The impact of the COVID-19 pandemic on presentations to health services following self-harm: systematic review,The British Journal of Psychiatry

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The impact of the COVID-19 pandemic on presentations to health services following self-harm: systematic review
The British Journal of Psychiatry ( IF 10.5 ) Pub Date : 2022-07-11 , DOI: 10.1192/bjp.2022.79
Sarah Steeg ₁ , Ann John ₂ , David J Gunnell ₃ , Nav Kapur ₄ , Dana Dekel ₅ , Lena Schmidt ₆ , Duleeka Knipe ₇ , Ella Arensman ₈ , Keith Hawton ₉ , Julian P T Higgins ₁₀ , Emily Eyles ₁₁ , Catherine Macleod-Hall ₇ , Luke A McGuiness ₇ , Roger T Webb ₁₂

Affiliation

Centre for Mental Health and Safety, Division of Psychology and Mental Health, University of Manchester, UK; and Manchester Academic Health Science Centre, UK.
Medical School, Swansea University, UK; and Public Health Wales NHS Trust, UK.
Population Health Sciences, Bristol Medical School, University of Bristol, UK; and National Institute for Health Research Biomedical Research Centre, University Hospitals Bristol and Weston NHS Foundation Trust and the University of Bristol, UK.
Division of Psychology and Mental Health, University of Manchester, UK;NIHR Greater Manchester Patient Safety Translational Research Centre, UK; and Greater Manchester Mental Health NHS Foundation Trust, UK.
Department of Population Psychiatry, Suicide and Informatics, Swansea University, UK.
Sciome LLC, North Carolina, USA; Population Health Sciences, Bristol Medical School, University of Bristol, UK.
Population Health Sciences, Bristol Medical School, University of Bristol, UK.
School of Public Health and National Suicide Research Foundation, University College Cork, Ireland; and Australian Institute for Suicide Research and Prevention, School of Applied Psychology, Griffith University, Australia.
Centre for Suicide Research, Department of Psychiatry, University of Oxford, UK; and Warneford Hospital, Oxford Health NHS Foundation Trust, UK.
National Institute for Health Research Biomedical Research Centre, University Hospitals Bristol and Weston NHS Foundation Trust and the University of Bristol, UK; National Institute for Health Research Applied Research Collaboration West, University Hospitals Bristol and Weston NHS Foundation Trust, UK; and Population Health Sciences, Bristol Medical School, University of Bristol, UK.
National Institute for Health Research Applied Research Collaboration West, University Hospitals Bristol and Weston NHS Foundation Trust, UK; and Population Health Sciences, Bristol Medical School, University of Bristol, UK.
Division of Psychology and Mental Health, University of Manchester, UK; and NIHR Greater Manchester Patient Safety Translational Research Centre, UK.

Background

Evidence on the impact of the pandemic on healthcare presentations for self-harm has accumulated rapidly. However, existing reviews do not include studies published beyond 2020.

Aims

To systematically review evidence on presentations to health services following self-harm during the COVID-19 pandemic.

Method

A comprehensive search of databases (WHO COVID-19 database; Medline; medRxiv; Scopus; PsyRxiv; SocArXiv; bioRxiv; COVID-19 Open Research Dataset, PubMed) was conducted. Studies published from 1 January 2020 to 7 September 2021 were included. Study quality was assessed with a critical appraisal tool.

Results

Fifty-one studies were included: 57% (29/51) were rated as ‘low’ quality, 31% (16/51) as ‘moderate’ and 12% (6/51) as ‘high-moderate’. Most evidence (84%, 43/51) was from high-income countries. A total of 47% (24/51) of studies reported reductions in presentation frequency, including all six rated as high-moderate quality, which reported reductions of 17–56%. Settings treating higher lethality self-harm were overrepresented among studies reporting increased demand. Two of the three higher-quality studies including study observation months from 2021 reported reductions in self-harm presentations. Evidence from 2021 suggests increased numbers of presentations among adolescents, particularly girls.

Conclusions

Sustained reductions in numbers of self-harm presentations were seen into the first half of 2021, although this evidence is based on a relatively small number of higher-quality studies. Evidence from low- and middle-income countries is lacking. Increased numbers of presentations among adolescents, particularly girls, into 2021 is concerning. Findings may reflect changes in thresholds for help-seeking, use of alternative sources of support and variable effects of the pandemic across groups.

中文翻译：

COVID-19 大流行对自我伤害后对卫生服务的介绍的影响：系统评价

背景

关于大流行对自我伤害的医疗保健介绍的影响的证据已经迅速积累。但是，现有评论不包括 2020 年以后发表的研究。

目标

系统地审查在 COVID-19 大流行期间自我伤害后向卫生服务提供的证据。

方法

对数据库（WHO COVID-19 数据库；Medline；medRxiv；Scopus；PsyRxiv；SocArXiv；bioRxiv；COVID-19 开放研究数据集，PubMed）进行了全面搜索。包括 2020 年 1 月 1 日至 2021 年 9 月 7 日发表的研究。研究质量通过一个重要的评估工具进行评估。

结果

纳入了 51 项研究：57% (29/51) 被评为“低”质量，31% (16/51) 被评为“中等”，12% (6/51) 被评为“高-中”。大多数证据（84%，43/51）来自高收入国家。共有 47% (24/51) 的研究报告出现频率降低，包括所有 6 项被评为高度中等质量的研究，报告降低了 17-56%。在报告需求增加的研究中，治疗高致死率自残的设置过多。包括 2021 年研究观察月在内的三项高质量研究中的两项报告了自残表现的减少。2021 年的证据表明，青少年，尤其是女孩的演讲数量有所增加。

结论

到 2021 年上半年，自残病例的数量持续减少，尽管这一证据是基于数量相对较少的高质量研究。缺乏来自低收入和中等收入国家的证据。到 2021 年，青少年，尤其是女孩的演讲数量增加令人担忧。调查结果可能反映了寻求帮助的阈值的变化、替代支持来源的使用以及大流行对不同群体的不同影响。

更新日期：2022-07-11

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