{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,18]],"date-time":"2026-08-18T01:36:54Z","timestamp":1787017014923,"version":"build-2736575974"},"reference-count":31,"publisher":"BMJ","issue":"4","funder":[{"DOI":"10.13039\/100018688","name":"Korea Disease Control and Prevention Agency","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100018688","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["Inj Prev"],"accepted":{"date-parts":[[2025,6,21]]},"published-print":{"date-parts":[[2025,8]]},"abstract":"<jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Suicide is a leading cause of mortality worldwide, and self-harm is a key risk factor. Continuous monitoring of self-harm trends facilitates effective prevention. During the coronavirus disease pandemic, social distancing significantly influenced self-harm incidence. This study aimed to compare self-harm rates and patient characteristics in 3-year prepandemic and pandemic periods (2017\u20132019 and 2020\u20132022, respectively).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>We retrospectively analysed and subdivided the data over 6 years into 3-month intervals, obtained from the Emergency Department (ED)-based Injury In-depth Surveillance database, South Korea, to examine changes in the incidence of self-harm in patients visiting the ED from the prepandemic to pandemic period and compared the characteristics of patients who attempted self-harm and risk factors for in-hospital mortality.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Among 8\u200902\u2009032 patients (age: 18\u201364 years), we identified 45\u2009535 patients with self-harm injuries (overall rate: 5.68%), which significantly increased during the pandemic (4.6% (21 852) in 2017\u20132019 to 7.2% (n=23\u2009683) in 2020\u20132022). Age-group-stratified comparisons showed increased self-harm incidence across all age groups, especially among women younger than 30 years, during the pandemic period. The proportion of self-harm attributed to psychological problems increased markedly. However, the two periods showed no significant difference in the in-hospital mortality.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Discussion and conclusion<\/jats:title>\n                    <jats:p>The incidence of self-harm significantly increased and remained consistently higher in patients visiting EDs throughout the pandemic period than during the 3 years prepandemic, even after the relaxation of social distancing measures. Young women primarily drove this increase, and psychological problems constituted a major risk factor.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1136\/ip-2024-045452","type":"journal-article","created":{"date-parts":[[2025,7,15]],"date-time":"2025-07-15T21:40:33Z","timestamp":1752615633000},"page":"291-297","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":1,"title":["Incidence and characteristics of self-harm during the 3-year period of COVID-19-related social distancing in the Republic of Korea"],"prefix":"10.1136","volume":"31","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-5688-2581","authenticated-orcid":false,"given":"Kwang Yul","family":"Jung","sequence":"first","affiliation":[{"name":"Department of Emergency Medicine Medicine, Chung-Ang University College of Medicine, Seoul, The Republic of Korea"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sejin","family":"Heo","sequence":"additional","affiliation":[{"name":"Department of Emergency Medicine, Sungkyunkwan University School of Medicine, Suwon, The Republic of Korea"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Taerim","family":"Kim","sequence":"additional","affiliation":[{"name":"Department of Emergency Medicine, Sungkyunkwan University School of Medicine, Suwon, The Republic of Korea"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Won Chul","family":"Cha","sequence":"additional","affiliation":[{"name":"Department of Emergency Medicine, Sungkyunkwan University School of Medicine, Suwon, The Republic of Korea"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"239","published-online":{"date-parts":[[2025,7,15]]},"reference":[{"key":"2025092509221592000_31.4.291.1","unstructured":"World Health Organization . Suicide in the world: global health estimates. 2019."},{"key":"2025092509221592000_31.4.291.2","doi-asserted-by":"crossref","DOI":"10.1136\/bmjopen-2018-023144","article-title":"Changing trends in suicide rates in South Korea from 1993 to 2016: a descriptive study","volume":"8","author":"Lee","year":"2018","journal-title":"BMJ Open"},{"key":"2025092509221592000_31.4.291.3","doi-asserted-by":"publisher","DOI":"10.1016\/j.jad.2014.12.062"},{"key":"2025092509221592000_31.4.291.4","doi-asserted-by":"publisher","DOI":"10.1192\/bjp.bp.112.116111"},{"key":"2025092509221592000_31.4.291.5","doi-asserted-by":"crossref","first-page":"257","DOI":"10.24095\/hpcdp.37.8.05","article-title":"A contextual analysis of the Suicide Surveillance Indicators","volume":"37","author":"Skinner","year":"2017","journal-title":"Health Promot Chronic Dis Prev Can"},{"key":"2025092509221592000_31.4.291.6","doi-asserted-by":"crossref","DOI":"10.3389\/ijph.2022.1604552","article-title":"Pandemic Fatigue and Anxiety Sensitivity as Associated Factors With Posttraumatic Stress Symptoms Among University Students in South Korea During the Prolonged COVID-19 Pandemic","volume":"67","author":"Kim","year":"2022","journal-title":"Int J Public Health"},{"key":"2025092509221592000_31.4.291.7","doi-asserted-by":"crossref","DOI":"10.1371\/journal.pgph.0002137","article-title":"Impact of COVID-19 on health-related quality of life in the general population: A systematic review and meta-analysis","volume":"3","author":"Nshimirimana","year":"2023","journal-title":"PLOS Glob Public Health"},{"key":"2025092509221592000_31.4.291.8","doi-asserted-by":"crossref","DOI":"10.1371\/journal.pone.0286398","article-title":"Physical distancing and emergency medical services utilization after self-harm in Korea during the early COVID-19 pandemic: A nationwide quantitative study","volume":"18","author":"Lee","year":"2023","journal-title":"PLoS One"},{"key":"2025092509221592000_31.4.291.9","doi-asserted-by":"crossref","first-page":"31","DOI":"10.1192\/bjp.2021.130","article-title":"Factors influencing self-harm thoughts and behaviours over the first year of the COVID-19 pandemic in the UK: longitudinal analysis of 49 324 adults","volume":"220","author":"Paul","year":"2022","journal-title":"Br J Psychiatry"},{"key":"2025092509221592000_31.4.291.10","doi-asserted-by":"crossref","DOI":"10.1371\/journal.pone.0250706","article-title":"Impact of the COVID-19 pandemic on suicide and self-harm among patients presenting to the emergency department of a teaching hospital in Nepal","volume":"16","author":"Shrestha","year":"2021","journal-title":"PLoS One"},{"key":"2025092509221592000_31.4.291.11","doi-asserted-by":"crossref","first-page":"S261","DOI":"10.1192\/j.eurpsy.2024.552","article-title":"The Effect of the COVID-19 Pandemic on Suicide Attempts and Self-Harm in Teenagers and Young Adults: An Analysis of Regional Emergency Medical Center Data of a Metropolitan City in South Korea","volume":"67","author":"Bae","year":"2024","journal-title":"Eur Psychiatr"},{"key":"2025092509221592000_31.4.291.12","doi-asserted-by":"crossref","first-page":"318","DOI":"10.3928\/00485713-20220718-01","article-title":"The Impact of the COVID-19 Pandemic on the Suicidal and Self-Harming Behavior of Young People","volume":"52","author":"Briggs","year":"2022","journal-title":"Psychiatr Ann"},{"key":"2025092509221592000_31.4.291.13","doi-asserted-by":"crossref","unstructured":"Baetens I , Lloyd-Richardson E , Whitlock J , et al . NSSI and self-harm behavior and the covid-19 pandemic. 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