{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,26]],"date-time":"2026-08-26T15:32:11Z","timestamp":1787758331115,"version":"build-2784847793"},"reference-count":43,"publisher":"MDPI AG","issue":"17","license":[{"start":{"date-parts":[[2026,8,26]],"date-time":"2026-08-26T00:00:00Z","timestamp":1787702400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"name":"\u201cDunarea de Jos\u201d University of Galati","award":["VAT RO50411550"],"award-info":[{"award-number":["VAT RO50411550"]}]},{"award":["VAT RO50411550"],"award-info":[{"award-number":["VAT RO50411550"]}],"id":[{"id":"https:\/\/ror.org\/052sta926","id-type":"ROR","asserted-by":"publisher"}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Diagnostics"],"abstract":"<jats:p>Background: Interrupted time-series studies have not shown a consistent increase in suicide mortality during COVID-19, but civil mortality registries cannot ascertain SARS-CoV-2 infection individually. We evaluated pandemic-related change in suicide mortality and the feasibility of integrating infection ascertainment into medico-legal surveillance. Methods: We analysed 395 suicide deaths in Gala\u021bi and Br\u0103ila counties, Romania (January 2018\u2013December 2024), where mandatory forensic autopsy ensures exhaustive ascertainment. The pre-specified primary analysis was seasonally adjusted segmented Poisson regression in January 2018\u2013December 2022 with an onset in March 2020; the period 2023\u20132024 was excluded as incompletely ascertained. Changepoint detection and unadjusted period comparisons were descriptive. Infection was classified as laboratory-confirmed (documented ante-mortem RT-PCR) or possible\/probable (compatible autopsy findings); no post-mortem testing was performed. Results: The level change at onset was not significant (IRR 1.29, 95% CI 0.80\u20132.08; p = 0.302), nor was the slope change (IRR 1.01, 95% CI 0.98\u20131.04; p = 0.639); power was 80% only against IRR \u2265 1.98. Posterior probabilities were 0.85 for any increase and 0.035 for a doubling. The unadjusted comparison (6.00 vs. 4.62 deaths\/month; IRR 1.30, 95% CI 1.04\u20131.63) was descriptive; no changepoint coincided with onset. Among 140 deaths in 2020\u20132021, 34 (24.3%) met ascertainment criteria, 21 (15.0%) laboratory-confirmed. Conclusions: The data exclude a doubling of suicide mortality but not a modest increase: a regional surveillance signal, not a causal finding. Infection ascertainment proved feasible within routine medico-legal investigation, yielding a reproducible framework for other registries, an Eastern European series for future meta-analyses, and a proof-of-concept for a standing forensic surveillance capacity adaptable to future epidemics.<\/jats:p>","DOI":"10.3390\/diagnostics16172736","type":"journal-article","created":{"date-parts":[[2026,8,26]],"date-time":"2026-08-26T15:04:32Z","timestamp":1787756672000},"page":"2736","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["COVID-19 and Suicide Mortality in a Population-Based Medico-Legal Registry: An Interrupted Time-Series and Changepoint Analysis from Southeast Romania"],"prefix":"10.3390","volume":"16","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-9664-2128","authenticated-orcid":false,"given":"Alin Ionut","family":"Piraianu","sequence":"first","affiliation":[{"name":"Research Centre in the Medical-Pharmaceutical Field, Faculty of Medicine and Pharmacy, \u201cDunarea de Jos\u201d University of Galati, 800216 Galati, Romania"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Anisia-Luiza","family":"Culea-Florescu","sequence":"additional","affiliation":[{"name":"Research Center for Electronics, Information Technology and Communications, Faculty of Automation, Computers, Electrical and Electronic Engineering, \u201cDunarea de Jos\u201d University of Galati, 800201 Galati, Romania"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5056-1015","authenticated-orcid":false,"given":"Elena","family":"Stamate","sequence":"additional","affiliation":[{"name":"Research Centre in the Medical-Pharmaceutical Field, Faculty of Medicine and Pharmacy, \u201cDunarea de Jos\u201d University of Galati, 800216 Galati, Romania"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ana","family":"Fulga","sequence":"additional","affiliation":[{"name":"Research Centre in the Medical-Pharmaceutical Field, Faculty of Medicine and Pharmacy, \u201cDunarea de Jos\u201d University of Galati, 800216 Galati, Romania"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Doriana","family":"Iancu","sequence":"additional","affiliation":[{"name":"Research Centre in the Medical-Pharmaceutical Field, Faculty of Medicine and Pharmacy, \u201cDunarea de Jos\u201d University of Galati, 800216 Galati, Romania"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5853-393X","authenticated-orcid":false,"given":"Octavian Stefan","family":"Patrascanu","sequence":"additional","affiliation":[{"name":"Research Centre in the Medical-Pharmaceutical Field, Faculty of Medicine and Pharmacy, \u201cDunarea de Jos\u201d University of Galati, 800216 Galati, Romania"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Iuliu","family":"Fulga","sequence":"additional","affiliation":[{"name":"Research Centre in the Medical-Pharmaceutical Field, Faculty of Medicine and Pharmacy, \u201cDunarea de Jos\u201d University of Galati, 800216 Galati, Romania"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2026,8,26]]},"reference":[{"key":"ref_1","unstructured":"World Health Organization (2021). 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