There is increasing concern that the coronavirus disease 2019 (COVID-19) pandemic could harm psychological health and exacerbate suicide risk. Here, based on month-level records of suicides covering the entire Japanese population in 1,848 administrative units, we assessed whether suicide mortality changed during the pandemic. Using difference-in-difference estimation, we found that monthly suicide rates declined by 14% during the first 5 months of the pandemic (February to June 2020). This could be due to a number of complex reasons, including the government’s generous subsidies, reduced working hours and school closure. By contrast, monthly suicide rates increased by 16% during the second wave (July to October 2020), with a larger increase among females (37%) and children and adolescents (49%). Although adverse impacts of the COVID-19 pandemic may remain in the long term, its modifiers (such as government subsidies) may not be sustained. Thus, effective suicide prevention—particularly among vulnerable populations—should be an important public health consideration.

人们越来越担心 2019 年冠状病毒病 (COVID-19) 大流行可能会损害心理健康并加剧自杀风险。在这里，我们根据覆盖 1,848 个行政单位的整个日本人口的月级自杀记录，评估了大流行期间自杀死亡率是否发生了变化。使用差异估计，我们发现在大流行的前 5 个月（2020 年 2 月至 2020 年 6 月），每月自杀率下降了 14%。这可能是由于许多复杂的原因造成的，包括政府的慷慨补贴、工作时间减少和学校停课。相比之下，在第二波（2020 年 7 月至 2020 年 10 月）期间，每月自杀率增加了 16%，女性（37%）和儿童和青少年（49%）的增幅更大。尽管 COVID-19 大流行的不利影响可能会长期存在，但其修正因素（如政府补贴）可能无法持续。因此，有效的自杀预防——特别是在弱势群体中——应该是一个重要的公共卫生考虑因素。