Table_1_Trends in online searching toward suicide pre-, during, and post the first wave of COVID-19 outbreak in China.DOCX

COVID-19 may increase the risk of suicide, but the conclusion is still unclear. This study was designed to assess the impact of COVID-19 on suicide pre-, during, and post the first wave of COVID-19 in China. It was reported that online public searching was associated with their offline thoughts and behaviors. Therefore, this study was designed to explore the online search for suicide pre-, during, and post-COVID-19 in China. The keywords on suicide, COVID-19, unemployment, and depression were collected in 2019 and 2020 using the Baidu Search Index (BSI). A time-series analysis examined the dynamic correlations between BSI-COVID-19 and BSI-suicide. A generalized estimating equation model was used to calculate the coefficients of variables associated with the BSI-suicide. The BSI-suicide showed a significant increase (15.6%, p = 0.006) from the 5th to 9th week, which was also the point of the first wave of the COVID-19 outbreak. A time-series analysis between BSI-suicide and BSI-COVID-19 showed that the strongest correlation occurred at lag 1+ and lag 2+ week. In the pre-COVID-19 model, only BSI-depression was highly associated with BSI-suicide (β = 1.38, p = 0.008). During the COVID-19 model, BSI-depression (β = 1.77, p = 0.040) and BSI-COVID-19 (β = 0.03, p < 0.001) were significantly associated with BSI-suicide. In the post-COVID-19 model, BSI depression (β = 1.55, p = 0.010) was still highly associated with BSI-suicide. Meanwhile, BSI-unemployment (β = 1.67, p = 0.007) appeared to be linked to BSI-suicide for the first time. There was a surge in suicide-related online searching during the early stage of the first wave of the COVID-19 outbreak. Online suicide search volume peaked 1–2 weeks after the COVID-19 peak. The BSI of factors associated with suicide varied at different stages of the COVID-19 pandemic. The findings in this study are preliminary and further research is needed to arrive at evidence of causality.

新型冠状病毒肺炎（COVID-19）或可增加自杀风险，但相关结论尚未明确。本研究旨在评估中国首次新冠疫情浪潮前后及流行期间，新冠疫情对自杀相关情况的影响。另有研究表明，公众线上搜索行为与其线下自杀意念及行为存在关联，故此本研究同时探讨中国新冠疫情前后及流行期间，自杀相关的线上搜索情况。本研究借助百度搜索指数（Baidu Search Index, BSI），收集了2019年至2020年间与自杀、新冠疫情、失业及抑郁相关的关键词搜索数据。采用时间序列分析法，探究新冠相关百度搜索指数（BSI-COVID-19）与自杀相关百度搜索指数（BSI-suicide）之间的动态相关关系；并通过广义估计方程模型，计算与自杀相关百度搜索指数相关的各变量的回归系数。自杀相关百度搜索指数在第5周至第9周期间显著上升15.6%（p=0.006），而该时段恰为中国首次新冠疫情暴发阶段。针对自杀相关百度搜索指数与新冠相关百度搜索指数的时间序列分析显示，二者最强相关出现在滞后1周及滞后2周时段。在新冠疫情前模型中，仅抑郁相关百度搜索指数（BSI-depression）与自杀相关百度搜索指数存在显著关联（β=1.38，p=0.008）。在新冠疫情流行期间模型中，抑郁相关百度搜索指数（β=1.77，p=0.040）与新冠相关百度搜索指数（β=0.03，p<0.001）均与自杀相关百度搜索指数存在显著关联。在后新冠疫情模型中，抑郁相关百度搜索指数仍与自杀相关百度搜索指数存在显著关联（β=1.55，p=0.010）；与此同时，失业相关百度搜索指数（BSI-unemployment）首次与自杀相关百度搜索指数呈现关联（β=1.67，p=0.007）。在首次新冠疫情暴发早期，自杀相关的线上搜索量出现激增。自杀相关线上搜索量的峰值出现在新冠疫情峰值后的1至2周。与自杀相关的各类因素的百度搜索指数，在新冠疫情的不同阶段呈现出动态变化。本研究结果尚属初步结论，仍需开展进一步研究以验证因果关联。