Suicide mortality in Spain in 2020: The impact of the COVID-19 pandemic

Abstract

Introduction

Suicide constitutes a major concern with evident contribution to global mortality worldwide. Evidence on suicide trends is mixed in the COVID-19 pandemic era. Spain may be an at-risk country for increased suicide risk in the time of COVID-19 pandemic due to prolonged restrictions and lockdown, elevated COVID-19 wave recurrence and related mental health impact. This brief report aims to provide some insight into the suicide mortality trends in the first COVID-19 pandemic year in Spain, using national data.

Material and methods

Data from the National Death Index were used. Annual mortality rate was calculated at a province level under random-effects models for the 2019 and 2020 years. Poisson timeseries regression was used to study the relationship between monthly suicide mortality and COVID-19 pandemic outbreak and lockdown, and second COVID-19 wave peak covariates.

Results

3671 people died by suicide in 2019 in Spain and 3941 people died by suicide in 2020. The random-effects mortality rate in 2019 was 8.3 (CI₉₅ = 7.6, 9.0) per 100,000 inhabitants, and mortality rate in 2020 was 8.9 (CI₉₅ = 8.3, 9.6). No significant differences between mortality rates were found (p = .18). The Poisson regression showed a significant relationship between the COVID-19 outbreak and suicide mortality trend, with OR = 1.07 (CI₉₅ = 1.02, 1.12).

Conclusions

Although annual mortality rates were not significantly different, an increased suicide risk was found from May, 2020 onwards. Our results claim for action to tackle suicide in the post-pandemic era taking into account the discouraging upcoming scenario.

Resumen

Introducción

El suicidio constituye uno de los problemas de salud pública más importantes a nivel mundial. Los estudios no dejan clara la tendencia de mortalidad por suicidio en la pandemia por COVID-19. España podría registrar tasas crecientes de mortalidad por suicidio, dadas las restricciones prolongadas, la recurrencia de olas del virus y el elevado impacto en salud mental. Este estudio breve pretende proporcionar evidencia de las tendencias de mortalidad en el primer año de pandemia COVID-19 en España.

Materiales y método

Se estimaron tasas anuales de mortalidad, usando modelos de efectos aleatorios a partir del índice nacional de mortalidad para los años 2019 y 2020. Se usaron regresiones poissonianas para estudiar la relación de la mortalidad mensual por suicidio y factores temporales asociados a la pandemia.

Resultados

Tres mil setecientos sesenta y una personas murieron por suicidio en España en 2019, y 3.941 personas murieron en 2020. La tasa de mortalidad en 2019 fue de 8,3 (IC₉₅ = 7,6-9,0) por cada 100.000 habitantes, y de 8,9 (IC₉₅ = 8,3-9,6) en 2020. No se encontraron diferencias significativas entre ambas tasas (p = 0,18). La regresión poissoniana reveló una relación significativa entre la tendencia de mortalidad por suicidio y el inicio de la pandemia COVID-19, OR = 1,07 (IC₉₅ = 1,02-1,12).

Conclusiones

No se observó tasa de mortalidad por suicidio significativamente mayor en 2020, pero sí una tendencia creciente de casos desde mayo del 2020 en adelante. Nuestros resultados pretenden instar a tomar medidas para atajar la conducta suicida en la época pospandemia.