Changes in the pattern of suicides and suicide attempt admissions in relation to the COVID-19 pandemic.

The consequences of the current COVID-19 pandemic for mental health remain unclear, especially regarding the effects on suicidal behaviors. To assess changes in the pattern of suicide attempt (SA) admissions and completed suicides (CS) in association with the COVID-19 pandemic. As part of a longitudinal study, SA admissions and CS are systematically documented and analyzed in all psychiatric hospitals in Frankfurt/Main (765.000 inhabitants). Number, sociodemographic factors, diagnoses and methods of SA and CS were compared between the periods of March-December 2019 and March-December 2020. The number of CS did not change, while the number of SA significantly decreased. Age, sex, occupational status, and psychiatric diagnoses did not change in SA, whereas the percentage of patients living alone while attempting suicide increased. The rate and number of intoxications as a SA method increased and more people attempted suicide in their own home, which was not observed in CS. Such a shift from public places to home is supported by the weekday of SA, as the rate of SA on weekends was significantly lower during the pandemic, likely because of lockdown measures. Only admissions to psychiatric hospitals were recorded, but not to other institutions. As it seems unlikely that the number of SA decreased while the number of CS remained unchanged, it is conceivable that the number of unreported SA cases increased during the pandemic. Our data suggest that a higher number of SA remained unnoticed during the pandemic because of their location and the use of methods associated with lower lethality.

[Effectiveness of cognitive-behavioral therapy in children and adolescents with obsessive-compulsive disorders treated in an outpatient clinic]. / Alltagswirksamkeit kognitiver Verhaltenstherapie bei Kindern und Jugendlichen mit Zwangsstörungen in einer Ausbildungsambulanz.

Background: Cognitive-behavioral therapy (CBT) is considered as treatment of first choice for children and adolescents with obsessive-compulsive disorders (OCD). However, its effectiveness has so far mostly been examined in randomized controlled trials with strictly manualized interventions. Only few studies have examined whether the effectiveness of CBT for juvenile OCD generalizes to clinical practice. Method: To test the effectiveness of CBT under routine care conditions, data of n = 53 patients with parent-ratings and n = 53 patients with self-ratings that were treated in a university-based outpatient clinic for child and adolescent psychotherapy was analyzed. Pre-post-mean-comparisons, effect sizes and the clinical significance of changes of the symptoms were examined. Results: OCD and comorbid symptoms were significantly reduced during treatment. Strong effect sizes (Cohen's d) were found for parent rated (d = 0.91) and patient rated (d = 0.88) OCD symptoms. Moderate to strong pre-post-effect sizes were found for the reduction of parent rated (d = 0.55 to d = 0.87) and patient rated (d = 0.46 to d = 0.74) comorbid symptoms. The percentage of children and adolescents who achieved clinically significant improvements and no longer showed dysfunctional OCD symptoms post-treatment was 46.3 % according to the parent-ratings and 59.4 % according to the self-ratings. Concerning comorbid symptoms the same was reached for between 22.5 % and 45.5 % of the patients (parent-ratings) and between 32.0 % and 81.8 % (self-ratings) respectively. Conclusions: Significant reductions in both OCD and comorbid symptoms were demonstrated over the course of cognitive-behavioral therapy of juvenile OCD disorders in a university outpatient clinic for child and adolescent psychotherapy. These results indicate that routine CBT treatment is an effective way to treat juvenile OCD disorders in clinical practice.

[Data by the Frankfurt Network for Suicide Prevention (FRANS): Suicide Statistics 2014-2017]. / Daten des Frankfurter Netzwerks für Suizidprävention (FRANS): Suizidstatistik 2014­2017.

OBJECTIVE: The Frankfurt Network for Suicide Prevention (FRANS) documents the number of suicides in Frankfurt a. M., in order to determine precise and strategic prevention requirements. METHOD: Analysis of death certificates listing "suicide" as cause of death. Several data points are recorded: Sex, age, method, place and date of suicide, place of residence and place of birth. Further information is drawn from the local register of residents. RESULTS: The results show a relatively consistent number of about 90 suicides per year in Frankfurt a. M., considering the years from 2014 through 2017 the overall suicide rate slightly decreased from 12.84 to 12.68 per 100 000 inhabitants. The highest rates were found amongst the over 81 year-olds. The number of suicides was considerably higher for men than women. The most chosen method was death by hanging. CONCLUSION: These data facilitate more tailored, needs-based prevention measures.