The effect of COVID-19 on completed suicide rate in Iran: an Interrupted Time Series study (ITS)

BackgroundSuicide represents a critical public health concern and one of the most devastating forms of death. Based on a report from the World Health Organization, around 700,000 deaths by suicide occur globally each year. In 2019, the worldwide suicide mortality rate was 9.0 per 100,000 people, whi...

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Main Authors: Azadeh Nouhi Siahroudi, Seyed Saeed Hashemi Nazari, Mahshid Namdari, Mohammad Hossein Panahi, Seyed Amirhosein Mahdavi, Ali Khademi
Format: Article
Language:English
Published: Frontiers Media S.A. 2025-02-01
Series:Frontiers in Public Health
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Online Access:https://www.frontiersin.org/articles/10.3389/fpubh.2025.1387213/full
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author Azadeh Nouhi Siahroudi
Seyed Saeed Hashemi Nazari
Mahshid Namdari
Mohammad Hossein Panahi
Mohammad Hossein Panahi
Seyed Amirhosein Mahdavi
Ali Khademi
author_facet Azadeh Nouhi Siahroudi
Seyed Saeed Hashemi Nazari
Mahshid Namdari
Mohammad Hossein Panahi
Mohammad Hossein Panahi
Seyed Amirhosein Mahdavi
Ali Khademi
author_sort Azadeh Nouhi Siahroudi
collection DOAJ
description BackgroundSuicide represents a critical public health concern and one of the most devastating forms of death. Based on a report from the World Health Organization, around 700,000 deaths by suicide occur globally each year. In 2019, the worldwide suicide mortality rate was 9.0 per 100,000 people, while in Iran, this rate has been reported to be an average of 5.2 per 100,000. Suicide is influenced by various factors spanning individual, relational, community, and social domains, all of which may elevate the risk of suicide and related death. One significant factor potentially impacting this issue was the COVID-19 pandemic, which may have affected these trends by disrupting individuals’ social interactions and gatherings. To explore this further, the present study was carried out to investigate the impact of the COVID-19 pandemic on the changes in suicide rates leading to death in Iran.MethodsThis study was designed using an Interrupted Time Series approach combined with negative binomial regression. Seasonal variations were adjusted for using the harmonic method. The research sample comprised 63,514 suicide-related deaths recorded between April 20, 2009, and March 20, 2023. Suicide mortality data were sourced from the National Legal Medicine Organization, while population statistics were obtained from the official website of the Statistical Center of Iran. The study analyzed trends in suicide incidence both prior to and during the COVID-19 pandemic. The period used to evaluate pandemic-related changes in Iran began in May 2020, following the World Health Organization’s declaration of COVID-19 as a global public health emergency. Descriptive analyses were performed using Stata software, and trend assessments through the Interrupted Time Series (ITS) method were conducted using R software and the “lmtest” statistical package.ResultsThe changes in the incidence of suicide during the study increased by 1.003 monthly (p < 0.001). This rate increased by 1.1 (p < 0.001) compared to the times before the onset of the pandemic after entering the effect of the COVID-19 pandemic in the model. When the interaction effect of time with the COVID-19 pandemic was added to the base model, no significant relationship was observed.ConclusionBefore the COVID-19 pandemic, suicides in Iran had a proportional increasing trend. However, three months after the pandemic, an increasing trend in the level of suicide deaths was observed. Most likely, the COVID-19 pandemic phenomenon had an impact on the occurrence of suicide.
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spelling doaj-art-6cdae6dcea104b0fa8830660a21ede9f2025-08-20T03:11:37ZengFrontiers Media S.A.Frontiers in Public Health2296-25652025-02-011310.3389/fpubh.2025.13872131387213The effect of COVID-19 on completed suicide rate in Iran: an Interrupted Time Series study (ITS)Azadeh Nouhi Siahroudi0Seyed Saeed Hashemi Nazari1Mahshid Namdari2Mohammad Hossein Panahi3Mohammad Hossein Panahi4Seyed Amirhosein Mahdavi5Ali Khademi6Department of Epidemiology, School of Public Health and Safety, Shahid Beheshti University of Medical Sciences, Tehran, IranDepartment of Epidemiology, School of Public Health and Safety, Shahid Beheshti University of Medical Sciences, Tehran, IranDepartment of Epidemiology, School of Public Health and Safety, Shahid Beheshti University of Medical Sciences, Tehran, IranDepartment of Epidemiology, School of Public Health and Safety, Shahid Beheshti University of Medical Sciences, Tehran, IranSafety Promotion and Injury Prevention Research Center, Shahid Beheshti University of Medical Sciences, Tehran, IranLegal Medicine Research Center, Legal Medicine Organization of IRAN, Tehran, IranLegal Medicine Research Center, Iranian Legal Medicine Organization, Tehran, IranBackgroundSuicide represents a critical public health concern and one of the most devastating forms of death. Based on a report from the World Health Organization, around 700,000 deaths by suicide occur globally each year. In 2019, the worldwide suicide mortality rate was 9.0 per 100,000 people, while in Iran, this rate has been reported to be an average of 5.2 per 100,000. Suicide is influenced by various factors spanning individual, relational, community, and social domains, all of which may elevate the risk of suicide and related death. One significant factor potentially impacting this issue was the COVID-19 pandemic, which may have affected these trends by disrupting individuals’ social interactions and gatherings. To explore this further, the present study was carried out to investigate the impact of the COVID-19 pandemic on the changes in suicide rates leading to death in Iran.MethodsThis study was designed using an Interrupted Time Series approach combined with negative binomial regression. Seasonal variations were adjusted for using the harmonic method. The research sample comprised 63,514 suicide-related deaths recorded between April 20, 2009, and March 20, 2023. Suicide mortality data were sourced from the National Legal Medicine Organization, while population statistics were obtained from the official website of the Statistical Center of Iran. The study analyzed trends in suicide incidence both prior to and during the COVID-19 pandemic. The period used to evaluate pandemic-related changes in Iran began in May 2020, following the World Health Organization’s declaration of COVID-19 as a global public health emergency. Descriptive analyses were performed using Stata software, and trend assessments through the Interrupted Time Series (ITS) method were conducted using R software and the “lmtest” statistical package.ResultsThe changes in the incidence of suicide during the study increased by 1.003 monthly (p < 0.001). This rate increased by 1.1 (p < 0.001) compared to the times before the onset of the pandemic after entering the effect of the COVID-19 pandemic in the model. When the interaction effect of time with the COVID-19 pandemic was added to the base model, no significant relationship was observed.ConclusionBefore the COVID-19 pandemic, suicides in Iran had a proportional increasing trend. However, three months after the pandemic, an increasing trend in the level of suicide deaths was observed. Most likely, the COVID-19 pandemic phenomenon had an impact on the occurrence of suicide.https://www.frontiersin.org/articles/10.3389/fpubh.2025.1387213/fullcomplete suicideCOVID-19 diseaseInterrupted Time Series methodIranRate incidence
spellingShingle Azadeh Nouhi Siahroudi
Seyed Saeed Hashemi Nazari
Mahshid Namdari
Mohammad Hossein Panahi
Mohammad Hossein Panahi
Seyed Amirhosein Mahdavi
Ali Khademi
The effect of COVID-19 on completed suicide rate in Iran: an Interrupted Time Series study (ITS)
Frontiers in Public Health
complete suicide
COVID-19 disease
Interrupted Time Series method
Iran
Rate incidence
title The effect of COVID-19 on completed suicide rate in Iran: an Interrupted Time Series study (ITS)
title_full The effect of COVID-19 on completed suicide rate in Iran: an Interrupted Time Series study (ITS)
title_fullStr The effect of COVID-19 on completed suicide rate in Iran: an Interrupted Time Series study (ITS)
title_full_unstemmed The effect of COVID-19 on completed suicide rate in Iran: an Interrupted Time Series study (ITS)
title_short The effect of COVID-19 on completed suicide rate in Iran: an Interrupted Time Series study (ITS)
title_sort effect of covid 19 on completed suicide rate in iran an interrupted time series study its
topic complete suicide
COVID-19 disease
Interrupted Time Series method
Iran
Rate incidence
url https://www.frontiersin.org/articles/10.3389/fpubh.2025.1387213/full
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