Suicidological analysis of Moscow and Saint Petersburg in the context of the pandemic
BACKGROUND: Suicide mortality in Moscow and St. Petersburg - the two most populated federal cities of Russia - is not characterized enough. However, these cities have been mostly affected by the pandemic. AIM: To analyze the latest trends in suicidal behavior in the historic capitals of Russia in an observational study, taking into account pandemic waves. METHODS: The monthly numbers of suicides (date of death, sex, age, and method), and number of cases in Moscow (n=1558) and St. Petersburg (n=2077) from January 01, 2016, to September 30, 2021, were used to calculate frequencies per 100,000 and to analyze tendencies across sex and age groups. Statistics were based on Z-criterion, and confidence intervals were calculated as per Wilson. RESULTS: Moscow and St. Petersburg belong to regions with suicide rates lower than the world average rates. Suicide mortality in both capitals was declining, but was more pronounced in Moscow. In St. Petersburg, the average rate was 3.28 higher, with 3.53 times in men and 2.84 times higher in women. The male-to-female ratio in St. Petersburg was also higher than that in Moscow (3.39:1 versus 2.87:1). In both cities, the highest rates were found among citizens aged >80 years, and the rates in young and adults (aged 20-49 years) are also high. Those aged 60-69 years have comparatively low rates. After a brief decline in the suicide rates during the first quarantine period in 2021, the decline in Moscow stopped, whereas in St. Petersburg, a gradual increase began, reaching significant levels among men in September. The most traditional method of self-harm (hanging) decreased, whereas the proportion of falls from a height increased (38.8% growth), as well as self-poisoning and self-cutting. A more detailed analysis of the “urban” method of suicide such as falling from a height revealed that in 2021, in St. Petersburg, a category of persons emerged among whom this method has grown dramatically (five times) in men aged >60 years. CONCLUSIONS: Suicides among the urbanized population of the largest metropolitan areas in Russia during the pandemic demonstrate trends that raise concerns, and the structure of mortality and methods of self-harm are changing. Further monitoring and intensification of preventive measures are needed, especially in St. Petersburg.