Temporal Changes in Suicide Mortality Rates Before and During the COVID-19 Pandemic in Colombia. A Joint Point Regression Model

Abstract

IntroductionThe coronavirus disease (COVID-19) pandemic was declared in March 2020. This disease affects the respiratory system, and shown high rates of morbidity and mortality during 2020 and 2021. Neurological compromise and increased rates of depression, anxiety, insomnia, and substance abuse have also been described. Public health policies to prevent COVID-19 infection, decrease in control and monitoring of mental illness, and social and economic impact may have contributed to the increase in suicidal ideation and suicides. It is not yet clear if there have been changes in suicide mortality rates in Colombia before and during the pandemic. ObjectiveTo describe and analyze the changes in the temporal trends of suicide mortality rates in Colombia between 2008 and 2020. MethodsBased on national records, suicide mortality rates observed in Colombia during the COVID-19 pandemic were calculated and compared with those reported in previous years (2008–2019). Mortality rates were analyzed by age, sex, educational level, type of affiliation to health system, region, and etiology of death by suicide. Using the joint point regression software 3.4.4, changes in time trends in suicide mortality rates were estimated for each mentioned variable. Annual percentage changes (APC) were estimated, and their statistical significance was calculated. ResultsThe crude suicide mortality rate in Colombia in 2020 (5.4 per 100000 inhabitants) decreased compared to those reported in the previous 3 years. Estimates of changes in time trends in suicide mortality rates between 2008 and 2020 showed a decrease in men of −5.28 (APC) (p<0.05) between 2018 and 2020, and an increase in women of 3.75 (APC) (p<0.05) between 2011 and 2020. Regarding age (by five-year periods), an increase of 3.87 (APC) (p<0.05) was determined in people between 15 and 19 years old between 2012 and 2020. According to health system affiliation regimen, decreases were estimated between 2016 and 2020 (−58.45 CPA; p<0.05) for people affiliated to especial and exceptional health regimes; and between 2015 and 2020 (−53.49 CPA; p<0.05) for the uninsured. ConclusionsThe crude suicide mortality rate during the COVID-19 pandemic in Colombia decreased compared to what was reported in the previous years. Although significant changes were found in the temporal trends of suicide mortality rates in different periods for all variables, no significant increases were identified between 2019 and 2020.