Trends in suicide rates during the COVID-19 pandemic restrictions in a major German city

Background It remains unclear whether the COVID-19 pandemic is having an impact on suicide rates. Social distancing, economic insecurity and increasing prevalence rates of mental disorders may cause an increase in risk factors for suicide. Methods Data on suicide events in a major city in Germany, and the corresponding life years were provided by the local authorities. For the year 2020, periods without restrictions on freedom of movement and social contact were compared with periods of moderate and severe COVID-19 restrictions. To avoid distortions due to seasonal fluctuations in suicide risk, data from 2020 were compared to data from 2010 to 2019. Outcomes A total of 333 suicides were registered and 2,791,131 life years (LY) were spent between 2010 and 2020. Of these, 42 suicides and 300,834 LY accounted for the year 2020. In 2020, suicide rates (SR, suicides per 100,000 LY) were lower in periods with moderate (SR = 8.5, χ2 = 4.374, p = 0.037) or severe COVID-19 restrictions (SR = 7.0, χ2 = 3.999, p = 0.046) compared with periods without restrictions (SR = 18.0). A comparison with preceding years showed that differences cannot be attributed to seasonal variations. No age- or gender differences were found. Interpretation SR decreased during the COVID-19 restrictions; we expect SR to rise in the medium term. Careful monitoring of SR in the further course of the COVID-19 crisis is therefore urgently needed. The findings have regional reference and should not be over-generalized. Funding This study was conducted without external funding. ### Competing Interest Statement The authors have declared no competing interest. ### Clinical Trial DRKS00022536 / Registration was retrospective. The input mask for clinical trials was not suitable for this observational cohort design, which resulted in a delay of registration. ### Funding Statement no external funding ### Author Declarations I confirm all relevant ethical guidelines have been followed, and any necessary IRB and/or ethics committee approvals have been obtained. Yes The details of the IRB/oversight body that provided approval or exemption for the research described are given below: ethics comittee of the medical faculty of the University Hospital Leipzig, Germany (study ID: 272/20-ek) All necessary patient/participant consent has been obtained and the appropriate institutional forms have been archived. Yes I understand that all clinical trials and any other prospective interventional studies must be registered with an ICMJE-approved registry, such as ClinicalTrials.gov. I confirm that any such study reported in the manuscript has been registered and the trial registration ID is provided (note: if posting a prospective study registered retrospectively, please provide a statement in the trial ID field explaining why the study was not registered in advance). Yes I have followed all appropriate research reporting guidelines and uploaded the relevant EQUATOR Network research reporting checklist(s) and other pertinent material as supplementary files, if applicable. Yes Aggregate data is available on request.