Hospitalization for self-harm during the early months of the Covid-19 pandemic in France: a nationwide study

Jollant, F.; Roussot, A.; Corruble, E.; CHAUVET-GELINIER, J.-C.; Falissard, B.; Mikaeloff, Y.; Quantin, C.

Introduction. Little is known to date about the impact of Covid-19 pandemic on self-harm incidence. Methods. The number of hospitalizations for self-harm in France (mainland and overseas) from January to August 2020 (which includes the first confinement from March 17th to May 11th) was compared to the same period in 2019-2017. Hospital data with the ICD-10 codes X60-84 were extracted from the national administrative database (PMSI). Results. There were 53,583 hospitalizations for self-harm in France between January and August 2020. Compared to the same period in 2019, this represents an overall 8.5% decrease. This decrease started the first week of the confinement and the number of hospitalizations remained at lower levels relative to 2019 until the end of August. The decrease was more marked in women (-9.8%) than men (-6.4%). However, an increase in hospitalizations was observed in individuals aged 75 and older (+5.3 to +11.6%). Moreover, the number of self-harm by firearm (+20.3%), jumping from height (+10.5%), and drowning (+4.7%) increased between 2019 and 2020, as well as the number of hospitalizations in intensive care (+3.5%) and deaths at discharge from hospital (+8.0%). No correlation was found between the evolution in the number of hospitalizations for self-harm and the number of severe cases of Covid-19 (hospitalization and mortality rates) across administrative departments. Discussion. During the early months of the Covid-19 pandemic in France - including the first confinement -, a general decrease in the number of hospitalizations for self-harm was observed. However, an increase was found among elderly, a population at higher Covid 19- related mortality risk, and in the number of more severe suicidal acts. These results, therefore, shed light on a complex relationship between the pandemic and self-harm occurrence. This situation may change with time, which requires active suicide prevention strategies.