Background The coronavirus disease 2019 (COVID-19) pandemic profoundly impacts on mental health, yet it is still unclear whether COVID-19 distress makes people more vulnerable to suicidal behavior. The present study aims to examine the association between COVID-19 related psychological distress and risk for suicide attempt, and moderators of this association, among hotline callers. Methods This case-control study was conducted at the largest psychological support hotline in China. Hotline callers who sought help for psychological distress and reported whether or not they attempted suicide in the last 2 weeks (recent suicide attempt) were analyzed. The primary predictor of recent suicide attempt was the presence or absence of COVID-19 related psychological distress. Demographic variables and common risk and protective factors for suicidal behavior were also studied. Callers with COVID-19 related distress (COVID-19 callers) and those without such distress (non-COVID-19 callers) were compared on these variables. Recent suicide attempt was regressed on COVID-19 related distress and the other variables, and significant interaction terms of aforementioned predictors by COVID-19 related distress, to identify variables that moderate the association of COVID-19 related distress and recent suicide attempt. Results Among 7337 included callers, there were 1252 COVID-19 callers (17.1%) and 6085 non-COVID-19 callers (82.9%). The COVID-19 callers were less likely to report recent suicide attempt ( n = 73, 5.8%) than the non-COVID-19 callers ( n = 498, 8.2%, P = 0.005). The COVID-19 callers were also less likely to have high scores on depressive symptoms (22.6% vs 26.3%, P < 0.001) and psychological distress (19.5% vs 27.3%, P < 0.001), and were more likely to have high hopefulness scores (46.5% vs 38.0%, P < 0.001). Tests of moderating effects showed that acute life events were associated with one-half lower risk ( P = 0.021), and a trend that suicide attempt history was associated with two-thirds greater risk ( P = 0.063) for recent suicide attempt, among COVID-19 callers than non-COVID-19 callers. Conclusions The COVID-19 calls are from individuals with lower suicide-related risk compared to more typical callers. Acute stressful life events provided a key context for suicide attempt in non-COVID-19 callers, i.e., more typical calls. Supplementary Information The online version contains supplementary material available at 10.1186/s12888-021-03371-3.
【저자키워드】 Coronavirus disease 2019, Suicide attempt, Hotline, Life events, Prior suicide attempt history, Moderator, 【초록키워드】 COVID-19, coronavirus disease, pandemic, mental health, Test, risk, China, Impact, Psychological distress, psychological support, predictor, demographic, moderate, case-control study, association, distress, Attempted suicide, Non-COVID-19, supplementary material, individual, help, lower risk, protective factor, significant interaction, variable, Effect, recent, event, depressive symptom, other variables, COVID-19 related distress, Result, greater, analyzed, identify, reported, conducted, provided, less, absence, variables, with COVID-19, 【제목키워드】 coronavirus disease, Suicide, risk, Psychological, case-control study,