Suicide mortality in Spain in 2020: The impact of the COVID-19 pandemic

INTRODUCTION: Suicide constitutes a major concern with evident contribution to global mortality worldwide. Evidence on suicide trends is mixed in the COVID-19 pandemic era. Spain may be an at-risk country for increased suicide risk in the time of COVID-19 pandemic due to prolonged restrictions and lockdown, elevated COVID-19 wave recurrence and related mental health impact. This brief report aims to provide some insight into the suicide mortality trends in the first COVID-19 pandemic year in Spain, using national data. MATERIAL AND METHODS: Data from the National Death Index were used. Annual mortality rate was calculated at a province level under random-effects models for the 2019 and 2020 years. Poisson timeseries regression was used to study the relationship between monthly suicide mortality and COVID-19 pandemic outbreak and lockdown, and second COVID-19 wave peak covariates. RESULTS: 3671 people died by suicide in 2019 in Spain and 3941 people died by suicide in 2020. The random-effects mortality rate in 2019 was 8.3 (CI(95) = 7.6, 9.0) per 100,000 inhabitants, and mortality rate in 2020 was 8.9 (CI(95) = 8.3, 9.6). No significant differences between mortality rates were found (p = .18). The Poisson regression showed a significant relationship between the COVID-19 outbreak and suicide mortality trend, with OR = 1.07 (CI(95) = 1.02, 1.12). CONCLUSIONS: Although annual mortality rates were not significantly different, an increased suicide risk was found from May, 2020 onwards. Our results claim for action to tackle suicide in the post-pandemic era taking into account the discouraging upcoming scenario.