TY  - JOUR
AU  - Baillet, Maëlle
AU  - Wathelet, Marielle
AU  - Lamer, Antoine
AU  - Frévent, Camille
AU  - Fovet, Thomas
AU  - D'Hondt, Fabien
AU  - Notredame, Charles-Edouard
AU  - Vaiva, Guillaume
AU  - Génin, Michael
PY  - 2024
DA  - 2024/8/27
TI  - Association Between COVID-19 and Self-Harm: Nationwide Retrospective Ecological Spatiotemporal Study in Metropolitan France
JO  - JMIR Public Health Surveill
SP  - e52759
VL  - 10
KW  - self-harm
KW  - COVID-19
KW  - spatiotemporal analysis
KW  - ecological regression
KW  - data reuse
AB  - Background: The COVID-19 pandemic has not been associated with increases in suicidal behavior at the national, regional, or county level. However, previous studies were not conducted on a finer scale or adjusted for ecological factors. Objective: Our objective was to assess the fine-scale spatiotemporal association between self-harm and COVID-19 hospitalizations, while considering ecological factors. Methods: Using the French national hospital discharge database, we extracted data on hospitalizations for self-harm of patients older than 10 years (from 2019 to 2021) or for COVID-19 (from 2020 to 2021) in metropolitan France. We first calculated monthly standardized incidence ratios (SIRs) for COVID-19 between March 2020 and December 2021, using a Besag, York, and Mollié spatiotemporal model. Next, we entered the SIRs into an ecological regression in order to test the association between hospital admissions for self-harm and those for COVID-19. Lastly, we adjusted for ecological variables with time lags of 0 to 6 months. Results: Compared with a smoothed SIR of ≤1, smoothed SIRs from 1 to 3, from 3 to 4, and greater than 4 for COVID-19 hospital admissions were associated with a subsequent increase in hospital admissions for self-harm, with a time lag of 2 to 4 months, 4 months, and 6 months, respectively. Conclusions: A high SIR for hospital admissions for COVID-19 was a risk factor for hospital admission for self-harm some months after the epidemic peaks. This finding emphasizes the importance of monitoring and seeking to prevent suicide attempts outside the epidemic peak periods. 
SN  - 2369-2960
UR  - https://publichealth.jmir.org/2024/1/e52759
UR  - https://doi.org/10.2196/52759
DO  - 10.2196/52759
ID  - info:doi/10.2196/52759
ER  -