Suicidality and substance use during the second COVID-19 pandemic wave in Italy: findings from a retrospective study

BACKGROUND: Although self-harm and suicidality during the pandemic have been investigated in many studies, it is still difficult to determine any causality between the pandemic period and suicidal behaviors due to methodological issues and the heterogeneity of the available studies. Likewise, there is conflicting evidence on alcohol abuse during the pandemic, with a wide range of variation in prevalence within different populations. This study analyzed a large cohort of psychiatric patients attending the local public health service during the second pandemic wave with the aim of identifying which factors are associated with suicidality and substance abuse.<br /> METHODS: Data, collected between October 2020 and March 2021, were retrospectively extracted from all the clinical charts of the first visits in the six psychiatric outpatient clinics of the public local healthcare service of Genoa, Italy (Asl3 Genovese).<br /> RESULTS: Data from 962 patients who attended the six psychiatric outpatient clinics of the local public health agency in Genoa between October 2020 and March 2021 were collected. Substance abuse was positively associated with diagnosis of personality disorder (P=0.011), fear of contagion/health concerns (P=0.004) and occurrence of a previous mourning for COVID-19 (P=0.017). Substance abuse was negatively associated with diagnosis of anxiety (P=0.008) and age of the patients (P=0.030). Personality disorder and mood disorder were positively associated with suicidality (P=0.001, P=0.003), together with changes in working methods after the pandemic (P=0.002) and with the presence of economic problems (P=0.031).<br /> CONCLUSIONS: The study highlights the association of social stressors with substance abuse and suicidality during the pandemic.