Citation

Chen R. Lancet Reg. Health Eur. 2021; 6: e100123.

Copyright

(Copyright © 2021, Elsevier Publishing)

DOI

10.1016/j.lanepe.2021.100123

PMID

34557832

Abstract

Self-harm is one of the strongest predictors of suicide. There have been increased concerns regarding the impact of the COVID-19 pandemic on self-harm in Europe [1] and in other places globally [2], following research showing that population mental health has deteriorated during the pandemic [3,4]. In The Lancet Regional Health - Europe, Jollant F et al. [5] examined the impact of COVID-19 on self-harm hospitalisations in France through comprehensive analysis of the French national database Programme de Médicalisation des Systèmes d'Information (PMSI). They identified 53,583 self-harm hospitalisations during January to August 2020, and found an overall 8.5% decrease in self-harm hospital admission compared to the same period in 2019. The decrease started from the middle of March 2020 when the national lockdown was implemented, while it did not occur in January, February and in early March before the lockdown. Such patterns of decreased self-harm hospitalisations in 2020 were confirmed by further historical comparison to 2017 and 2018. Jollant F et al. [5] also showed that the decrease was more obvious in younger age groups (<19 years old) and in women. Among those with self-harm admitted to hospital, however, there were increased numbers of severe cases (including self-harm by firearm, jumping from height, drowning), intensive care stay, and self-harm mortality [5]. The study has provided new evidence on the presentation of self-harm as a result of the policy effects of COVID-19, and will have important implications on the management of self-harm across populations during the COVID-19 pandemic.

The findings of decreased self-harm during the COVID-19 in France were consistent to those in the UK. Carr et al. [6] analysed the UK national representative data from Clinical Practice Research Datalink (CPRD), including 14 million individuals and found that the recorded incidence of self-harm during 1st March to 10th September 2020 was significantly lower than expected, in England by 18.0% and in Northern Ireland, Scotland and Wales by 9.0%. The reduced incidence of self-harm was particularly marked in people aged < 45 years and in women [7].

There are some theories to explain the decrease in self-harm during the COVID-19 pandemic and lockdown periods, particularly in younger age groups, including so-called "pulling-together effect or honeymoon effect" [8], less academic pressure and peer bullying due to the school closedown, more parental care and attention given to children, and increased hospital attendance due to emerged COVID-19...

Language: en