Did the COVID-19 pandemic impact on time trends in self-poisoning in youth? A sex-specific national register-based interrupted time-series analysis in Sweden.

Abstract

Objectives: To assess the extent to which the COVID-19 pandemic impacted trends of self-poisoning in young boys and girls in Sweden, and whether impacts differed by sociodemographic and psychiatric health factors.

Methods: We used an interrupted time series analysis of a register-based national cohort to assess the sex-specific associations between the COVID-19 pandemic and monthly rate of hospitalization for intentional self-poisoning. Individual-level data were collected from a rolling cohort of Swedish young people ages 10-19 between 2005 and 2021 (approximately 1.13 million individuals per year). Separate models were run to examine differential associations among girls by age group, socioeconomic position, and prior anxiety or depression diagnosis.

Results: A total of 17,151 cases of self-poisoning were observed across the study period, 78.4% among girls. The association between the pandemic and self-poisoning was sex-specific. An annualized increase of 19% per year (95% CI: 5%-35%) between March 2020 and December 2021 occurred among girls, corresponding to a reversal of a declining pre-pandemic trend (p = .0002). No significant change in level or trend occurred for boys. Increases among girls were higher among ages 10-14 and were observed regardless of socioeconomic position or prior psychiatric diagnosis.

Conclusion: In Sweden, despite a less restrictive public health response, the COVID-19 pandemic was accompanied by a substantial increase in rates of self-poisoning and a reversal of previously declining trends among young girls, exacerbating long-standing gender gaps. This underscores the need for enhanced preparedness to deal with indirect effects of future health crises on this dangerous expression of mental distress.