Impact of the Early COVID-19 Pandemic on Suicide Attempts and Suicide Deaths in South Korea, 2016-2020: An Interrupted Time Series Analysis

Objective: This study aimed to investigate the impact of coronavirus disease-2019 (COVID-19) on suicide attempts and suicide deaths in South Korea, focusing on age and sex differences.

Methods: We analyzed the monthly number of suicide attempts and suicide deaths during pre-pandemic (January 2016-February 2020) and pandemic (March-December 2020) periods using nationally representative databases. We conducted an interrupted time series analysis and calculated the relative risk (RR) with a 95% confidence interval (CI), categorizing subjects into adolescents (<18), young adults (18-29), middle-aged (30-59), and older adults (≥60).

Results: During the pandemic, the number of suicide attempts abruptly declined in adolescents (RR [95% CI] level change: 0.58 [0.45-0.75]) and older adults (RR [95% CI] level change: 0.74 [0.66-0.84]). In older males, there was a significant rebound in the suicide attempt trend (RR [95% CI] slope change: 1.03 [1.01-1.05]). The number of suicide deaths did not change among age/sex strata significantly except for older males. There was a brief decline in suicide deaths in older males, while the trend showed a following increase with marginal significance (RR [95% CI] level change: 0.76 [0.66-0.88], slope change: 1.02 [1.00-1.04]).

Conclusion: This study suggests the heterogeneous impact of the COVID-19 pandemic on suicide attempts and suicide deaths across age and sex strata in South Korea. These findings highlight the need for more targeted mental health interventions, given the observed trends in suicide attempts and suicide deaths during the pandemic.