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Prevalence of Mental Disorders, Suicidal Ideation and Suicides in the General Population Before and During the COVID-19 Pandemic in Norway. A Population-Based Repeated Cross-Sectional Analysis from the HUNT Study and the Norwegian Cause of Death Registry

22 Pages Posted: 26 Jan 2021

See all articles by Ann Kristin Knudsen

Ann Kristin Knudsen

Norwegian Institute of Public Health - Centre for Disease Burden

Kim Stene-Larsen

Norwegian Institute of Public Health - Department of Mental Health and Suicide

Kristin Gustavson

Norwegian Institute of Public Health - Department of Mental Disorders

Matthew Hotopf

King’s College London - Department of Psychological Medicine

Ronald C. Kessler

Harvard Medical School

Steinar Krokstad

Norwegian University of Science and Technology (NTNU) - HUNT Research Centre

Jens Christoffer Skogen

Norwegian Institute of Public Health - Department of Health Promotion

Simon Øverland

Norwegian Institute of Public Health - Centre for Disease Burden

Anne Reneflot

Norwegian Institute of Public Health - Department of Mental Health and Suicide

More...

Abstract

Background: Self-report data indicate a deterioration of population mental health in many countries during the COVID-19 pandemic. A Norwegian epidemiological diagnostic psychiatric interview survey was conducted from January to September 2020, allowing for comparison of current prevalence of mental disorders from before through different pandemic phases. Prevalence of suicide deaths were compared between 2020 and 2014-2018.

Methods: Participants from the Trøndelag Health Study (HUNT) in Trondheim were recruited through repeated probability sampling. Using the Composite International Diagnostic Interview (CIDI 5.0) (n=2,154), current prevalence of mental disorders was examined in repeated cross-sectional analyses. Data on suicide was retrieved from the Norwegian Cause of Death Registry and compared for the first phase of the pandemic with the same months 2014-2018. 

Findings: Prevalence of mental disorders decreased significantly from the pre-pandemic phase (January 28th to March 11th 2020; 15·3% [95% CI 12·4-18·8]) to the first pandemic phase (March 12th – May 31st ; 8·7% [6·8-11·0]) and was fairly stable through the interim phase (June 1st July 31st ; 14·2% [11·4-17·5]) and the second phase (August 1st -September 18th ; 11·9% [9·0-15·6]). Suicidal ideation was non-significantly (n.s) increased during the pandemic. Suicide deaths were 15% lower (n.s) in March-May 2020 (n=140) compared with the same months pooled over 2014-2018 (n=165).    

Interpretation: We found no increase in mental disorders or suicides during the COVID-19 pandemic up through early autumn 2020. COVID-19 related mortality, transmission rates, intensity and implementation of measures and lockdowns have been less severe in Norway than many other countries and could account for these results.

Funding: None

Declaration of Interests: Dr. Hotopf reports grants from European Commission IMI/EFPIA, grants from National Institute of Health Research, grants from Medical Research Council, and grants from Economic and Social Research Council outside the submitted work. In the past 3 years, Dr. Kessler was a consultant for Datastat, Inc., Sage Pharmaceuticals, and Takeda. The authors Dr. Knudsen, Dr. Gustavson, Dr. Krokstad, Dr. Skogen, Dr. Stene-Larsen, Dr. Øverland and Dr. Reneflot report no conflict of interest.

Ethics Approval Statement: The survey was a collaboration between the Norwegian Institute of Public Health (NIPH) and the HUNT Research Centre and approved by the Regional Committee for Medical Research Ethics (2017/28/REK midt).

Keywords: COVID-19, mental disorders, suicidality, suicides, prevalence, general population, epidemiological survey, diagnostic interview

Suggested Citation

Knudsen, Ann Kristin and Stene-Larsen, Kim and Gustavson, Kristin and Hotopf, Matthew and Kessler, Ronald C. and Krokstad, Steinar and Skogen, Jens Christoffer and Øverland, Simon and Reneflot, Anne, Prevalence of Mental Disorders, Suicidal Ideation and Suicides in the General Population Before and During the COVID-19 Pandemic in Norway. A Population-Based Repeated Cross-Sectional Analysis from the HUNT Study and the Norwegian Cause of Death Registry. Available at SSRN: https://ssrn.com/abstract=3749231 or http://dx.doi.org/10.2139/ssrn.3749231

Ann Kristin Knudsen (Contact Author)

Norwegian Institute of Public Health - Centre for Disease Burden ( email )

PO Box 973 Sentrum
5-5808 Bergen
Norway

Kim Stene-Larsen

Norwegian Institute of Public Health - Department of Mental Health and Suicide ( email )

PO Box 4404
Nydalen, N-0403
Oslo
Norway

Kristin Gustavson

Norwegian Institute of Public Health - Department of Mental Disorders ( email )

Oslo
Norway

Matthew Hotopf

King’s College London - Department of Psychological Medicine

Strand
London, England WC2R 2LS
United Kingdom

Ronald C. Kessler

Harvard Medical School ( email )

Health Care Policy
Boston, MA 02115
United States

Steinar Krokstad

Norwegian University of Science and Technology (NTNU) - HUNT Research Centre ( email )

Trondheim NO-7491
Norway

Jens Christoffer Skogen

Norwegian Institute of Public Health - Department of Health Promotion ( email )

Bergen
Norway

Simon Øverland

Norwegian Institute of Public Health - Centre for Disease Burden ( email )

PO Box 973 Sentrum
5-5808 Bergen
Norway

Anne Reneflot

Norwegian Institute of Public Health - Department of Mental Health and Suicide ( email )

PO Box 4404
Nydalen, N-0403
Oslo
Norway