Abstract
We explored the association between influenza epidemic and suicide mortality rates in a large population using a time-series regression of 13-year mortality data in South Korea. Weekly suicide mortalities and influenza-like illness (ILI) were analyzed using time series regression. Regression coefficient for suicide mortality based on percentage change of ILI was calculated using a quasi-Poisson regression. Non-linear distributed lag models with quadratic function up to 24 weeks were constructed. The association between ILI and suicide mortality increased significantly up to 8 weeks post-influenza diagnosis. A significant positive association between ILI and suicide mortality was observed from 2009, when a novel influenza A(H1N1)pdm09 virus provoked a worldwide pandemic. No meaningful association between these factors was observed before 2009. There was a significant positive relationship between ILI and suicide mortality after 2009, when a novel influenza A(H1N1)pdm09 virus provoked a worldwide pandemic.
Highlights
As the information regarding virus genotyping was unavailable, we could not distinguish between H1N1 infection and other flu-like illness, we obtained information about influenza-like illness (ILI) outpatient visits weekly ranging from the 35th International Organization for Standardization (ISO) week in 2004 to the 52th ISO week in 2017
In our study using population data, we identified a significant positive association between ILI and suicide mortality only after the 2009 pandemic, the year in which a novel influenza A (H1N1)pdm09 virus provoked a worldwide pandemic
We found lags shorter than 8 weeks with significantly positive association between ILI and suicidal behavior, and the result from Denmark study [8] did not apply any lag, which could imply that their result represent more immediate effect of infection and suicide death
Summary
Influenza monitoring data from 2004 to 2018 was available from KCDC website without any requirement for permission (http://www.cdc.go.kr/ npt/biz/npp/iss/influenzaStatisticsMain.do)
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