Abstract
There are concerns that suicide rates may have increased during the coronavirus disease 2019 (COVID-19) pandemic. To assess whether suicide rates in Japan increased in April through November 2020 compared with previous years. This cross-sectional study used national data obtained from the Ministry of Health, Labor and Welfare from 2016 to 2020 on the monthly number of individuals who died of suicide in Japan from January to November of 2016 to 2020. 2020 vs previous years. The main outcome was monthly suicide rates, calculated as the number of individuals who died of suicide divided by the total population. A difference-in-difference regression model was used to estimate the change in monthly suicide rates in April to November 2020 vs these months in 2016 to 2019. Analyses included 90 048 individuals (61 366 [68.1%] men) who died of suicide from 2016 to 2020. The difference-in-difference analysis of men showed that there was no increase in suicide rates from April through September 2020 compared with these months in 2016 to 2019, but that suicide rates were increased in October (difference-in-difference, 0.40 [95% CI, 0.14 to 0.67] suicide deaths per 100 000 population) and November (difference-in-difference, 0.34 [95% CI, 0.07 to 0.60] suicide deaths per 100 000 population). Among women, suicide rates in 2020 compared with 2016 to 2019 increased in July (difference-in-difference, 0.24 [95% CI, 0.09 to 0.38] suicide deaths per 100 000 population), August (difference-in-difference, 0.30 [95% CI, 0.16 to 0.45] suicide deaths per 100 000 population), September (difference-in-difference, 0.29 [95% CI, 0.15 to 0.44] suicide deaths per 100 000 population), October (difference-in-difference, 0.62 [95% CI, 0.48 to 0.77] suicide deaths per 100 000 population), and November (difference-in-difference, 0.29 [95% CI, 0.15 to 0.44] suicide deaths per 100 000 population). In secondary analyses in which the suicide rates of 2020 were compared with the expected rates based on trends from 2011 to 2019, the increases in suicide rates were most pronounced among men aged younger than 30 years (eg, November: observed vs expected rate ratio [RR], 1.48 [95% CI, 1.26-1.71]) and women aged younger than 30 years (eg, October: observed vs expected RR, 2.14 [95% CI, 1.76 to 2.52]) and 30 to 49 years (eg, October: observed vs expected RR, 2.30 [95% CI, 2.01 to 2.58]). These findings suggest that compared with previous years, suicide rates in Japan in 2020 increased in October and November for men and in July through November for women.
Highlights
Measures taken to mitigate the coronavirus disease 2019 (COVID-19) pandemic have raised concerns that suicide rates might increase as a result of heightened economic stress, decreased human contact, and exacerbations of preexisting mental health conditions.[1,2,3] While data from high-income countries indicate that there was no increase in suicide rates during the early months of the pandemic,[4] a recent analysis from Japan[5] using data on suicide rates from 2010 through September 2020 found an excess of suicide deaths among women, but not men, in July, August, and September 2020; data by age group were not presented
The difference-in-difference analysis of men showed that there was no increase in suicide rates from April through September 2020 compared with these months in 2016 to 2019, but that suicide rates were increased in October and November
In secondary analyses in which the suicide rates of 2020 were compared with the expected rates based on trends from 2011 to 2019, the increases in suicide rates were most pronounced among men aged younger than 30 years and women aged younger than 30 years and 30 to 49 years
Summary
Measures taken to mitigate the coronavirus disease 2019 (COVID-19) pandemic have raised concerns that suicide rates might increase as a result of heightened economic stress, decreased human contact, and exacerbations of preexisting mental health conditions.[1,2,3] While data from high-income countries indicate that there was no increase in suicide rates during the early months of the pandemic,[4] a recent analysis from Japan[5] using data on suicide rates from 2010 through September 2020 found an excess of suicide deaths among women, but not men, in July, August, and September 2020; data by age group were not presented. We assessed potential changes in suicide rates associated with the pandemic in Japan through November 2020 and performed analyses by sex, age group, and occupational status
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