{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,2,10]],"date-time":"2026-02-10T18:35:41Z","timestamp":1770748541057,"version":"3.50.0"},"update-to":[{"DOI":"10.1371\/journal.pmed.1004171","type":"new_version","label":"New version","source":"publisher","updated":{"date-parts":[[2023,4,4]],"date-time":"2023-04-04T00:00:00Z","timestamp":1680566400000}}],"reference-count":33,"publisher":"Public Library of Science (PLoS)","issue":"2","license":[{"start":{"date-parts":[[2023,2,14]],"date-time":"2023-02-14T00:00:00Z","timestamp":1676332800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100005979","name":"Direction de la Recherche, des \u00c9tudes, de l\u2019\u00c9valuation et des Statistiques","doi-asserted-by":"publisher","award":["R21094LL"],"award-info":[{"award-number":["R21094LL"]}],"id":[{"id":"10.13039\/501100005979","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100001677","name":"Institut National de la Sant\u00e9 et de la Recherche M\u00e9dicale","doi-asserted-by":"crossref","id":[{"id":"10.13039\/501100001677","id-type":"DOI","asserted-by":"crossref"}]},{"name":"Direction de la Recherche, des Etudes, de l'Evaluation et des Statistiques"},{"DOI":"10.13039\/501100004690","name":"Minist\u00e8re de la sant\u00e9","doi-asserted-by":"crossref","id":[{"id":"10.13039\/501100004690","id-type":"DOI","asserted-by":"crossref"}]},{"name":"R\u00e9gion Ile-de-France"}],"content-domain":{"domain":["www.plosmedicine.org"],"crossmark-restriction":false},"short-container-title":["PLoS Med"],"abstract":"<jats:sec id=\"sec001\">\n<jats:title>Background<\/jats:title>\n<jats:p>A higher risk of suicidal ideation associated with self-report of Coronavirus Disease 2019 (COVID-19)-like symptoms or COVID-19 infection has been observed in cross-sectional studies, but evidence from longitudinal studies remains limited. The aims of this study were 2-fold: (1) to explore if self-reported COVID-19-like symptoms in 2020 were associated with suicidal ideation in 2021; (2) to explore if the association also existed when using a biological marker of Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2) infection in 2020.<\/jats:p>\n<\/jats:sec>\n<jats:sec id=\"sec002\">\n<jats:title>Methods and findings<\/jats:title>\n<jats:p>A total of 52,050 participants from the French EpiCov cohort were included (median follow-up time = 13.7 months). In terms of demographics, 53.84% were women, 60.92% were over 45 years old, 82.01% were born in mainland France from parents born in mainland France, and 59.38% completed high school. COVID-19-like symptoms were defined as participant report of a sudden loss of taste\/smell or fever alongside cough, shortness of breath, or chest oppression, between February and November 2020. Symptoms were self-reported at baseline in May 2020 and at the first follow-up in Autumn 2020. Serology-confirmed SARS-CoV-2 infection in 2020 was derived from Spike protein ELISA test screening in dried-blood-spot samples. Samples were collected from October 2020 to March 2021, with 94.4% collected in 2020. Suicidal ideation since December 2020 was self-reported at the second follow-up in Summer 2021. Associations of self-reported COVID-19-like symptoms and serology-confirmed SARS-CoV-2 infection in 2020 with suicidal ideation in 2021 were ascertained using modified Poisson regression models, weighted by inverse probability weights computed from propensity scores. Among the 52,050 participants, 1.68% [1.54% to 1.82%] reported suicidal ideation in 2021, 9.57% [9.24% to 9.90%] had a serology-confirmed SARS-CoV-2 infection in 2020, and 13.23% [12.86% to 13.61%] reported COVID-19-like symptoms in 2020. Self-reported COVID-19-like symptoms in 2020 were associated with higher risks of later suicidal ideation in 2021 (Relative Risk<jats:sub>ipw<\/jats:sub> [95% CI] = 1.43 [1.20 to 1.69]), while serology-confirmed SARS-CoV-2 infection in 2020 was not (RR<jats:sub>ipw<\/jats:sub> = 0.89 [0.70 to 1.13]). Limitations of this study include the use of a single question to assess suicidal ideation, the use of self-reported history of mental health disorders, and limited generalizability due to attrition bias.<\/jats:p>\n<\/jats:sec>\n<jats:sec id=\"sec003\">\n<jats:title>Conclusions<\/jats:title>\n<jats:p>Self-reported COVID-19-like symptoms in 2020, but not serology-confirmed SARS-CoV-2 infection in 2020, were associated with a higher risk of subsequent suicidal ideation in 2021. The exact role of SARS-CoV-2 infection with respect to suicide risk has yet to be clarified. Including mental health resources in COVID-19-related settings could encourage symptomatic individuals to care for their mental health and limit suicidal ideation to emerge or worsen.<\/jats:p>\n<\/jats:sec>","DOI":"10.1371\/journal.pmed.1004171","type":"journal-article","created":{"date-parts":[[2023,2,14]],"date-time":"2023-02-14T18:33:27Z","timestamp":1676399607000},"page":"e1004171","update-policy":"https:\/\/doi.org\/10.1371\/journal.pmed.corrections_policy","source":"Crossref","is-referenced-by-count":8,"title":["Suicidal ideation following self-reported COVID-19-like symptoms or serology-confirmed SARS-CoV-2 infection in France: A propensity score weighted analysis from a cohort study"],"prefix":"10.1371","volume":"20","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-0521-7351","authenticated-orcid":true,"given":"Camille","family":"Davisse-Paturet","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1389-2610","authenticated-orcid":true,"given":"Massimiliano","family":"Orri","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1704-2499","authenticated-orcid":true,"given":"St\u00e9phane","family":"Legleye","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Aline-Marie","family":"Florence","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1834-4413","authenticated-orcid":true,"given":"Jean-Baptiste","family":"Hazo","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8590-7952","authenticated-orcid":true,"given":"Josiane","family":"Warszawski","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Bruno","family":"Falissard","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8587-8378","authenticated-orcid":true,"given":"Marie-Claude","family":"Geoffroy","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2377-619X","authenticated-orcid":true,"given":"Maria","family":"Melchior","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2473-1719","authenticated-orcid":true,"given":"Alexandra","family":"Rouquette","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"name":"the EPICOV study group","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"340","published-online":{"date-parts":[[2023,2,14]]},"reference":[{"issue":"6","key":"pmed.1004171.ref001","doi-asserted-by":"crossref","first-page":"468","DOI":"10.1016\/S2215-0366(20)30171-1","article-title":"Suicide risk and prevention during the COVID-19 pandemic","volume":"7","author":"D Gunnell","year":"2020","journal-title":"Lancet Psychiatry"},{"issue":"3s","key":"pmed.1004171.ref002","first-page":"S66","article-title":"[Suicidal behavior in light of COVID-19 outbreak: Clinical challenges and treatment perspectives].","volume":"46","author":"I Conejero","year":"2020","journal-title":"Enc\u00e9phale"},{"issue":"2","key":"pmed.1004171.ref003","doi-asserted-by":"crossref","first-page":"95","DOI":"10.1093\/qjmed\/hcab007","article-title":"Post-COVID syndrome and suicide risk","volume":"114","author":"L. 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