Thirty-day suicidal thoughts and behaviours in the Spanish adult general population during the first wave of the Spain COVID-19 pandemic

P Mortier, G Vilagut, M Ferrer, I Alayo, R Bruffaerts, P Cristóbal-Narváez, I Del Cura-González, J Domènech-Abella, M Felez-Nobrega, B Olaya, J I Pijoan, E Vieta, V Pérez-Solà, R C Kessler, J M Haro, J Alonso, MINDCOVID Working group, MINDCOVID Working group, Itxaso Alayo, Jordi Alonso, Manuel Alonso, Mar Álvarez-Villalba, Benedikt Amann, Franco F Amigo, Gerard Anmella, Andrés Aragón, Núria Aragonès, Enric Aragonès, Ana Isabel Arizón, Angel Asunsolo, Alfons Ayora, Laura Ballester, Puri Barbas, Josep Basora, Elena Bereciartua, Inés Bravo, Ignasi Bolíbar, Xavier Bonfill, Ronny Bruffaerts, Alberto Cotillas-Rodero, Paula Cristóbal-Narváez, Andrés Cuartero, Concha de Paz, Isabel Del Cura-González, Maria Jesús Del Yerro, Joke De Vocht, Domingo Díaz, Joan Domènech-Abella, José Luís Domingo, José I Emparanza, Mireia Espallargues, Meritxell Espuga, Patricia Estevan-Burdeus, Mireia Félez-Nobrega, M Isabel Fernández, Tania Fernández, Montse Ferrer, Yolanda Ferreres, Giovanna Fico, María João Forjaz, Rosa García-Barranco, Carles García-Ribera, J Manuel García-Torrecillas, Araceli Garrido-Barral, Elisa Gil, María Giola-Insigna, Marta Gómez, Javier Gómez, Ana González-Pinto, Josep Maria Haro, Margarita Hernando, Milagros Iriberri, Leontien Jansen, Núria Jiménez, Xavi Jiménez, Ronald C Kessler, Amparo Larrauri, Fernando León-Vázquez, Mayte López-Atanes, Nieves López-Fresneña, Carmen López-Rodríguez, Juan A López-Rodríguez, Germán López-Cortacans, Alba Marcos, Jesús Martín, Vicente Martín, Mercedes Martínez-Cortés, Raquel Martínez-Martínez, Alma D Martínez de Salázar, Isabel Martínez, Marco Marzola, Nelva Mata, Josep María Molina, Juan D Molina, Emilia Molinero, Philippe Mortier, Carmen Muñoz-Ruipérez, Andrea Murru, Lydia Navarro, Beatriz Olaya, Jorge Olmedo-Galindo, Rafael M Ortí-Lucas, Rafael Padrós, Meritxell Pallejà, Raúl Parra, Julio Pascual, José María Pelayo-Terán, Rosa Pla, Nieves Plana, Coro Pérez-Aznar, Beatriz Pérez-Gómez, Víctor Pérez-Solà, Aurora Pérez-Zapata, José Ignacio Pijoan, Elena Polentinos-Castro, Beatriz Puértolas, María Teresa Puig, Álex Quílez, María Jesús Quintana, Antonio Quiroga, David Rentero, Cristina Rey, Cristina Rius, Carmen Rodríguez-Blázquez, M José Rojas-Giraldo, Yamina Romero-Barzola, Gabriel Rubio, Pedro Ruiz, Mercedes Rumayor, Margarita Sáenz, Jesús Sánchez, Ignacio Sánchez-Arcilla, Ferran Sanz, Cònsol Serra, Victòria Serra-Sutton, Manuela Serrano, Sílvia Solà, Sara Solera, Miguel Soto, Alejandra Tarragó, Natividad Tolosa, Mireia Vázquez, Margarita Viciola, Eduard Vieta, Gemma Vilagut, Wouter Voorspoels, Sara Yago-González, Jesús Yáñez-Sánchez, Yolanda Zapico, Luís María Zorita, Iñaki Zorrilla, Saioa L Zurbano, P Mortier, G Vilagut, M Ferrer, I Alayo, R Bruffaerts, P Cristóbal-Narváez, I Del Cura-González, J Domènech-Abella, M Felez-Nobrega, B Olaya, J I Pijoan, E Vieta, V Pérez-Solà, R C Kessler, J M Haro, J Alonso, MINDCOVID Working group, MINDCOVID Working group, Itxaso Alayo, Jordi Alonso, Manuel Alonso, Mar Álvarez-Villalba, Benedikt Amann, Franco F Amigo, Gerard Anmella, Andrés Aragón, Núria Aragonès, Enric Aragonès, Ana Isabel Arizón, Angel Asunsolo, Alfons Ayora, Laura Ballester, Puri Barbas, Josep Basora, Elena Bereciartua, Inés Bravo, Ignasi Bolíbar, Xavier Bonfill, Ronny Bruffaerts, Alberto Cotillas-Rodero, Paula Cristóbal-Narváez, Andrés Cuartero, Concha de Paz, Isabel Del Cura-González, Maria Jesús Del Yerro, Joke De Vocht, Domingo Díaz, Joan Domènech-Abella, José Luís Domingo, José I Emparanza, Mireia Espallargues, Meritxell Espuga, Patricia Estevan-Burdeus, Mireia Félez-Nobrega, M Isabel Fernández, Tania Fernández, Montse Ferrer, Yolanda Ferreres, Giovanna Fico, María João Forjaz, Rosa García-Barranco, Carles García-Ribera, J Manuel García-Torrecillas, Araceli Garrido-Barral, Elisa Gil, María Giola-Insigna, Marta Gómez, Javier Gómez, Ana González-Pinto, Josep Maria Haro, Margarita Hernando, Milagros Iriberri, Leontien Jansen, Núria Jiménez, Xavi Jiménez, Ronald C Kessler, Amparo Larrauri, Fernando León-Vázquez, Mayte López-Atanes, Nieves López-Fresneña, Carmen López-Rodríguez, Juan A López-Rodríguez, Germán López-Cortacans, Alba Marcos, Jesús Martín, Vicente Martín, Mercedes Martínez-Cortés, Raquel Martínez-Martínez, Alma D Martínez de Salázar, Isabel Martínez, Marco Marzola, Nelva Mata, Josep María Molina, Juan D Molina, Emilia Molinero, Philippe Mortier, Carmen Muñoz-Ruipérez, Andrea Murru, Lydia Navarro, Beatriz Olaya, Jorge Olmedo-Galindo, Rafael M Ortí-Lucas, Rafael Padrós, Meritxell Pallejà, Raúl Parra, Julio Pascual, José María Pelayo-Terán, Rosa Pla, Nieves Plana, Coro Pérez-Aznar, Beatriz Pérez-Gómez, Víctor Pérez-Solà, Aurora Pérez-Zapata, José Ignacio Pijoan, Elena Polentinos-Castro, Beatriz Puértolas, María Teresa Puig, Álex Quílez, María Jesús Quintana, Antonio Quiroga, David Rentero, Cristina Rey, Cristina Rius, Carmen Rodríguez-Blázquez, M José Rojas-Giraldo, Yamina Romero-Barzola, Gabriel Rubio, Pedro Ruiz, Mercedes Rumayor, Margarita Sáenz, Jesús Sánchez, Ignacio Sánchez-Arcilla, Ferran Sanz, Cònsol Serra, Victòria Serra-Sutton, Manuela Serrano, Sílvia Solà, Sara Solera, Miguel Soto, Alejandra Tarragó, Natividad Tolosa, Mireia Vázquez, Margarita Viciola, Eduard Vieta, Gemma Vilagut, Wouter Voorspoels, Sara Yago-González, Jesús Yáñez-Sánchez, Yolanda Zapico, Luís María Zorita, Iñaki Zorrilla, Saioa L Zurbano

Abstract

Aims: To investigate the prevalence of suicidal thoughts and behaviours (STB; i.e. suicidal ideation, plans or attempts) in the Spanish adult general population during the first wave of the Spain coronavirus disease 2019 (COVID-19) pandemic (March-July, 2020), and to investigate the individual- and population-level impact of relevant distal and proximal STB risk factor domains.

Methods: Cross-sectional study design using data from the baseline assessment of an observational cohort study (MIND/COVID project). A nationally representative sample of 3500 non-institutionalised Spanish adults (51.5% female; mean age = 49.6 [s.d. = 17.0]) was taken using dual-frame random digit dialing, stratified for age, sex and geographical area. Professional interviewers carried out computer-assisted telephone interviews (1-30 June 2020). Thirty-day STB was assessed using modified items from the Columbia Suicide Severity Rating Scale. Distal (i.e. pre-pandemic) risk factors included sociodemographic variables, number of physical health conditions and pre-pandemic lifetime mental disorders; proximal (i.e. pandemic) risk factors included current mental disorders and a range of adverse events-experiences related to the pandemic. Logistic regression was used to investigate individual-level associations (odds ratios [OR]) and population-level associations (population attributable risk proportions [PARP]) between risk factors and 30-day STB. All data were weighted using post-stratification survey weights.

Results: Estimated prevalence of 30-day STB was 4.5% (1.8% active suicidal ideation; n = 5 [0.1%] suicide attempts). STB was 9.7% among the 34.3% of respondents with pre-pandemic lifetime mental disorders, and 1.8% among the 65.7% without any pre-pandemic lifetime mental disorder. Factors significantly associated with STB were pre-pandemic lifetime mental disorders (total PARP = 49.1%) and current mental disorders (total PARP = 58.4%), i.e. major depressive disorder (OR = 6.0; PARP = 39.2%), generalised anxiety disorder (OR = 5.6; PARP = 36.3%), post-traumatic stress disorder (OR = 4.6; PARP = 26.6%), panic attacks (OR = 6.7; PARP = 36.6%) and alcohol/substance use disorder (OR = 3.3; PARP = 5.9%). Pandemic-related adverse events-experiences associated with STB were lack of social support, interpersonal stress, stress about personal health and about the health of loved ones (PARPs 32.7-42.6%%), and having loved ones infected with COVID-19 (OR = 1.7; PARP = 18.8%). Up to 74.1% of STB is potentially attributable to the joint effects of mental disorders and adverse events-experiences related to the pandemic.

Conclusions: STB at the end of the first wave of the Spain COVID-19 pandemic was high, and large proportions of STB are potentially attributable to mental disorders and adverse events-experiences related to the pandemic, including health-related stress, lack of social support and interpersonal stress. There is an urgent need to allocate resources to increase access to adequate mental healthcare, even in times of healthcare system overload.

Study registration number: NCT04556565.

Keywords: COVID-19; Spain; epidemiology; pandemic; risk factors; suicide.

Conflict of interest statement

EV reports personal fees from Abbott, personal fees from Allergan, personal fees from Angelini, grants from Novartis, grants from Ferrer, grants and personal fees from Janssen, personal fees from Lundbeck, personal fees from Sage, personal fees from Sanofi, outside the submitted work. In the past 3 years, RCK was a consultant for Datastat, Inc, Sage Pharmaceuticals and Takeda. VPS has been a consultant to or has received honoraria or grants from AB-Biotics, AstraZeneca, Bristol-Myers-Squibb, CIBERSAM, FIS- ISCIII, Janssen Cilag, Lundbeck, Otsuka, Servier and Pfizer. All other authors reported no conflict of interest.

References

    1. Adult Psychiatric Morbidity Survey (APMS). Survey of Mental Health and Wellbeing, England, 2014. NHS Digital, 2016 Available at (). Accessed 21 January 2021.
    1. Alfonso-Sánchez JL, Martin-Moreno JM, Martinez IM and Martinez AA (2020) Epidemiological study and cost analysis of suicide in Spain: over 100 years of evolution. Archives of Suicide Research 24, S356–S369.
    1. Allison PD (2012) Binary logistic regression: Details and options. In Logistic Regression Using SAS®: Theory and Application, 2nd Edn., Cary, NC: SAS Institute Inc, p. 57.
    1. Ammerman BA, Burke TA, Jacobucci R and McClure K (2021) Preliminary investigation of the association between COVID-19 and suicidal thoughts and behaviors in the U.S. Journal of Psychiatric Research 15, 32–38.
    1. Bahraini N, Brenner LA, Barry C, Hostetter T, Keusch J, Post EP, Kessler C, Smith C and Matarazzo BB (2020) Assessment of rates of suicide risk screening and prevalence of positive screening results among US veterans after implementation of the veterans affairs suicide risk identification strategy. JAMA Network Open 3, e2022531.
    1. Barzilay R, Moore TM, Greenberg DM, DiDomenico GE, Brown LA, White LK, Gur RC and Gur RE (2020) Resilience, COVID-19-related stress, anxiety and depression during the pandemic in a large population enriched for healthcare providers. Translational Psychiatry 10, 291.
    1. Bryan CJ, Bryan AO and Baker JC (2020) Associations among state-level physical distancing measures and suicidal thoughts and behaviors among U.S. adults during the early COVID-19 pandemic. Suicide and Life-Threatening Behavior 50, 1223–1229.
    1. Calderon-Anyosa RJC and Kaufman JS (2021) Impact of COVID-19 lockdown policy on homicide, suicide, and motor vehicle deaths in Peru. Preventive Medicine 143, 106331.
    1. Carrasco-Barrios MT, Huertas P, Martín P, Martín C, Castillejos MC, Petkari E and Moreno-Küstner B (2020) Determinants of suicidality in the European general population: a systematic review and meta-analysis. International Journal of Environmental Research and Public Health 17, 4115.
    1. Christensen H, Cuijpers P and Reynolds CF (2016) Changing the direction of suicide prevention research. JAMA Psychiatry 73, 435.
    1. Coroners Court of Victoria (2020) Coroners Court Monthly Suicide Data Report: Report 2–5 October 2020. Available at (). Accessed 21 January 2021.
    1. Czeisler MÉ, Lane RI, Petrosky E, Wiley JF, Christensen A, Njai R, Weaver MD, Robbins R, Facer-Childs ER, Barger LK, Czeisler CA, Howard ME and Rajaratnam SMW (2020) Mental health, substance use, and suicidal ideation during the COVID-19 pandemic − United States, 24−30 June 2020. MMWR. Morbidity and Mortality Weekly Report 69, 1049–1057.
    1. Dalgard O (1996) Community mental health profile as tool for psychiatric prevention. In Trent C and Reed DR (eds), Promotion of Mental Health. Aldershot: Avebury, pp. 681–695.
    1. Dohrenwend BS, Krasnoff L, Askenasy AR and Dohrenwend BP (1978) Exemplification of a method for scaling life events: the Peri Life Events Scale. Journal of Health and Social Behavior 19, 205–229.
    1. Eskin M, Tran US, Carta MG, Poyrazli S, Flood C, Mechri A, Shaheen A, Janghorbani M, Khader Y, Yoshimasu K, Sun J-M, Kujan O, Abuidhail J, Aidoudi K, Bakhshi S, Harlak H, Moro MF, Phillips L, Hamdan M, Abuderman A, Tsuno K and Voracek M (2020) Is individualism suicidogenic? Findings from a multinational study of young adults from 12 countries. Frontiers in Psychiatry 11, 1–16.
    1. Faust JS, Shah SB, Du C, Li S-X, Lin Z and Krumholz HM (2021) Suicide deaths during the COVID-19 stay-at-home advisory in Massachusetts, March to May 2020. JAMA Network Open 4, e2034273.
    1. Fazel S and Runeson B (2020) Suicide. New England Journal of Medicine 382, 266–274.
    1. Fitzpatrick KM, Harris C and Drawve G (2020) How bad is it? Suicidality in the middle of the COVID-19 pandemic. Suicide and Life-Threatening Behavior 50, 1241–1249.
    1. Fleiss JL (1979) Inference about population attributable risk from cross-sectional studies. American Journal of Epidemiology 110, 103–104.
    1. Franklin JC, Ribeiro JD, Fox KR, Bentley KH, Kleiman EM, Huang X, Musacchio KM, Jaroszewski AC, Chang BP and Nock MK (2017) Risk factors for suicidal thoughts and behaviors: a meta-analysis of 50 years of research. Psychological Bulletin 143, 187–232.
    1. Gratz KL, Tull MT, Richmond JR, Edmonds KA, Scamaldo KM and Rose JP (2020) Thwarted belongingness and perceived burdensomeness explain the associations of COVID-19 social and economic consequences to suicide risk. Suicide and Life-Threatening Behavior 50, 1140–1148.
    1. Gunnell D, Appleby L, Arensman E, Hawton K, John A, Kapur N, Khan M, O'Connor RC, Pirkis J, Appleby L, Arensman E, Caine ED, Chan LF, Chang S-S, Chen Y-Y, Christensen H, Dandona R, Eddleston M, Erlangsen A, Gunnell D, Harkavy-Friedman J, Hawton K, John A, Kapur N, Khan M, Kirtley OJ, Knipe D, Konradsen F, Liu S, McManus S, Mehlum L, Miller M, Moran P, Morrissey J, Moutier C, Niederkrotenthaler T, Nordentoft M, O'Connor RC, O'Neill S, Page A, Phillips MR, Pirkis J, Platt S, Pompili M, Qin P, Rezaeian M, Silverman M, Sinyor M, Stack S, Townsend E, Turecki G, Vijayakumar L and Yip PS (2020) Suicide risk and prevention during the COVID-19 pandemic. The Lancet Psychiatry 7, 468–471.
    1. Hinkin CH, Castellon SA, Dickson-Fuhrman E, Daum G, Jaffe J and Jarvik L (2001) Screening for drug and alcohol abuse among older adults using a modified version of the CAGE. The American Journal on Addictions 10, 319–326.
    1. Iob E, Steptoe A and Fancourt D (2020) Abuse, self-harm and suicidal ideation in the UK during the COVID-19 pandemic. The British Journal of Psychiatry 217, 543–546.
    1. Kessler RC and Üstün TB (2004) The World Mental Health (WMH) survey initiative version of the World Health Organization (WHO) Composite International Diagnostic Interview (CIDI). International Journal of Methods in Psychiatric Research 13, 93–121.
    1. Kessler RC, McGonagle KA, Zhao S, Nelson CB, Hughes M, Eshleman S, Wittchen HU and Kendler KS (1994) Lifetime and 12-month prevalence of DSM-III-R psychiatric disorders in the United States. Results from the National Comorbidity Survey. Archives of General Psychiatry 51, 8–19.
    1. Kessler RC, Santiago PN, Colpe LJ, Dempsey CL, First MB, Heeringa SG, Stein MB, Fullerton CS, Gruber MJ, Naifeh JA, Nock MK, Sampson NA, Schoenbaum M, Zaslavsky AM and Ursano RJ (2013) Clinical reappraisal of the Composite International Diagnostic Interview Screening Scales (CIDI-SC) in the Army Study to Assess Risk and Resilience in Service members (Army STARRS). International Journal of Methods in Psychiatric Research 22, 303–321.
    1. Kroenke K, Strine TW, Spitzer RL, Williams JBW, Berry JT and Mokdad AH (2009) The PHQ-8 as a measure of current depression in the general population. Journal of Affective Disorders 114, 163–173.
    1. Krysinska K and Martin G (2009) The struggle to prevent and evaluate: application of population attributable risk and preventive fraction to suicide prevention research. Suicide and Life-Threatening Behavior 39, 548–557.
    1. MIND/COVID-19. Mental health Impact and NeeDs associated with COVID-19: a comprehensive national evaluation in Spain (COV20/00711; 2020). Available at (). Accessed 8 February 2021.
    1. Miret M, Caballero FF, Huerta-Ramírez R, Moneta MV, Olaya B, Chatterji S, Haro JM and Ayuso-Mateos JL (2014) Factors associated with suicidal ideation and attempts in Spain for different age groups. Prevalence before and after the onset of the economic crisis. Journal of Affective Disorders 163, 1–9.
    1. Moutier C (2020) Suicide prevention in the COVID-19 era: transforming threat into opportunity. JAMA Psychiatry [Published Online].
    1. Newman MG, Zuellig AR, Kachin KE, Constantino MJ, Przeworski A, Erickson T and Cashman-McGrath L (2002) Preliminary reliability and validity of the generalized anxiety disorder questionnaire-IV: a revised self-report diagnostic measure of generalized anxiety disorder. Behavior Therapy 33, 215–233.
    1. Nock MK, Borges G and Ono Y (2015) Chapter 3: Methods of the world mental health surveys. In Nock MK, Borges G and Ono Y (eds), Suicide. Global Perspectives From the WHO World Mental Health Surveys. New York: Cambridge University Press, pp. 57.
    1. O'Connor RC and Kirtley OJ (2018) The integrated motivational–volitional model of suicidal behaviour. Philosophical Transactions of the Royal Society B: Biological Sciences 373, 20170268.
    1. O'Connor RC, Wetherall K, Cleare S, McClelland H, Melson AJ, Niedzwiedz CL, O'Carroll RE, O'Connor DB, Platt S, Scowcroft E, Watson B, Zortea T, Ferguson E and Robb KA (2020) Mental health and well-being during the COVID-19 pandemic: longitudinal analyses of adults in the UK COVID-19 Mental Health & Wellbeing study. The British Journal of Psychiatry [Published Online].
    1. Posner K, Brown GK, Stanley B, Brent DA, Yershova K V, Oquendo MA, Currier GW, Melvin GA, Greenhill L, Shen S and Mann JJ (2011) The Columbia-suicide severity rating scale: initial validity and internal consistency findings from three multisite studies with adolescents and adults. American Journal of Psychiatry 168, 1266–1277.
    1. Qi J, Zhang D, Zhang X, Yin P, Liu J, Pan Y, Takana T, Xie P, Wang Z, Liu S, Gao GF, He G, Zhou M, Qi J, Yin P, Liu MPHJ, Zhou M, Zhang D, Zhang XB, Xie PM, Wang ZM and Kong H (2020) Do Lockdowns Bring about Additional Mortality Benefits or Costs? Evidence based on Death Records from 300 Million Chinese People. medRxiv 2020.08.28.20183699.
    1. Qin P and Mehlum L (2020) National observation of death by suicide in the first 3 months under COVID-19 pandemic. Acta Psychiatrica Scandinavica 43, 92–93.
    1. Quarterly Suicide Death Registrations in England. 2001 to 2019 Registrations and Quarter 1 (Jan to Mar) to Quarter 2 (Apr to June) 2020 Provisional Data. Office for National Statistics. Available at (). Accessed 21 January 2021.
    1. Radeloff D, Papsdorf R, Uhlig K, Vasilache A, Putnam K and von Klitzing K (2021) Trends in suicide rates during the COVID-19 pandemic restrictions in a major German city. Epidemiology and Psychiatric Sciences [Published online].
    1. Red Nacional de Vigilancia Epidemiólogica (RENAVE) (2020) Ministerio de Sanidad, España. Available at (). Accessed 21 January 2021.
    1. Roser M, Ritchie H, Ortiz-Ospina E and Hasell J (2020) Coronavirus Pandemic (COVID-19). Our World in Data Available at (). Accessed 8 February 2021.
    1. Sáiz PA, de la Fuente-Tomas L, García-Alvarez L, Bobes-Bascarán MT, Moya-Lacasa C, García-Portilla MP and Bobes J (2020) Prevalence of passive suicidal ideation in the early stage of the coronavirus disease 2019 (COVID-19) pandemic and lockdown in a large Spanish sample. The Journal of Clinical Psychiatry 81, 4–5.
    1. Sangha O, Stucki G, Liang MH, Fossel AH and Katz JN (2003) The self-administered comorbidity questionnaire: a new method to assess comorbidity for clinical and health services research. Arthritis and Rheumatism 49, 156–163.
    1. SAS Institute Inc (2013) SAS® Software, Version 9.4. Cary, NC: SAS Institute Inc.
    1. Schisterman EF, Cole SR and Platt RW (2009) Overadjustment bias and unnecessary adjustment in epidemiologic studies. Epidemiology (Cambridge, Mass.) 20, 488–495.
    1. Schooling CM and Jones HE (2018) Clarifying questions about “risk factors”: predictors versus explanation. Emerging Themes in Epidemiology 15, 10.
    1. Substance Abuse and Mental Health Services Administration (2018) Key Substance use and Mental Health Indicators in the United States: Results From the 2018 National Survey on Drug Use and Health. Rockville, MD: US Department of Health and Human Services, Substance Abuse and Mental Health Services Administration; Available at (). Accessed 21 January 2021.
    1. Tanaka T and Okamoto S (2021) Increase in suicide following an initial decline during the COVID-19 pandemic in Japan. Nature Human Behaviour [Published online].
    1. Torok M, Han J, Baker S, Werner-Seidler A, Wong I, Larsen ME and Christensen H (2020) Suicide prevention using self-guided digital interventions: a systematic review and meta-analysis of randomised controlled trials. The Lancet Digital Health 2, e25–e36.
    1. van Buuren SV (2018) Flexible Imputation of Missing Data, Second Edition. Florida: CRC Press.
    1. Vandoros S, Theodorikakou O, Katsadoros K, Zafeiropoulou D, Kawachi I, Nadeau-Routhier C, Knotts R, Bar-Cohen R, Barbhaiya C, Aizer A, Holmes D, Bernstein S, Spinelli M, Park D, Chinitz L, Jankelosn L, Jones-Beatty K, Golden WC, Satin AJ, Sheffield JS, Pekosz A, Klein S and Burd I (2020) No evidence of increase in suicide in Greece during the first wave of Covid-19. medRxiv 2020.11.13.20231571.
    1. Vieta E, Pérez V and Arango C (2020) Psychiatry in the aftermath of COVID-19. Revista de psiquiatria y salud mental 13, 105–110.
    1. Vindegaard N and Benros ME (2020) COVID-19 pandemic and mental health consequences: systematic review of the current evidence. Brain, Behavior, and Immunity 89, 531–542.
    1. Wasserman D, Iosue M, Wuestefeld A and Carli V (2020) Adaptation of evidence-based suicide prevention strategies during and after the COVID-19 pandemic. World Psychiatry 19, 294–306.
    1. WHO Coronavirus Disease (COVID-19) Dashboard. World Health Organization Available at () Accessed 21 January 2021.
    1. Winkler P, Formanek T, Mlada K, Kagstrom A, Mohrova Z, Mohr P and Csemy L (2020) Increase in prevalence of current mental disorders in the context of COVID-19: analysis of repeated nationwide cross-sectional surveys. Epidemiology and Psychiatric Sciences 29, e173.
    1. Zuromski KL, Ustun B, Hwang I, Keane TM, Marx BP, Stein MB, Ursano RJ and Kessler RC (2019) Developing an optimal short-form of the PTSD checklist for DSM-5 (PCL-5). Depression and Anxiety 36, 790–800.

Source: PubMed

Sponzoři a spolupracovníci

Zdravotní podmínky

Drogové intervence

3
Předplatit