Abstract
The aim of the study was to describe the characteristics of subjects accessing the emergency rooms for suicidal behavior during the first epidemic wave of COVID-19 in three Emergency Departments (EDs) in Lombardy (Italy). A retrospective chart review was conducted for the period 8 March–3 June 2020, and during the same time frame in 2019. For all subjects accessing for suicidality, socio-demographic and clinical data were collected and compared between the two years. The proportion of subjects accessing for suicidality was significantly higher in 2020 than in 2019 (13.0 vs. 17.2%, p = 0.03). No differences between the two years were found for sex, triage priority level, history of substance abuse, factor triggering suicidality and discharge diagnosis. During 2020 a greater proportion of subjects did not show any mental disorders and were psychotropic drug-free. Women were more likely than men to receive inpatient psychiatric treatment, while men were more likely to be discharged with a diagnosis of acute alcohol/drug intoxication. Our study provides hints for managing suicidal behaviors during the still ongoing emergency and may be primary ground for further studies on suicidality in the course of or after massive infectious outbreaks.
Highlights
About 800,000 people worldwide die every year due to suicide and an even greater number attempts suicide or engages in self-injuring behaviors [1]
At the end of Emergency Departments (EDs) consultation, the vast majority, 87.2%, received a mental disorder diagnosis, while the remaining 12.8% were discharged with no psychiatric diagnosis/substance harmful use
There is the possibility that a number of people needing psychiatric emergency consultation during the first epidemic wave was shifted to the nearby Department of Pavia, in which the number of accesses for psychiatric consultation was especially high compared to the other two centers and significantly higher than in 2019
Summary
About 800,000 people worldwide die every year due to suicide and an even greater number attempts suicide or engages in self-injuring behaviors [1]. Up to 90% of suicides around the world are associated with mental disorders and substance abuse, including harmful use of alcohol [2]. A broad variety of environmental factors contribute to suicidal behavior, many of which originate from the concurrent cultural, social and economic context [1]. Suicidal spectrum behaviors include a broad variety of manifestations, from suicidal thoughts and plans, to suicidal self-injuring and suicide attempts, to completed suicide [3,4]. According to the ideation-to-action framework, the development of suicidal ideation and the progression from ideation to suicide attempts are distinct phenomena with distinct explanations and predictors [5]
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