SARS-CoV-2 Infection and the Risk of Suicidal and Self-Harm Thoughts and Behaviour: A Systematic Review. (November 2022)

• Record Type: Journal Article
• Authors: Sinyor, Mark; Zaheer, Rabia; Webb, Roger T.; Knipe, Duleeka; Eyles, Emily; Higgins, Julian P.T.; McGuinness, Luke; Schmidt, Lena; Macleod-Hall, Catherine; Dekel, Dana; Gunnell, David; John, Ann
• Is Part Of: Canadian journal of psychiatry =. Volume 67:Number 11(2022)
• Page Start: 813
• Page End: 828
• Publication Date: 2022-11
• Subjects: systematic review -- SARS-CoV-2 -- COVID-19 -- suicide -- self-harm; Psychiatry -- Periodicals; Psychiatry -- Canada -- Periodicals; 616.8900971
• DOI: 10.1177/07067437221094552
• Languages: English
• ISSNs: 0706-7437

Abstract

Objective: The COVID-19 pandemic has had a complex impact on risks of suicide and non-fatal self-harm worldwide with some evidence of increased risk in specific populations including women, young people, and people from ethnic minority backgrounds. This review aims to systematically address whether SARS-CoV-2 infection and/or COVID-19 disease confer elevated risk directly. Method: As part of a larger Living Systematic Review examining self-harm and suicide during the pandemic, automated daily searches using a broad list of keywords were performed on a comprehensive set of databases with data from relevant articles published between January 1, 2020 and July 18, 2021. Eligibility criteria for our present review included studies investigating suicide and/or self-harm in people infected with SARS-CoV-2 with or without manifestations of COVID-19 disease with a comparator group who did not have infection or disease. Suicidal and self-harm thoughts and behaviour (STBs) were outcomes of interest. Studies were excluded if they reported data for people who only had potential infection/disease without a confirmed exposure, clinical/molecular diagnosis or self-report of a positive SARS-CoV-2 test result. Studies of news reports, treatment studies, and ecological studies examining rates of both SARS-CoV-2 infections and suicide/self-harm rates across a region were also excluded. Results: We identified 12 studies examining STBs in nine distinct samples of people with SARS-CoV-2. These studies, which investigated STBs in the general population and in subpopulations, including healthcare workers, generally found positive associations between SARS-CoV-2 infection and/or COVID-19 disease and subsequent suicidal/self-harm thoughts and suicidal/self-harm behaviour. Conclusions: This review identified some evidence that infection with SARS-CoV-2 and/or COVID-19 disease may be associated with increased risks for suicidal and self-harm thoughts and behaviours but a causal link cannot be inferred. Further research with longer follow-up periods is required to confirm these findings and to establish whether these associations are causal.