Table 1 Suicide and Covid-19 in subjects with pre-existing mental disorder, longitudinal studies patients’ sample.

Rømer et al. 2021

Psychiatric Admissions, Referrals, and Suicidal Behavior Before and During the COVID‐19 Pandemic in Denmark: A Time‐Trend Study

Denmark, Capital Region of Denmark and Region Zealand

2,693,924 health records

Health records from hospitals and Emergency Medical Services. With regard to suicide attempts, self-harm episodes and suicides registered at hospitals in The Capital Region of Denmark and Region Zealand between

2019–2021 subjects with pre-existing mental disorders

were:

829 in 2019 (76.8%);

770 in 2020 (76.3%);

224 in 2021 (83.3%)

Age range of the sample with pre-existing mental disorder:

in 2019:

between 0–17: 262,

between 18–29: 238,

 > 30: 355;

in 2020:

between 0–17: 247,

between 18–29: 221,

 > 30: 344;

in 2021 (Jan–Feb) between 0–17: 108,

between 18–29: 54,

 > 30: 63;

female in 2019: 676 (62.6%), female in 2020: 648 (64.2%), female in 2021 (Jan–Feb) 190 (70.6%)

To assess the patterns in psychiatric admissions, referrals, and suicidal behavior before and during the COVID‐19 pandemic

Diagnoses in the electronic health records (EHRs)—including codes for suicide and self‐harm—defined and coded according to the ICD‐10 system by the responsible clinicians

Population‐based study,

Longitudinal study

From January 1, 2016 to February 28, 2021. Regarding pandemic during the first lockdown (March 11, 2020 – May 17, 2020), the inter‐lockdown period (May 18, 2020–December 15, 2020), and the second lockdown (December 16, 2020 –February 28, 2021)

Most patients exhibiting suicidal behavior had pre‐existing mental disorders. The hospital‐registered rate of suicidal behavior events during the pandemic did not change significantly compared to the pre‐pandemic period; nor did it change during the first lockdown, the inter‐lockdown period or second lockdown. This pattern was observed for all people with pre-existing mental disorder. Moreover, trend in hospital‐recorded suicidal behavior during the pandemic as a whole showed a relative decline compared with the pre‐pandemic trend among patients with pre‐existing mental disorders. In particular, the relative change in rate ratio regarding suicidal behavior during the pandemic vs. pre-pandemic shows a statistically significant decrease in subjects with mood disorder and neurotic, stress-related and somatoform disorders

Khosravani et al. 2021

The associations of obsessive–compulsive symptom dimensions and general severity with suicidal ideation in patients with obsessive–compulsive disorder: The role of specific stress responses to COVID-19

Shahid Beheshti University of Medical Sciences, Teheran, Iran

390 OCD patients

Patients referred for treatment of a primary OCD diagnosis. Common comorbid disorders were major depressive disorder (MDD), bipolar disorder (BD), various anxiety disorders, and substance use disorders (SUDs)

Mean age of the sample: 35.8 years; 126 males, 178 females

To examine the effects of obsessive–compulsive (OC) symptom dimensions and OCD severity on suicidal ideation by considering the role of stress responses in reaction to COVID‐19 in a clinical sample of patients with OCD

Suicide risk assessed using Beck Scale for Suicidal Ideation (BSSI)

Longitudinal study

Between 5 June to 30 October 2020

The obsessive–compulsive symptom dimensions of responsibility for harm and unacceptable obsessional thoughts as well as general severity had indirect effects on suicidal ideation through the specific stress responses to COVID-19, including traumatic stress and compulsive checking. The study shows that OCD patients with specific obsessive–compulsive symptom dimensions and severe OCD are more likely to have suicidal ideation during the pandemic

Alonso

et al. 2021

How is COVID-19 affecting patients with obsessive–compulsive disorder? A longitudinal study on the initial phase of the pandemic in a Spanish cohort

Hospital de Bellvitge, Barcelona, Spain

364;

127 OCD patients,

237 controls

Participants from the general population recruited through social networks, using a snowball method

Adult outpatients who had been attending the specialist for at least one year before March 2020

Mean age of the sample:

42.0 years OCD patients;

40.8 years controls

To evaluate the impact of the COVID-19 pandemic on a sample of patients with OCD at the initial stage of the health crisis, assessing not only changes in OCD severity, but also in pre-existing conditions, newly developed conditions, treatment, use of mental health resources, development of obsessive fears of SARS-CoV-2 contamination, and use of emotional regulation and stress coping strategies

Suicidal ideation assessed according to the Hamilton Depression Rating Scale (HDRS; item on suicide)

Naturalistic cohort study,

Longitudinal study

From April 27 to May 25, 2020

Suicide-related thoughts were more frequent among the OCD cohort than among healthy controls. The current crisis constitutes a risk factor for a significant worsening of symptoms and suicidal ideation

Na et al. 2021

Prevalence, risk and protective factors associated with suicidal ideation during the COVID-19 pandemic in U.S. military veterans with pre-existing psychiatric conditions

USA

661 veterans

Data analyzed from the National Health and Resilience in Veterans Study, which surveyed a nationally representative cohort of U.S. veterans

Veterans screened positive for major depressive disorder (MDD), generalized anxiety disorder (GAD), post-traumatic stress disorder (PTSD), and/or substance use disorder (SUD) at the pre-pandemic assessment

Mean age of the sample:

55.2 years; 86.8%, male

To examine pre-pandemic, COVID-related, and changes in risk and protective factors associated with peri-pandemic suicidal ideation. To evaluate interactions between SARS-CoV2 infection and age, and significant protective factors, in predicting suicide ideation in the examined population

Suicidal ideation assessed using Patient Health Questionnaire-9 (PHQ-9)

Prospective, Longitudinal survey cohort,

Longitudinal study

Pre-pandemic survey: until 11/21/2019 peripandemic survey: until 11/14/2020

Those who were infected with SARS-CoV 2 and aged 45 or older or who reported lower purpose in life may be at the highest risk of suicide and may deserve close clinical attention and monitoring