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Suicide-Related Internet Searches During the Early Stages of the COVID-19 Pandemic in the US

Educational Objective
To identify the key insights or developments described in this article
1 Credit CME

Experts anticipate that the societal fallout associated with the coronavirus disease 2019 (COVID-19) pandemic will increase suicidal behavior, and strategies to address this anticipated increase have been woven into policy decision-making without contemporaneous data.1,2 For instance, President Trump cited increased suicides as an argument against COVID-19 control measures during the first presidential debate on September 29, 2020.

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Article Information

Accepted for Publication: November 30, 2020.

Published: January 21, 2021. doi:10.1001/jamanetworkopen.2020.34261

Open Access: This is an open access article distributed under the terms of the CC-BY License. © 2021 Ayers JW et al. JAMA Network Open.

Corresponding Author: John W. Ayers, PhD, MA, Division of Infectious Diseases and Global Public Health, Department of Medicine, University of California San Diego, #333 CRSF 9500 Gilman Dr, La Jolla, CA 92093 (ayers.john.w@gmail.com).

Author Contributions: Drs Ayers and Nobles had full access to all of the data in the study and take responsibility for the integrity of the data and the accuracy of the data analysis.

Concept and design: Ayers, Poliak, Leas, Dredze, Nobles.

Acquisition, analysis, or interpretation of data: Ayers, Johnson, Leas, Caputi, Nobles.

Drafting of the manuscript: Ayers, Leas, Caputi, Nobles.

Critical revision of the manuscript for important intellectual content: Poliak, Johnson, Leas, Dredze.

Statistical analysis: Leas, Caputi.

Obtained funding: Nobles.

Administrative, technical, or material support: Dredze.

Supervision: Dredze.

Conflict of Interest Disclosures: Dr Ayers reported owning equity positions in Directing Medicine LLC, Health Watcher Inc, and Good Analytics Inc, outside the submitted work. Dr Poliak reported being a paid advisor for Bloomberg LP, MyFitnessPal, and Lincoln Labs. Dr Leas reported receiving personal fees from Good Analytics outside the submitted work. Dr Dredze reported holding equity in Good Analytics, receiving consulting fees from Directing Medicine, and receiving financial support from Sickweather and Bloomberg LP outside the submitted work. Mr Caputi reported receiving personal fees from Good Analytics and having an equity interest in Data Science Solutions outside the submitted work. No other disclosures were reported.

Funding/Support: This work was supported by grants 587873 and R00RG2545 from the University of California Office of the President Research Grants Program Office.

Role of the Funder/Sponsor: The University of California Office of the President Research Grants Program Office had no role in the design and conduct of the study; collection, management, analysis, and interpretation of the data; preparation, review, or approval of the manuscript; and decision to submit the manuscript for publication.

References
1.
Reger  MA , Stanley  IH , Joiner  TE .  Suicide mortality and coronavirus disease 2019—a perfect storm?   JAMA Psychiatry. Published online April 10, 2020. doi:10.1001/jamapsychiatry.2020.1060 PubMedGoogle Scholar
2.
Simon  NM , Saxe  GN , Marmar  CR .  Mental health disorders related to COVID-19–related deaths.   JAMA. 2020;324(15):1493-1494. doi:10.1001/jama.2020.19632 PubMedGoogle ScholarCrossref
3.
Leas  EC , Dredze  M , Ayers  JW .  Ignoring data delays our reaction to emerging public health tragedies like 13 Reasons Why.   JAMA Psychiatry. 2020;77(1):102-103. doi:10.1001/jamapsychiatry.2019.2755 PubMedGoogle ScholarCrossref
4.
Ayers  JW , Althouse  BM , Leas  EC , Dredze  M , Allem  JP .  Internet searches for suicide following the release of 13 Reasons Why.   JAMA Intern Med. 2017;177(10):1527-1529. doi:10.1001/jamainternmed.2017.3333 PubMedGoogle ScholarCrossref
5.
Barros  JM , Melia  R , Francis  K ,  et al.  The validity of Google trends search volumes for behavioral forecasting of national suicide rates in Ireland.   Int J Environ Res Public Health. 2019;16(17):3201. doi:10.3390/ijerph16173201 PubMedGoogle ScholarCrossref
6.
Gordon  KH , Bresin  K , Dombeck  J , Routledge  C , Wonderlich  JA .  The impact of the 2009 Red River Flood on interpersonal risk factors for suicide.   Crisis. 2011;32(1):52-55. doi:10.1027/0227-5910/a000051 PubMedGoogle ScholarCrossref
AMA CME Accreditation Information

Credit Designation Statement: The American Medical Association designates this Journal-based CME activity activity for a maximum of 1.00  AMA PRA Category 1 Credit(s)™. Physicians should claim only the credit commensurate with the extent of their participation in the activity.

Successful completion of this CME activity, which includes participation in the evaluation component, enables the participant to earn up to:

  • 1.00 Medical Knowledge MOC points in the American Board of Internal Medicine's (ABIM) Maintenance of Certification (MOC) program;;
  • 1.00 Self-Assessment points in the American Board of Otolaryngology – Head and Neck Surgery’s (ABOHNS) Continuing Certification program;
  • 1.00 MOC points in the American Board of Pediatrics’ (ABP) Maintenance of Certification (MOC) program;
  • 1.00 Lifelong Learning points in the American Board of Pathology’s (ABPath) Continuing Certification program; and
  • 1.00 CME points in the American Board of Surgery’s (ABS) Continuing Certification program

It is the CME activity provider's responsibility to submit participant completion information to ACCME for the purpose of granting MOC credit.

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