Suicidal ideation may have increased significantly during COVID-19 lockdown

The lockdowns during the COVID-19 pandemic had a significant effect on levels of suicidal ideation, a new study finds. The research, published in De Gruyter's Open Medicine, was conducted in a Serbian psychiatric clinic shortly after a nationwide lockdown.

For people with serious mental illness, the COVID-19 pandemic was particularly challenging. During lockdown, loss of social contacts and employment, economic worries, fear of illness, feelings of isolation and reduced access to psychiatric treatment all acted as stressors that could exacerbate a mental illness or even prompt such illness in previously healthy individuals.

To study the effect of lockdowns on serious mental illness and one of its most serious consequences, suicide, lead author Suzana Tosic Golubovic of the University of Nis in Serbia and colleagues examined patient records in a psychiatric clinic in Serbia and asked patients about their experience of the pandemic.

The researchers investigated patients who were admitted to the clinic between May and August 2020, which was just after Serbia had come out of a lockdown. They then compared these patients with patients who were admitted during the same months in 2018 and 2019.

Suicidal ideation, which involves someone thinking about or wishing for their own death, was significantly increased in the 2020 post-lockdown patients compared with the 2018 and 2019 patients. Suicide attempts also increased in the 2020 patients, although this trend was not statistically significant.

The 2020 patients also showed higher levels of adjustment disorder, in which patients have a hard time adjusting to a stressful situation or event in their life. Patients who had attempted suicide in 2020 were more likely to be exposed to information about the pandemic on social media and were more likely to present with adjustment disorder and major depressive disorder. Strikingly, 60% of the patients who had attempted suicide in 2020 had never received psychiatric treatment before, which was a significantly higher proportion than in the patients who attempted suicide in 2019.

The results show the serious impact that lockdown had on vulnerable patients, and highlight the need to provide protections for such patients if lockdowns are required in the future.

"Suicide prevention in the COVID-19 era is an important and difficult issue," the authors stated. "Further research studies are needed to find out how mental health consequences can be mitigated during and after the COVID-19 pandemic."