Trends in Emergency Department Visits for Suicide Attempts Before and During the COVID-19 Pandemic in Korea: A Nationwide Study, 2016–2021

Background: There is increasing concern that the effects of the COVID-19 pandemic will result in excess suicides by increasing known risk factors, such as suicide attempts. However, evidence on the long-term impacts of COVID-19 on suicide attempts is lacking. We aimed to assess the short- and long-term effects of the COVID-19 pandemic on patients with suicide attempts in emergency departments and to evaluate age- and sex-specific differences by the year of emergency department visits for suicide attempts. Methods: We conducted nationwide cross-sectional study using the National Emergency Department Information System database. Patients (12 years old and older) with suicide attempts in the emergency departments from January 1, 2016, to December 31, 2021 were included. The trend test were used to determine whether characteristics of study subjects were affected by changes in ED visits for suicide attempts according to the year. We estimated the average annual percentage change (APC) stratified by sex and age groups. Findings: The number of emergency department visits related to suicide attempts increased from 27,581 in 2016 to 37,719 in 2021. In particular, it decreased immediately after the COVID-19 pandemic but increased again in 2021. There were 49,245 patients (24.5%) aged 20–29 years old who visited emergency department and the proportion of females was 57.7%, and it increased each year. We identified that the average annual percentage change increased by 6.8% overall, 1.6% among males, and 10.8% among females. Moreover, the annual percentage changes of trend sharply increased in patients aged 12–19 years (22.3%) and 20–29 (17.2%) years. The in-hospital mortality was 3.6% for females, compared to 9.5% for males, which showed sex differences. Interpretation: The incidence of suicide attempts in emergency department has increased in Korea. In particular, there was a sharp increase among women and 12–19 years and 20–29 years. Patient-tailored treatment for suicide attempts is important, and a preventive medical system should be established according to sex and age groups, especially for females, adolescents, and younger adults in Korea.