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      Suicide rates during social crises: Changes in the suicide rate in Japan after the Great East Japan earthquake and during the COVID-19 pandemic

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          Abstract

          We aimed to observe the changes in suicide rates after the Great East Japan Earthquake and during the coronavirus (COVID-19) pandemic, as typical cases of social crises, in Japan. A descriptive epidemiological study was conducted using data on the number of deaths by suicide published by the National Police Agency. The suicide rate ratio during the crisis—the monthly suicide mortality rate in the year of the crisis divided by the average suicide mortality rate in the three years before the crisis—was used as the indicator. After the earthquake, in March 2011 the suicide rate was 18% lower than the average mortality rate for the previous three years. However, it increased by 18% in May and 8% in June; increased mortality was observed among women. The suicide rate began to decline after October 2011. During the COVID-19 pandemic, the suicide rate decreased from February to June 2020. The declines in April and May were significant at 20% and 18%, respectively. From July onwards, the suicide rate of women began to rise, and from October, the overall suicide also began to increase. The rise in female suicide rates was significant, especially in October, with an increase of 70%. Thus, during these crises, suicide rates fell temporarily but then rose, especially among women. The period of increase in suicide rates was longer during the COVID-19 pandemic than after the earthquake. Therefore, there is an urgent need to promote measures for suicide prevention currently, and during a future crisis.

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          Most cited references20

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          Increase in suicide following an initial decline during the COVID-19 pandemic in Japan

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            Is Open Access

            Impact of 2008 global economic crisis on suicide: time trend study in 54 countries

            Objective To investigate the impact of the 2008 global economic crisis on international trends in suicide and to identify sex/age groups and countries most affected. Design Time trend analysis comparing the actual number of suicides in 2009 with the number that would be expected based on trends before the crisis (2000-07). Setting Suicide data from 54 countries; for 53 data were available in the World Health Organization mortality database and for one (the United States) data came the CDC online database. Population People aged 15 or above. Main outcome measures Suicide rate and number of excess suicides in 2009. Results There were an estimated 4884 (95% confidence interval 3907 to 5860) excess suicides in 2009 compared with the number expected based on previous trends (2000-07). The increases in suicide mainly occurred in men in the 27 European and 18 American countries; the suicide rates were 4.2% (3.4% to 5.1%) and 6.4% (5.4% to 7.5%) higher, respectively, in 2009 than expected if earlier trends had continued. For women, there was no change in European countries and the increase in the Americas was smaller than in men (2.3%). Rises in European men were highest in those aged 15-24 (11.7%), while in American countries men aged 45-64 showed the largest increase (5.2%). Rises in national suicide rates in men seemed to be associated with the magnitude of increases in unemployment, particularly in countries with low levels of unemployment before the crisis (Spearman’s rs =0.48). Conclusions After the 2008 economic crisis, rates of suicide increased in the European and American countries studied, particularly in men and in countries with higher levels of job loss.
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              Association between suicide reporting in the media and suicide: systematic review and meta-analysis

              Abstract Objective To examine the association between reporting on suicides, especially deaths of celebrities by suicide, and subsequent suicides in the general population. Design Systematic review and meta-analysis. Data sources PubMed/Medline, PsychInfo, Scopus, Web of Science, Embase, and Google Scholar, searched up to September 2019. Review methods Studies were included if they compared at least one time point before and one time point after media reports on suicide; follow-up was two months or less; the outcome was death by suicide; and the media reports were about non-fictional suicides. Data from studies adopting an interrupted time series design, or single or multiple arm before and after comparisons, were reviewed. Results 31 studies were identified and analysed, and 20 studies at moderate risk of bias were included in the main analyses. The risk of suicide increased by 13% in the period after the media reported a death of a celebrity by suicide (rate ratio 1.13, 95% confidence interval 1.08 to 1.18; 14 studies; median follow-up 28 days, range 7-60 days). When the suicide method used by the celebrity was reported, there was an associated 30% increase in deaths by the same method (rate ratio 1.30, 95% confidence interval 1.18 to 1.44; 11 studies; median follow-up 28 days, range 14-60 days). For general reporting of suicide, the rate ratio was 1.002 (0.997 to 1.008; five studies; median follow-up 1 day, range 1-8 days) for a one article increase in the number of reports on suicide. Heterogeneity was large and partially explained by celebrity and methodological factors. Enhanced funnel plots suggested some publication bias in the literature. Conclusions Reporting of deaths of celebrities by suicide appears to have made a meaningful impact on total suicides in the general population. The effect was larger for increases by the same method as used by the celebrity. General reporting of suicide did not appear to be associated with suicide although associations for certain types of reporting cannot be excluded. The best available intervention at the population level to deal with the harmful effects of media reports is guidelines for responsible reporting. These guidelines should be more widely implemented and promoted, especially when reporting on deaths of celebrities by suicide. Systematic review registration PROSPERO CRD42019086559.
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                Author and article information

                Journal
                J Psychiatr Res
                J Psychiatr Res
                Journal of Psychiatric Research
                Elsevier Ltd.
                0022-3956
                1879-1379
                26 May 2021
                August 2021
                26 May 2021
                : 140
                : 39-44
                Affiliations
                [a ]Division of Environmental and Preventive Medicine, Department of Social Medicine, Faculty of Medicine, Tottori University, Japan
                [b ]Division of Medical Zoology, Department of Microbiology and Immunology, Faculty of Medicine, Tottori University, Japan
                [c ]Division of Pediatrics and Perinatology, Faculty of Medicine, Tottori University, Japan
                [d ]Department of Plastic and Reconstructive Surgery, Japan
                Author notes
                []Corresponding author. Division of Environmental and Preventive Medicine, Department of Social Medicine, Faculty of Medicine, Tottori University, 683-8503, Nishi-cho 86, Yonago, Tottori, Japan.
                Article
                S0022-3956(21)00304-6
                10.1016/j.jpsychires.2021.05.035
                8674964
                34090102
                4099ac3b-0712-49d9-93e1-49a01e556824
                © 2021 Elsevier Ltd. All rights reserved.

                Since January 2020 Elsevier has created a COVID-19 resource centre with free information in English and Mandarin on the novel coronavirus COVID-19. The COVID-19 resource centre is hosted on Elsevier Connect, the company's public news and information website. Elsevier hereby grants permission to make all its COVID-19-related research that is available on the COVID-19 resource centre - including this research content - immediately available in PubMed Central and other publicly funded repositories, such as the WHO COVID database with rights for unrestricted research re-use and analyses in any form or by any means with acknowledgement of the original source. These permissions are granted for free by Elsevier for as long as the COVID-19 resource centre remains active.

                History
                : 10 March 2021
                : 21 April 2021
                : 20 May 2021
                Categories
                Short Communication

                Clinical Psychology & Psychiatry
                social crisis,covid-19 pandemic,earthquake,suicide,mortality
                Clinical Psychology & Psychiatry
                social crisis, covid-19 pandemic, earthquake, suicide, mortality

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