There is concern that the COVID-19 pandemic and its aftermath will result in excess suicides by increasing known risk factors such as self-harm, but evidence on how pandemic-related risk factors contribute to changes in these outcomes is lacking.

To examine how different COVID-19-related experiences of and worries about adversity contribute to changes in self-harm thoughts and behaviours.

Data from 49 324 UK adults in the University College London COVID-19 Social Study were analysed (1 April 2020 to 17 May 2021). Fixed-effects regressions explored associations between weekly within-person variation in five categories of adversity experience and adversity worries with changes in self-harm thoughts and behaviours across age groups (18–29, 30–44, 45–59 and 60+ years).

In total, 26.1% and 7.9% of respondents reported self-harm thoughts and behaviours respectively at least once over the study period. The number of adverse experiences was more strongly related to outcomes than the number of worries. The largest specific adversity contributing to increases in both outcomes was having experienced physical or psychological abuse. Financial worries increased the likelihood of both outcomes in most age groups, and having had COVID-19 increased the likelihood of both outcomes in young (18–29 years) and middle-aged (45–59 years) adults.

Findings suggest that a significant portion of UK adults may be at increased risk for self-harm thoughts and behaviours during the pandemic. Given the likelihood that the economic and social consequences of the pandemic will accumulate, policy makers can begin adapting evidence-based suicide prevention strategies and other social policies to help mitigate its consequences.

人们担心 COVID-19 大流行及其后果将通过增加已知的风险因素（如自残）导致过度自杀，但缺乏与大流行相关的风险因素如何促成这些结果变化的证据。

研究与 COVID-19 相关的不同经历和对逆境的担忧如何导致自残思想和行为的变化。

分析了伦敦大学学院 COVID-19 社会研究中 49 324 名英国成年人的数据（2020 年 4 月 1 日至 2021 年 5 月 17 日）。固定效应回归探讨了五类逆境经历和逆境担忧中每周个人内部变化与跨年龄组（18-29、30-44、45-59 和 60 岁以上）的自残思想和行为变化之间的关联.

总共有 26.1% 和 7.9% 的受访者在研究期间分别报告了至少一次自残的想法和行为。不良经历的数量与结果的相关性比担忧的数量更强烈。导致两种结果增加的最大特定逆境是经历过身体或心理虐待。在大多数年龄组中，财务担忧增加了这两种结果的可能性，而 COVID-19 增加了年轻（18-29 岁）和中年（45-59 岁）成年人出现这两种结果的可能性。

研究结果表明，在大流行期间，很大一部分英国成年人的自残想法和行为的风险可能会增加。鉴于大流行的经济和社会后果可能会累积，决策者可以开始调整以证据为基础的自杀预防策略和其他社会政策，以帮助减轻其后果。