (0.86; 1.66)	25	0.82 (0.50; 1.15)	71	2.58 (1.96; 3.20)	103	4.28 (3.41; 5.14)	83	3.75 (2.87; 4.64)	133	5.47 (4.49; 6.46)
Major depressive episode	35	27.81 (19.89; 35.73)	14	10.23 (5.04; 15.43)	123	34.53 (29.20; 39.85)	73	19.14 (14.91; 23.37)	139	35.31 (30.19; 40.43)	88	23.36 (18.78; 27.93)
Anxiety disorders	47	19.17 (14.21; 24;13)	20	7.64 (4.37; 10.90)	102	24.08 (19.75; 28.40)	86	19.90 (15.90; 23.90)	130	30.84 (25.99; 35.70)	102	27.63 (22.57; 32.69)
Panic disorder	4	56.90 (18.41; 90.10)	1	16.57 (0.36; 57.87)	15	45.60 (26.03; 65.18)	14	45.08 (25.48; 64.69)	22	63.11 (45.32; 80.90)	15	45.64 (27.24; 64.05)
Social phobia	15	28.24 (15.85; 40.63)	9	15.35 (5.76; 24.95)	39	42.87 (31.72; 54.02)	24	26.97 (17.12; 36.82)	48	43.83 (33.49; 54.17)	34	34.23 (24.19; 44.27)
Agoraphobia	34	20.44 (14.23; 26.65)	16	9.44 (4.96; 13.92)	51	19.43 (14.30; 24.57)	60	21.76 (16.58; 26.93)	74	26.81 (21.05; 32.58)	72	30.56 (24.00; 37.12)
Post-traumatic stress disorder	14	48.14 (29.64; 66.64)	2	5.78 (0.77; 20.81)	20	35.94 (22.45; 49.43)	20	35.07 (21.83; 48.31)	39	51.41 (38.95; 63.87)	30	44.20 (31.68; 56.72)
Generalized anxiety disorder	26	27.21 (18.22; 36.20)	10	9.52 (3.75; 15.28)	70	41.81 (33.82; 49.79)	38	22.78 (15.96; 29.61)	85	50.21 (42.17; 58.25)	47	28.52 (21.17; 35.87)
Any above-mentioned diagnosis	56	18.61 (14.18; 23.03)	23	7.12 (4.28; 9.97)	147	25.54 (21.70; 29.37)	111	18.61 (15.27; 21.94)	173	28.38 (24.46; 32.30)	127	23.29 (19.36; 27.23)
Both major depressive episode and anxiety disorder	26	36.71 (25.26; 48.15)	11	14.36 (6.22; 22.49)	78	39.52 (32.23; 46.81)	48	22.28 (16.36; 28.21)	96	47.54 (40.14; 54.95)	63	32.76 (25.74; 39.77)

The results are presented as the number of individuals in a given group exhibiting suicidal thoughts and behavior and weighted proportions (%) with 95% confidence intervals.

TABLE 4. Bivariable logistic regressions on association of sociodemographic and clinical characteristics and suicide risk across the surveys.

	2017 November		2020 May		2020 November
	n (%)	OR	n (%)	OR	n (%)	OR
Being female	1,774 (53.66%)	1.35 (0.94; 1.95)	1,581 (52.33%)	1.36 (1.07; 1.72)*	1,534 (51.13%)	1.31 (1.04; 1.64)*
Age
18–29 years	553 (16.73%)	Ref.	528 (17.48%)	Ref.	550 (18.33%)	Ref.
30–49 years	1,175 (35.54%)	0.41 (0.24; 0.72)**	1,193 (39.49%)	0.63 (0.47; 0.86)**	1,106 (36.87%)	0.82 (0.61; 1.10)
50–64 years	817 (24.71%)	0.64 (0.37; 1.10)	730 (24.16%)	0.69 (0.50; 0.96)*	694 (23.13%)	0.55 (0.39; 0.78)**
65+ years	761 (23.02%)	1.38 (0.85; 2.25)	570 (18.87%)	0.44 (0.30; 0.65)***	650 (21.67%)	0.49 (0.34; 0.72)***
Education
Basic	278 (8.41%)	Ref.	180 (5.96%)	Ref.	222 (7.40%)	Ref.
Vocational	1,292 (39.08%)	0.27 (0.17; 0.43)***	1,159 (38.36%)	0.90 (0.56; 1.43)	1,078 (35.93%)	0.49 (0.33; 0.71)***
High school graduation	1,178 (35.60%)	0.21 (0.13; 0.35)***	1,046 (34.62%)	0.75 (0.47; 1.19)	1,078 (35.93%)	0.40 (0.27; 0.58)***
University	558 (16.88%)	0.08 (0.03; 0.19)***	636 (21.05%)	0.49 (0.29; 0.83)**	622 (20.73%)	0.25 (0.16; 0.38)***
Work status
Employed	1,560 (47.19%)	Ref.	1,692 (56.01%)	Ref.	1,445 (48.17%)	Ref.
Self-employed	120 (3.63%)	1.31 (0.55; 3.08)	166 (5.49%)	1.26 (0.78; 2.04)	180 (6.00%)	0.47 (0.26; 0.86)**
Unemployed	147 (4.45%)	7.49 (3.56; 15.79)***	32 (1.06%)	4.05 (2.49; 6.59)***	214 (7.13%)	2.75 (1.69; 4.48)***
Retired	872 (26.38%)	4.28 (2.61; 7.04)***	678 (22.44%)	1.09 (0.81; 1.48)	697 (23.23%)	0.92 (0.67; 1.27)
Student	367 (11.10%)	4.15 (1.74; 9.89)**	193 (6.39%)	2.78 (1.82; 4.27)***	177 (5.90%)	1.86 (1.20; 2.88)**
On maternity/Paternity leave	128 (3.87%)	2.93 (1.10; 7.85)*	156 (5.16%)	1.02 (0.57; 1.83)	185 (6.17%)	1.00 (0.58; 1.72)
Other	112 (3.39%)	12.30 (6.73; 22.50)***	104 (3.44%)	3.78 (1.67; 8.53)**	102 (3.40%)	2.97 (2.08; 4.25)***
Population of area of residence
<5,000 inhabitants	1,264 (38.23%)	Ref.	1,064 (35.22%)	Ref.	1,068 (35.60%)	Ref.
5,000–19,999 inhabitants	609 (18.42%)	1.15 (0.73; 1.80)	573 (18.97%)	1.05 (0.76; 1.46)	575 (19.17%)	0.67 (0.47; 0.94)*
20,000–99,999 inhabitants	725 (21.93%)	0.76 (0.47; 1.23)	671 (22.21%)	1.13 (0.83; 1.53)	666 (22.20%)	0.95 (0.70; 1.28)
100,000+ inhabitants	708 (21.42%)	0.46 (0.26; 0.82)**	713 (23.60%)	0.90 (0.65; 1.24)	691 (23.03%)	0.86 (0.65; 1.15)
Family status
Married	1,495 (45.22%)	Ref.	1,308 (43.30%)	Ref.	1,272 (42.40%)	Ref.
Co-habiting	497 (15.03%)	1.44 (0.77; 2.69)	470 (15.56%)	2.16 (1.54; 3.03)***	460 (15.33%)	2.55 (1.82; 3.56)***
Widowed	372 (11.25%)	4.80 (2.88; 7.99)***	134 (4.44%)	1.16 (0.58; 2.34)	143 (4.77%)	1.65 (0.95; 2.89)
Divorced	422 (12.76%)	2.58 (1.46; 4.56)**	421 (13.94%)	2.45 (1.74; 3.43)***	424 (14.13%)	2.34 (1.63; 3.34)***
Separated	30 (0.91%)	1.46 (0.19; 11.10)	51 (1.69%)	2.58 (1.13; 5.89)*	34 (1.13%)	2.93 (1.22; 7.06)*
Single	490 (14.82%)	2.96 (1.74; 5.02)***	637 (21.09%)	2.11 (1.54; 2.88)***	667 (22.23%)	2.52 (1.87; 3.40)***
Prescription drugs use	173 (5.23%)	8.78 (5.72; 13.48)***	187 (6.19%)	1.34 (0.84; 2.15)	179 (5.97%)	1.32 (0.88; 1.99)
Current binge drinking	129 (3.90%)	2.17 (1.11; 4.27)*	193 (6.39%)	1.94 (1.32; 2.86)**	202 (6.73%)	2.45 (1.71; 3.52)***
Lifetime help-seeking behavior	316 (9.56%)	11.69 (8.04; 16.98)***	800 (26.48%)	4.81 (3.77; 6.12)***	869 (28.97%)	4.67 (3.69; 5.90)***

The results are expressed as counts, unweighted proportions, and odds ratios with 95% confidence intervals.

*p < 0.05; **p < 0.01; ***p < 0.001.

DATA AVAILABILITY STATEMENT

Data are not available publicly following government regulations; however, data can be made available upon reasonable request. Similarly, the Stata and R codes will be made available upon reasonable request.