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SARS-CoV-2 Infection and the Risk of Suicidal and Self-Harm Thoughts and Behaviour: A Systematic Review

Mark Sinyor Orcid Logo, Rabia Zaheer, Roger T. Webb, Duleeka Knipe, Emily Eyles, Julian P.T. Higgins, Luke McGuinness, Lena Schmidt, Catherine Macleod-Hall Orcid Logo, Dana Dekel Orcid Logo, David Gunnell, Ann John Orcid Logo

The Canadian Journal of Psychiatry, Volume: 67, Issue: 11, Pages: 812 - 827

Swansea University Authors: Dana Dekel Orcid Logo, Ann John Orcid Logo

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DOI (Published version): 10.1177/07067437221094552

Abstract

ObjectiveThe COVID-19 pandemic has had a complex impact on risks of suicide and non-fatal self-harm worldwide with some evidence of increased risk in specific populations including women, young people, and people from ethnic minority backgrounds. This review aims to systematically address whether SA...

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Published in: The Canadian Journal of Psychiatry
ISSN: 0706-7437 1497-0015
Published: Canada SAGE Publications 2022
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This review aims to systematically address whether SARS-CoV-2 infection and/or COVID-19 disease confer elevated risk directly.MethodAs part of a larger Living Systematic Review examining self-harm and suicide during the pandemic, automated daily searches using a broad list of keywords were performed on a comprehensive set of databases with data from relevant articles published between January 1, 2020 and July 18, 2021. Eligibility criteria for our present review included studies investigating suicide and/or self-harm in people infected with SARS-CoV-2 with or without manifestations of COVID-19 disease with a comparator group who did not have infection or disease. Suicidal and self-harm thoughts and behaviour (STBs) were outcomes of interest. Studies were excluded if they reported data for people who only had potential infection/disease without a confirmed exposure, clinical/molecular diagnosis or self-report of a positive SARS-CoV-2 test result. Studies of news reports, treatment studies, and ecological studies examining rates of both SARS-CoV-2 infections and suicide/self-harm rates across a region were also excluded.ResultsWe identified 12 studies examining STBs in nine distinct samples of people with SARS-CoV-2. These studies, which investigated STBs in the general population and in subpopulations, including healthcare workers, generally found positive associations between SARS-CoV-2 infection and/or COVID-19 disease and subsequent suicidal/self-harm thoughts and suicidal/self-harm behaviour.ConclusionsThis review identified some evidence that infection with SARS-CoV-2 and/or COVID-19 disease may be associated with increased risks for suicidal and self-harm thoughts and behaviours but a causal link cannot be inferred. Further research with longer follow-up periods is required to confirm these findings and to establish whether these associations are causal.</abstract><type>Journal Article</type><journal>The Canadian Journal of Psychiatry</journal><volume>67</volume><journalNumber>11</journalNumber><paginationStart>812</paginationStart><paginationEnd>827</paginationEnd><publisher>SAGE Publications</publisher><placeOfPublication>Canada</placeOfPublication><isbnPrint/><isbnElectronic/><issnPrint>0706-7437</issnPrint><issnElectronic>1497-0015</issnElectronic><keywords>Systematic reviews, SARS-Cov-2, COVID-19, Suicide, Self harm</keywords><publishedDay>1</publishedDay><publishedMonth>11</publishedMonth><publishedYear>2022</publishedYear><publishedDate>2022-11-01</publishedDate><doi>10.1177/07067437221094552</doi><url/><notes/><college>COLLEGE NANME</college><department>Health Data Science</department><CollegeCode>COLLEGE CODE</CollegeCode><DepartmentCode>HDAT</DepartmentCode><institution>Swansea University</institution><apcterm/><funders>MS was supported by Academic Scholars Awards (MS) from the Departments of Psychiatry at the University of Toronto and Sunnybrook Health Sciences Centre. DK was supported by the Wellcome Trust through an Institutional Strategic Support Fund Award to the University of Bristol [204813] and the Elizabeth Blackwell Institute for Health Research, University of Bristol. DG and JPTH are supported by the NIHR Biomedical Research Centre at University Hospitals Bristol and Weston NHS Foundation Trust and the University of Bristol. JPTH is supported by NIHR Applied Research Collaboration West at University Hospitals Bristol and Weston NHS Foundation Trust. JPTH is a National Institute for Health Research (NIHR) Senior Investigator (NF-SI-0617-10145). LAM and LM are supported by NIHR Doctoral Research Fellowships (DRF-2018&#x2013;11-ST2-048). RTW is supported by the NIHR Greater Manchester Patient Safety Translational Research Centre at The University of Manchester. LW is supported by Sciome.</funders><projectreference/><lastEdited>2022-10-18T14:05:44.9670524</lastEdited><Created>2022-03-25T11:17:09.4288242</Created><path><level id="1">Faculty of Medicine, Health and Life Sciences</level><level id="2">Swansea University Medical School - Medicine</level></path><authors><author><firstname>Mark</firstname><surname>Sinyor</surname><orcid>0000-0002-7756-2584</orcid><order>1</order></author><author><firstname>Rabia</firstname><surname>Zaheer</surname><order>2</order></author><author><firstname>Roger T.</firstname><surname>Webb</surname><order>3</order></author><author><firstname>Duleeka</firstname><surname>Knipe</surname><order>4</order></author><author><firstname>Emily</firstname><surname>Eyles</surname><order>5</order></author><author><firstname>Julian P.T.</firstname><surname>Higgins</surname><order>6</order></author><author><firstname>Luke</firstname><surname>McGuinness</surname><order>7</order></author><author><firstname>Lena</firstname><surname>Schmidt</surname><order>8</order></author><author><firstname>Catherine</firstname><surname>Macleod-Hall</surname><orcid>0000-0002-0487-0674</orcid><order>9</order></author><author><firstname>Dana</firstname><surname>Dekel</surname><orcid>0000-0003-0137-5149</orcid><order>10</order></author><author><firstname>David</firstname><surname>Gunnell</surname><order>11</order></author><author><firstname>Ann</firstname><surname>John</surname><orcid>0000-0002-5657-6995</orcid><order>12</order></author></authors><documents><document><filename>59705__24110__47f28f9a81524c7e81286c7ea2c41cd7.pdf</filename><originalFilename>59705.pdf</originalFilename><uploaded>2022-05-17T12:55:57.3789788</uploaded><type>Output</type><contentLength>1092633</contentLength><contentType>application/pdf</contentType><version>Version of Record</version><cronfaStatus>true</cronfaStatus><documentNotes>This article is distributed under the terms of the Creative Commons Attribution 4.0 License</documentNotes><copyrightCorrect>true</copyrightCorrect><language>eng</language><licence>https://creativecommons.org/licenses/by/4.0/</licence></document></documents><OutputDurs/></rfc1807>
spelling 2022-10-18T14:05:44.9670524 v2 59705 2022-03-25 SARS-CoV-2 Infection and the Risk of Suicidal and Self-Harm Thoughts and Behaviour: A Systematic Review 7904c581b4da2217c348434c9f04f165 0000-0003-0137-5149 Dana Dekel Dana Dekel true false ed8a9c37bd7b7235b762d941ef18ee55 0000-0002-5657-6995 Ann John Ann John true false 2022-03-25 HDAT ObjectiveThe COVID-19 pandemic has had a complex impact on risks of suicide and non-fatal self-harm worldwide with some evidence of increased risk in specific populations including women, young people, and people from ethnic minority backgrounds. This review aims to systematically address whether SARS-CoV-2 infection and/or COVID-19 disease confer elevated risk directly.MethodAs part of a larger Living Systematic Review examining self-harm and suicide during the pandemic, automated daily searches using a broad list of keywords were performed on a comprehensive set of databases with data from relevant articles published between January 1, 2020 and July 18, 2021. Eligibility criteria for our present review included studies investigating suicide and/or self-harm in people infected with SARS-CoV-2 with or without manifestations of COVID-19 disease with a comparator group who did not have infection or disease. Suicidal and self-harm thoughts and behaviour (STBs) were outcomes of interest. Studies were excluded if they reported data for people who only had potential infection/disease without a confirmed exposure, clinical/molecular diagnosis or self-report of a positive SARS-CoV-2 test result. Studies of news reports, treatment studies, and ecological studies examining rates of both SARS-CoV-2 infections and suicide/self-harm rates across a region were also excluded.ResultsWe identified 12 studies examining STBs in nine distinct samples of people with SARS-CoV-2. These studies, which investigated STBs in the general population and in subpopulations, including healthcare workers, generally found positive associations between SARS-CoV-2 infection and/or COVID-19 disease and subsequent suicidal/self-harm thoughts and suicidal/self-harm behaviour.ConclusionsThis review identified some evidence that infection with SARS-CoV-2 and/or COVID-19 disease may be associated with increased risks for suicidal and self-harm thoughts and behaviours but a causal link cannot be inferred. Further research with longer follow-up periods is required to confirm these findings and to establish whether these associations are causal. Journal Article The Canadian Journal of Psychiatry 67 11 812 827 SAGE Publications Canada 0706-7437 1497-0015 Systematic reviews, SARS-Cov-2, COVID-19, Suicide, Self harm 1 11 2022 2022-11-01 10.1177/07067437221094552 COLLEGE NANME Health Data Science COLLEGE CODE HDAT Swansea University MS was supported by Academic Scholars Awards (MS) from the Departments of Psychiatry at the University of Toronto and Sunnybrook Health Sciences Centre. DK was supported by the Wellcome Trust through an Institutional Strategic Support Fund Award to the University of Bristol [204813] and the Elizabeth Blackwell Institute for Health Research, University of Bristol. DG and JPTH are supported by the NIHR Biomedical Research Centre at University Hospitals Bristol and Weston NHS Foundation Trust and the University of Bristol. JPTH is supported by NIHR Applied Research Collaboration West at University Hospitals Bristol and Weston NHS Foundation Trust. JPTH is a National Institute for Health Research (NIHR) Senior Investigator (NF-SI-0617-10145). LAM and LM are supported by NIHR Doctoral Research Fellowships (DRF-2018–11-ST2-048). RTW is supported by the NIHR Greater Manchester Patient Safety Translational Research Centre at The University of Manchester. LW is supported by Sciome. 2022-10-18T14:05:44.9670524 2022-03-25T11:17:09.4288242 Faculty of Medicine, Health and Life Sciences Swansea University Medical School - Medicine Mark Sinyor 0000-0002-7756-2584 1 Rabia Zaheer 2 Roger T. Webb 3 Duleeka Knipe 4 Emily Eyles 5 Julian P.T. Higgins 6 Luke McGuinness 7 Lena Schmidt 8 Catherine Macleod-Hall 0000-0002-0487-0674 9 Dana Dekel 0000-0003-0137-5149 10 David Gunnell 11 Ann John 0000-0002-5657-6995 12 59705__24110__47f28f9a81524c7e81286c7ea2c41cd7.pdf 59705.pdf 2022-05-17T12:55:57.3789788 Output 1092633 application/pdf Version of Record true This article is distributed under the terms of the Creative Commons Attribution 4.0 License true eng https://creativecommons.org/licenses/by/4.0/
title SARS-CoV-2 Infection and the Risk of Suicidal and Self-Harm Thoughts and Behaviour: A Systematic Review
spellingShingle SARS-CoV-2 Infection and the Risk of Suicidal and Self-Harm Thoughts and Behaviour: A Systematic Review
Dana Dekel
Ann John
title_short SARS-CoV-2 Infection and the Risk of Suicidal and Self-Harm Thoughts and Behaviour: A Systematic Review
title_full SARS-CoV-2 Infection and the Risk of Suicidal and Self-Harm Thoughts and Behaviour: A Systematic Review
title_fullStr SARS-CoV-2 Infection and the Risk of Suicidal and Self-Harm Thoughts and Behaviour: A Systematic Review
title_full_unstemmed SARS-CoV-2 Infection and the Risk of Suicidal and Self-Harm Thoughts and Behaviour: A Systematic Review
title_sort SARS-CoV-2 Infection and the Risk of Suicidal and Self-Harm Thoughts and Behaviour: A Systematic Review
author_id_str_mv 7904c581b4da2217c348434c9f04f165
ed8a9c37bd7b7235b762d941ef18ee55
author_id_fullname_str_mv 7904c581b4da2217c348434c9f04f165_***_Dana Dekel
ed8a9c37bd7b7235b762d941ef18ee55_***_Ann John
author Dana Dekel
Ann John
author2 Mark Sinyor
Rabia Zaheer
Roger T. Webb
Duleeka Knipe
Emily Eyles
Julian P.T. Higgins
Luke McGuinness
Lena Schmidt
Catherine Macleod-Hall
Dana Dekel
David Gunnell
Ann John
format Journal article
container_title The Canadian Journal of Psychiatry
container_volume 67
container_issue 11
container_start_page 812
publishDate 2022
institution Swansea University
issn 0706-7437
1497-0015
doi_str_mv 10.1177/07067437221094552
publisher SAGE Publications
college_str Faculty of Medicine, Health and Life Sciences
hierarchytype
hierarchy_top_id facultyofmedicinehealthandlifesciences
hierarchy_top_title Faculty of Medicine, Health and Life Sciences
hierarchy_parent_id facultyofmedicinehealthandlifesciences
hierarchy_parent_title Faculty of Medicine, Health and Life Sciences
department_str Swansea University Medical School - Medicine{{{_:::_}}}Faculty of Medicine, Health and Life Sciences{{{_:::_}}}Swansea University Medical School - Medicine
document_store_str 1
active_str 0
description ObjectiveThe COVID-19 pandemic has had a complex impact on risks of suicide and non-fatal self-harm worldwide with some evidence of increased risk in specific populations including women, young people, and people from ethnic minority backgrounds. This review aims to systematically address whether SARS-CoV-2 infection and/or COVID-19 disease confer elevated risk directly.MethodAs part of a larger Living Systematic Review examining self-harm and suicide during the pandemic, automated daily searches using a broad list of keywords were performed on a comprehensive set of databases with data from relevant articles published between January 1, 2020 and July 18, 2021. Eligibility criteria for our present review included studies investigating suicide and/or self-harm in people infected with SARS-CoV-2 with or without manifestations of COVID-19 disease with a comparator group who did not have infection or disease. Suicidal and self-harm thoughts and behaviour (STBs) were outcomes of interest. Studies were excluded if they reported data for people who only had potential infection/disease without a confirmed exposure, clinical/molecular diagnosis or self-report of a positive SARS-CoV-2 test result. Studies of news reports, treatment studies, and ecological studies examining rates of both SARS-CoV-2 infections and suicide/self-harm rates across a region were also excluded.ResultsWe identified 12 studies examining STBs in nine distinct samples of people with SARS-CoV-2. These studies, which investigated STBs in the general population and in subpopulations, including healthcare workers, generally found positive associations between SARS-CoV-2 infection and/or COVID-19 disease and subsequent suicidal/self-harm thoughts and suicidal/self-harm behaviour.ConclusionsThis review identified some evidence that infection with SARS-CoV-2 and/or COVID-19 disease may be associated with increased risks for suicidal and self-harm thoughts and behaviours but a causal link cannot be inferred. Further research with longer follow-up periods is required to confirm these findings and to establish whether these associations are causal.
published_date 2022-11-01T04:17:13Z
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