Suicide related to the COVID-19 pandemic in India: A systematic review

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Abstract

Background

The suicide rate has increased during the pandemic in India. Moreover, several studies, especially press-media reporting suicide studies have been conducted but no systematic review has been attempted in this context. Therefore, the present study systematically investigated the risk factors associated with suicidal behaviors, and the method of suicide during the COVID-19 pandemic in India.

Methods

Following the PRISMA guidelines, a systematic search was performed to include papers published up until September 30, 2022. From an initial 144 papers, 18 studies which met the inclusion criteria were included in the present review. The Pierson’s method was used for quality assessment of the included studies in the present review.

Results

The risk factors associated with suicide comprised: (i) socio-demographic factors (e.g., being aged between 31 and 50 years, male, married, unemployed), (ii) behavior and health-related factors (e.g., unavailability of alcohol and alcohol withdrawal symptoms, poor state of physical health and health issues, family disputes, relationship complexities, and sexual harassment), (iii) COVID-19-related factors (e.g., fear of COVID-19, COVID-19 test results, quarantine or isolation, financial hardship due to the pandemic, having influenza-like symptoms, experiencing stigmatization and ostracism despite testing negative, separation from family due to transport restrictions, misinterpreting other illness symptoms as COVID-19, saving the village from infection, watching COVID-19 videos on social media, online schooling, perceived stigma toward COVID-19, and being suspected of having COVID-19), and (iv) psychopathological stressors (depression, loneliness, stress, TikTok addiction, and poor mental health, suicidal tendencies, helplessness, and worrying). Hanging was the most common method of suicide. In addition, jumping from high buildings, poisoning, drowning, burning, cutting or slitting throat or wrists, self-immolation, medication overdose, electrocution, pesticide, and gun-shot were also used to carry out the suicide.

Conclusions

Findings from this research suggest multiple reasons for suicide during the COVID-19 pandemic and knowledge of such factors could aid in developing suicide prevention strategies focusing the most vulnerable cohorts inside and outside India.

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Most cited references 41

Record: found
Abstract: found
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The psychological impact of quarantine and how to reduce it: rapid review of the evidence

Samantha K. Brooks, Rebecca K Webster, Louise E. Smith … (2022)

Summary The December, 2019 coronavirus disease outbreak has seen many countries ask people who have potentially come into contact with the infection to isolate themselves at home or in a dedicated quarantine facility. Decisions on how to apply quarantine should be based on the best available evidence. We did a Review of the psychological impact of quarantine using three electronic databases. Of 3166 papers found, 24 are included in this Review. Most reviewed studies reported negative psychological effects including post-traumatic stress symptoms, confusion, and anger. Stressors included longer quarantine duration, infection fears, frustration, boredom, inadequate supplies, inadequate information, financial loss, and stigma. Some researchers have suggested long-lasting effects. In situations where quarantine is deemed necessary, officials should quarantine individuals for no longer than required, provide clear rationale for quarantine and information about protocols, and ensure sufficient supplies are provided. Appeals to altruism by reminding the public about the benefits of quarantine to wider society can be favourable.

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Record: found
Abstract: found
Article: not found

Preferred reporting items for systematic reviews and meta-analyses: the PRISMA statement

David Moher, Alessandro Liberati, Jennifer Tetzlaff … (2012)

David Moher and colleagues introduce PRISMA, an update of the QUOROM guidelines for reporting systematic reviews and meta-analyses

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Suicide trends in the early months of the COVID-19 pandemic: an interrupted time-series analysis of preliminary data from 21 countries

Jane Pirkis, Ann John, Sangsoo Shin … (2021)

Background The COVID-19 pandemic is having profound mental health consequences for many people. Concerns have been expressed that, at their most extreme, these consequences could manifest as increased suicide rates. We aimed to assess the early effect of the COVID-19 pandemic on suicide rates around the world. Methods We sourced real-time suicide data from countries or areas within countries through a systematic internet search and recourse to our networks and the published literature. Between Sept 1 and Nov 1, 2020, we searched the official websites of these countries’ ministries of health, police agencies, and government-run statistics agencies or equivalents, using the translated search terms “suicide” and “cause of death”, before broadening the search in an attempt to identify data through other public sources. Data were included from a given country or area if they came from an official government source and were available at a monthly level from at least Jan 1, 2019, to July 31, 2020. Our internet searches were restricted to countries with more than 3 million residents for pragmatic reasons, but we relaxed this rule for countries identified through the literature and our networks. Areas within countries could also be included with populations of less than 3 million. We used an interrupted time-series analysis to model the trend in monthly suicides before COVID-19 (from at least Jan 1, 2019, to March 31, 2020) in each country or area within a country, comparing the expected number of suicides derived from the model with the observed number of suicides in the early months of the pandemic (from April 1 to July 31, 2020, in the primary analysis). Findings We sourced data from 21 countries (16 high-income and five upper-middle-income countries), including whole-country data in ten countries and data for various areas in 11 countries). Rate ratios (RRs) and 95% CIs based on the observed versus expected numbers of suicides showed no evidence of a significant increase in risk of suicide since the pandemic began in any country or area. There was statistical evidence of a decrease in suicide compared with the expected number in 12 countries or areas: New South Wales, Australia (RR 0·81 [95% CI 0·72–0·91]); Alberta, Canada (0·80 [0·68–0·93]); British Columbia, Canada (0·76 [0·66–0·87]); Chile (0·85 [0·78–0·94]); Leipzig, Germany (0·49 [0·32–0·74]); Japan (0·94 [0·91–0·96]); New Zealand (0·79 [0·68–0·91]); South Korea (0·94 [0·92–0·97]); California, USA (0·90 [0·85–0·95]); Illinois (Cook County), USA (0·79 [0·67–0·93]); Texas (four counties), USA (0·82 [0·68–0·98]); and Ecuador (0·74 [0·67–0·82]). Interpretation This is the first study to examine suicides occurring in the context of the COVID-19 pandemic in multiple countries. In high-income and upper-middle-income countries, suicide numbers have remained largely unchanged or declined in the early months of the pandemic compared with the expected levels based on the pre-pandemic period. We need to remain vigilant and be poised to respond if the situation changes as the longer-term mental health and economic effects of the pandemic unfold. Funding None.

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Author and article information

Contributors

Mohammed A. Mamun:

ORCID: http://orcid.org/0000-0002-1728-8966

mamunphi46@gmail.com

Journal

Journal ID (iso-abbrev): Discov Psychol

Title: Discover Psychology

Publisher: Springer International Publishing (Cham )

ISSN (Electronic): 2731-4537

Publication date (Electronic): 10 January 2023

Publication date PMC-release: 10 January 2023

Publication date (Print): 2023

Volume: 3

Issue: 1

Electronic Location Identifier: 2

Affiliations

[1 ]CHINTA Research Bangladesh, Dhaka, 1342 Savar, Bangladesh

[2 ]GRID grid.411808.4, ISNI 0000 0001 0664 5967, Department of Public Health and Informatics, , Jahangirnagar University, ; Dhaka, Savar, 1342 Bangladesh

[3 ]GRID grid.449901.1, ISNI 0000 0004 4683 713X, Department of Public Health, , University of South Asia, ; Dhaka, Savar, Bangladesh

[4 ]GRID grid.33440.30, ISNI 0000 0001 0232 6272, Department of Psychiatry, Faculty of Medicine, , Mbarara University of Science and Technology, ; Mbarara, Uganda

[5 ]GRID grid.12361.37, ISNI 0000 0001 0727 0669, International Gaming Research Unit, Psychology Department, , Nottingham Trent University, ; Nottingham, UK

[6 ]GRID grid.25073.33, ISNI 0000 0004 1936 8227, Department of Psychiatry and Behavioural Neurosciences, , McMaster University, ; Hamilton, Ontario Canada

Author information

Firoj Al-Mamun http://orcid.org/0000-0003-4611-9624

Mohammed A. Mamun http://orcid.org/0000-0002-1728-8966

Article

Publisher ID: 63

DOI: 10.1007/s44202-022-00063-1

PMC ID: 9831013

SO-VID: 7fb49164-b0a3-4429-ab34-982c77627592

License:

Open AccessThis article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article's Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article's Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/.

History

Date received : 4 December 2022

Date accepted : 14 December 2022

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Keywords: covid-19 suicide,suicide,suicidal behavior,suicide risk factors,suicide methods,media reported suicide

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Keywords: covid-19 suicide, suicide, suicidal behavior, suicide risk factors, suicide methods, media reported suicide

Suicide related to the COVID-19 pandemic in India: A systematic review

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Novel Coronavirus Disease COVID-19

Most cited references 41

The psychological impact of quarantine and how to reduce it: rapid review of the evidence

Preferred reporting items for systematic reviews and meta-analyses: the PRISMA statement

Suicide trends in the early months of the COVID-19 pandemic: an interrupted time-series analysis of preliminary data from 21 countries

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