Role of regular medical visits in mitigating increased suicide risk during the early COVID-19 pandemic in Kobe, Japan.

IF 2.6 Q2 MEDICINE, GENERAL & INTERNAL BMC primary care Pub Date : 2025-01-23 DOI:10.1186/s12875-025-02707-2
Daisuke Miyamori, Yasushi Nagasaki, Shuhei Yoshida, Saori Kashima, Wataru Omori, Kei Itagaki, Masanori Ito
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Abstract

Background: Japan has one of the lowest COVID-19 death rates, while the annual suicide rate in 2020 has risen for the first time since 2007. This study aimed to identify high-risk populations and assess the impact of medical visits on suicide trends post-COVID-19 pandemic in Japan.

Method: This quasi-experimental study analyzed a population-based database from Hyogo Prefecture (2012-2022). Interrupted time-series analyses identified level and trend changes in monthly suicide rates per 1 million population during the exposure period (2020-2022) versus the control period (2012-2019). Regular visits to primary care and psychiatry stratified analysis.

Results: 2181 cases were analyzed, with two-thirds male and a median age of 54. Primary care physicians and psychiatric history were present in 69% and 40% of patients. The study found significant level changes in suicide rates overall (4.14, 95% CI: 1.70, 6.58) among individuals without regular primary care physician visits (2.83, 95% CI: 1.35, 4.32) and without psychiatric visits (2.85, 95% CI: 0.56, 5.14). In contrast, no significant changes were observed in individuals with regular primary care (0.99, 95% CI: -0.78, 2.76) or regular psychiatric visits (0.59, 95% CI: -0.98, 2.16). The trend changes were not significant in any of the groups.

Conclusion: This study suggests that a history of attending a medical institution may have prevented the rapid increase in suicides during the early stages of the COVID-19 pandemic.

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在日本神户COVID-19大流行早期,定期就诊对降低自杀风险增加的作用
背景:日本是COVID-19死亡率最低的国家之一,而2020年的年度自杀率自2007年以来首次上升。本研究旨在确定高危人群,并评估日本covid -19大流行后就诊对自杀趋势的影响。方法:采用准实验方法对兵库县2012-2022年人口数据库进行分析。中断时间序列分析确定了暴露期间(2020-2022年)与对照期间(2012-2019年)每100万人每月自杀率的水平和趋势变化。定期进行初级保健和精神病学分层分析。结果:共分析2181例,其中三分之二为男性,中位年龄54岁。69%和40%的患者有初级保健医生和精神病史。研究发现,在没有定期看初级保健医生(2.83,95% CI: 1.35, 4.32)和没有看精神科医生(2.85,95% CI: 0.56, 5.14)的个体中,总体自杀率(4.14,95% CI: 1.70, 6.58)发生了显著变化。相比之下,在定期接受初级保健(0.99,95% CI: -0.78, 2.76)或定期精神科就诊(0.59,95% CI: -0.98, 2.16)的个体中没有观察到显著变化。在任何一组中,趋势变化都不显著。结论:本研究表明,在COVID-19大流行的早期阶段,就医史可能阻止了自杀率的迅速上升。
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