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The Impact of the Covid-19 Pandemic and Lockdowns on Self-Poisoning and Suicide in Sri Lanka

An Interrupted Time Series Analysis

Bibliographic Data

ID15494434
AuthorsThilini Rajapakse (0000-0001-9732-4666, University of Peradeniya, corresponding author), Tharuka Silva (University of Peradeniya), Nirosha Madhuwanthi Hettiarachchi (0000-0001-9494-0949, University of Peradeniya), David Gunnell (0000-0002-0829-6470, University of Bristol), C Metcalfe (0000-0001-8318-8907, University of Bristol), Matthew J Spittal (0000-0002-2841-1536, The University of Melbourne), Duleeka Knipe (0000-0002-1040-7635, University of Peradeniya, corresponding author)
Year2023
Volume20
Issue3
Pages1833-1833
Publication date2023-01-19
Peer ReviewedYes
Open AccessYes
TypeARTICLE
VenueInternational Journal of Environmental Research and Public Health (JOURNAL)
Journal identifiersISSN: 1661-7827 • E-ISSN: 1660-4601
PublisherMultidisciplinary Digital Publishing Institute (PUBLISHER • CH)
DOI10.3390/ijerph20031833
PMID36767200
OpenAlexW4317423572
LanguageEN
Citations received3
References cited27

Evidence from high-income countries suggests that the impact of COVID-19 on suicide and self-harm has been limited, but evidence from low- and middle-income countries is lacking. Using data from a hospital-based self-poisoning register (January 2019-December 2021) and data from national records (2016-2021) of suicide in Sri Lanka, we aimed to assess the impact of the pandemic on both self-poisoning and suicide. We examined changes in admissions for self-poisoning and suicide using interrupted time series (ITS) analysis. For the self-poisoning hospital admission ITS models, we defined the lockdown periods as follows: (i) pre-lockdown: 01/01/2019-19/03/2020; (ii) first lockdown: 20/03/2020-27/06/2020; (iii) post-first lockdown: 28/06/2020-11/05/2021; (iv) second lockdown: 12/05/2021-21/06/2021; and (v) post-second lockdown: 22/06/2021-31/12/2021. For suicide, we defined the intervention according to the pandemic period. We found that during lockdown periods, there was a reduction in hospital admissions for self-poisoning, with evidence that admission following self-poisoning remained lower during the pandemic than would be expected based on pre-pandemic trends. In contrast, there was no evidence that the rate of suicide in the pandemic period differed from that which would be expected. As the long-term socioeconomic impacts of the pandemic are realised, it will be important to track rates of self-harm and suicide in LMICs to inform prevention

Coronavirus disease 2019 (COVID-19 · Disease · Environmental health · Injury prevention · Medical emergency · Occupational safety and health · Pandemic · Poison control · Population · Socioeconomic status · Suicide prevention · COVID-19 and Mental Health · Demography · Human Factors and Ergonomics · Long-Term Effects of COVID-19 · Medicine · Suicide and Self-Harm Studies · Internal Medicine

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  • Reflections on the trends of suicide in Sri Lanka, 1997–2022

    Open Access•Piumee Bandara, Prabath Wickrama et al.•PLOS Global Public Health•2024

  • Trends of poisoning types in Sri Lanka

    Open Access•Bruna Rubbo, Thilini Rajapakse et al.•BMC Public Health•2025

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    Open Access•Jane Pirkis, Ann John et al.•The Lancet Psychiatry•2021

  • Interrupted time series regression for the evaluation of public health interventions

    Open Access•Jamie Lopez Bernal, James Lopez Bernal et al.•International Journal of…•2016

  • Long-Term Unemployment and Suicide

    Open Access•Allison Milner, Andrew Page et al.•PLoS ONE•2013

  • Mental health outcomes in times of economic recession

    Open Access•Diana Frasquilho, Margarida Gaspar Matos et al.•BMC Public Health•2015

  • Suicide and self-harm in low- and middle- income countries during the Covid-19 pandemic

    Open Access•Duleeka Knipe, Ann John et al.•PLOS Global Public Health•2022

  • Economic recession and suicidal behaviour

    Open Access•Camilla Haw, Keith Hawton et al.•International Journal of Social…•2015

  • Suicide in Sri Lanka 1975–2012

    Open Access•Duleeka Knipe, Duleeka W Knipe et al.•BMC Public Health•2014

Unique citing works3
Citations per year1,5
Citation span2024 - 2025 (2)
Citation velocityrecent
Highly citedNo
Citation typesNeutral: 3
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