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Sadly Brodie on the money again: Teenage parasuicides double.


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Letter to the Editor
Free Access

Higher Rates of Hospital Treatment for Parasuicide are Temporally Associated with Covid-19 Lockdowns in New Zealand Children

First published: 15 September 2021

Conflict of interest: None declared.

 
Dear Editor,

HIGHER RATES OF HOSPITAL TREATMENT FOR PARASUICIDE ARE TEMPORALLY ASSOCIATED WITH COVID-19 LOCKDOWNS IN NEW ZEALAND CHILDREN

During the New Zealand COVID-19 lockdowns, paediatricians reported an increase in parasuicides in children under their care. Such an adverse trend in mental health of children has been noted overseas, with reports of increased childhood eating disorders in Victoria (Australia) that filled hospital wards and emergency departments during lockdowns.1 The most restrictive lockdowns in New Zealand started on 25 March for 6 weeks, then they recommenced in Auckland during 12–31 August 2020. This resulted in children being confined to their homes with consequent increases in screen time.

To investigate trends in mental health, we requested the last 5 years of monthly counts of hospital diagnoses for children aged 10–14 years from the Ministry of Health, with the International Classification of Disease discharge codes for parasuicide (version 9 codes E950–E958) for all of New Zealand. The data included counts from mid-2015 to the end of 2020.

Trends in the rate of hospital admissions for parasuicides were investigated using seasonal trend decomposition, a descriptive technique, which decomposes a time series into long-term trend and seasonal components. R (version 4.0.4 (R core team, R Foundation for Statistical Computing, Vienna, Austria)) software was used.

The results are portrayed in Figure 1 and show a clear upward trend in the latter half of 2020 from a stable baseline. The raw data are found in the uppermost plot with a sharp increase from base rates observed in August 2020 from a baseline of about 40 children per month to a peak of 90 cases. Rates have remained high, but have subsequently declined, but not back to baseline. The raw counts are decomposed into a long-term ‘trend’ (second plot), which reinforces the impression gained from the raw data. The ‘seasonal’ component shows peaks of parasuicide occurring in October of each year, with a gradually increasing magnitude of seasonal fluctuation. The ‘irregular’ plot shows the difference between the observed and the sum of seasonal and trend components, and represents a measure of model fit. The fit is worst for the peak observed in September 2020.

 

image

Anecdotal clinical experience from paediatricians during the 2020–2021 COVID-19 period suggests not only increases in parasuicides, but also in children with somatic symptoms, which are likely related to anxiety. This has led to an increase in violent and aggressive behaviour on wards and consequent stress for health-care professionals involved in their care.

In a meta-analysis of studies, an adverse association between lockdowns and youth mental health was observed, manifesting as depression and anxiety.2 In a survey of Chinese primary school students in Hubei province during the lockdown, almost a quarter of respondents reported depressive and anxiety-related symptoms.

Several studies do not support the use of lockdowns to contain cases and fatalities related to COVID-19 overseas.3, 4 Here, we have illustrated the clear detrimental effect of COVID-19 lockdown policies on child mental health, which is consistent with clinical and overseas experience. We suggest that this evidence is considered when contemplating the use of lockdowns in New Zealand and overseas.

Acknowledgement

We acknowledge the New Zealand Ministry of Health for the provision of these data.

     

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    22 hours ago, curious said:

    What the hell is parasuicide? And who invented it? And who is Sadly Brodie?

    In this article parasuicide is defined as any nonfatal, self-injurious behavior with a clear intent to cause bodily harm or death (3). Thus parasuicide includes both lethal suicide attempts and more habitual or low-lethality behaviors such as cutting or other self-mutilation.

     

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    24 minutes ago, Michael said:

    If your question isn't tongue in cheek Curious it's apparently a cry for help or attention, when they have all the signs of trying to commit suicide, but weren't totally serious

    Not correct as the definition I posted shows.

    Any attempted suicide that was not successful would be deemed parasuicide.

     

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    Medical Definition of Parasuicide

    Reviewed on 3/29/2021

    Parasuicide: An apparent attempt at suicide, commonly called a suicidal gesture, in which the aim is not death. For example, a sublethal drug overdose or wrist slash. Previous parasuicide is a predictor of suicide. The increased risk of subsequent suicide persists without decline for at least two decades.

     

    So not a suicide attempt by this definition.

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    10 minutes ago, Michael said:

    And you are right because?

    Oh, because you just are

    I quoted an official mental health definition.  Which further adds weight to my view that children and adolescents have carried a far greater and disproportionate burden during this pandemic.  What's more that burden is out of all proportion to the health risk that young people have.

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    4 hours ago, Chief Stipe said:

    I quoted an official mental health definition.  Which further adds weight to my view that children and adolescents have carried a far greater and disproportionate burden during this pandemic.  What's more that burden is out of all proportion to the health risk that young people have.

    And Ludwig quoted a Medical Definition 

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    The letter in the headpost does not define what they mean by parasuicide. However, they say the study was based on ICD discharge codes E950-E958. Not clear if that is what they are meaning by parasuicide but those codes include successful, unsuccessful suicide attempts as well as other self-harm events.

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    10 hours ago, curious said:

    The letter in the headpost does not define what they mean by parasuicide. However, they say the study was based on ICD discharge codes E950-E958. Not clear if that is what they are meaning by parasuicide but those codes include successful, unsuccessful suicide attempts as well as other self-harm events.

    So in terms of measuring a serious trend it is accurate.

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    Yes although the data on completed suicides in 2020 was significantly down during Covid and stayed down after. Those are presumably not included in thae above since it was hospital discharges. Also, I haven't seen an age breakdown of completed suicides, so that may have been different for 10-14yos.

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    Quick re-visit of that. Appears suicides were down in young people as well though the figure for 10-14s not given.

    CHIEF CORONER RELEASES ANNUAL PROVISIONAL SUICIDE FIGURES
    Chief Coroner Judge Deborah Marshall today released the annual provisional suicide statistics, which show the provisional suicide rate is at its lowest in three years.
    In the year to 30 June 2020, 654 people died by suicide, compared to 685 the year before – a decrease of 31 deaths, and a drop in the suicide rate from 13.93 deaths per 100,000 to 13.01.
    “While it is encouraging to see the suspected suicide rate and number drop for the past year, it’s important to remember that there are still more than 650 families who have lost someone in tragic circumstances,” Chief Coroner Judge Deborah Marshall says.
    “My sincere condolences to the families and friends of those who died by suspected suicide in the past year.”
    There was a decrease in the number of young people dying by suspected suicide, particularly in the 15-19 age range (down from 73 to 59) and the 20-24 age range (down from 91 to 60). Both rates decreased from 23.14 to 18.69 and from 26.87 to 17.77 respectively.
    However, there was an increase in suspected suicides in the 80-84 age range, with 12 more people dying by suicide in the past year (18) than the year before (6). The rate increased from 6.49 to 19.48.
    The Māori and Pacific Island suspected suicide rates both decreased over the past year, from 21.78 to 20.24 and from 8.91 to 7.07 respectively. The European rate also dropped from 13.02 to 12.08.
    However, the Asian rate went up from 5.09 to 7.91 – an increase of 20 deaths.
    “Throughout this year there has been unhelpful and irresponsible public commentary on the effect COVID-19 would have on the suicide rate,” Judge Marshall says. “During the first lockdown period I said it was unhelpful to release figures for such a short time frame, as it is nearly impossible to draw sound conclusions, nor do I believe such public discourse is helpful to people in distress.
    “I’m encouraged by the work the Suicide Prevention Office has started and for the reliable, strong and hope-filled voice that director Carla na Nagara has added to the wider public discourse.”

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    10 minutes ago, curious said:

    Quick re-visit of that. Appears suicides were down in young people as well though the figure for 10-14s not given.

    CHIEF CORONER RELEASES ANNUAL PROVISIONAL SUICIDE FIGURES
    Chief Coroner Judge Deborah Marshall today released the annual provisional suicide statistics, which show the provisional suicide rate is at its lowest in three years.
    In the year to 30 June 2020, 654 people died by suicide, compared to 685 the year before – a decrease of 31 deaths, and a drop in the suicide rate from 13.93 deaths per 100,000 to 13.01.
    “While it is encouraging to see the suspected suicide rate and number drop for the past year, it’s important to remember that there are still more than 650 families who have lost someone in tragic circumstances,” Chief Coroner Judge Deborah Marshall says.
    “My sincere condolences to the families and friends of those who died by suspected suicide in the past year.”
    There was a decrease in the number of young people dying by suspected suicide, particularly in the 15-19 age range (down from 73 to 59) and the 20-24 age range (down from 91 to 60). Both rates decreased from 23.14 to 18.69 and from 26.87 to 17.77 respectively.
    However, there was an increase in suspected suicides in the 80-84 age range, with 12 more people dying by suicide in the past year (18) than the year before (6). The rate increased from 6.49 to 19.48.
    The Māori and Pacific Island suspected suicide rates both decreased over the past year, from 21.78 to 20.24 and from 8.91 to 7.07 respectively. The European rate also dropped from 13.02 to 12.08.
    However, the Asian rate went up from 5.09 to 7.91 – an increase of 20 deaths.
    “Throughout this year there has been unhelpful and irresponsible public commentary on the effect COVID-19 would have on the suicide rate,” Judge Marshall says. “During the first lockdown period I said it was unhelpful to release figures for such a short time frame, as it is nearly impossible to draw sound conclusions, nor do I believe such public discourse is helpful to people in distress.
    “I’m encouraged by the work the Suicide Prevention Office has started and for the reliable, strong and hope-filled voice that director Carla na Nagara has added to the wider public discourse.”

    I only see one date in your post "year to end June 2020".  That is the first 4 months of the pandemic.

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    9 minutes ago, curious said:

    Yes, that's correct. Don't think there is any data broken down by month or quarter and the 20/21 data is still not out. Can only go by what the coroner said in that report.

    But the report is bordering on worthless.  It is out of date.  Is it broken down to months?  

    How can health authorities and agencies adjust resourcing or react if the data is not released regularly?

    Therefore the measure of "parasuicides" is a relevant one.

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    14 hours ago, Chief Stipe said:

    So you have no opinion on whether or not children and adolescents have been affected more than any other cohort in an effort to protect the likes of yourself?

    Or do you want to just nit pick and needle just because you can?

    I answered a question that was posted

    Aren’t posters allowed to do that?

    My brief reading of the article is that the study related to parasuicides as I described it

    Ic the article had meant to include  actual suicides then the writer would have probably used the terms attempted and actual suicides

    i do have an opinion on whether children or adolescents have been affected, but Curious merely asked a question to which I replied

    Now run along Cockwomble

     

     

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    1 minute ago, Chief Stipe said:

    Then what is it?

    Or are you just intent on scoring (in your own mind) juvenile points?

    What is the juvenile point in posting a response to Curious’s question? Enlighten me

    In order to post a reply to your query I would need to know what you mean by “the likes of myself” Such a sweeping generalisation makes it hard to reply 

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    2 minutes ago, Mikie said:

    What is the juvenile point in posting a response to Curious’s question? Enlighten me

    In order to post a reply to your query I would need to know what you mean by “the likes of myself” Such a sweeping generalisation makes it hard to reply 

    What is your opinion on the research?

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    3 minutes ago, Chief Stipe said:

    What is your opinion on the research?

    My opinion is that no age group is any more disadvantaged than any other

    Mh opinion is that their are many people struggling with mental health issues irrespective of their age during these times

    Now go argue with someone else’s post as that seems to be your modus operandi lately

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    2 minutes ago, Mikie said:

    My opinion is that no age group is any more disadvantaged than any other

    Mh opinion is that their are many people struggling with mental health issues irrespective of their age during these times

    I disagree with that opinion.  Children/adolescents missing many many months of schooling, socialisation and play when they are at next to zero risk of serious Covid illness is going to have long term effects.  In my mind it is bordering on criminal.

    For what end?  To save the lives of a few that have reached the twilight of their existence?

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    38 minutes ago, Chief Stipe said:

    For what end?  To save the lives of a few that have reached the twilight of their existence?

    Mmmm.. That sounds very discriminatory to me. I have a long track record as an advocate for childrens' rights but those can not come by diminishing the rights of other groups including other age groups. Give yourself an uppercut for that comment.

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