Swedish nationwide time series analysis of influenza and suicide deaths from 1910 to 1978
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Abstract
There is concern that the COVID-19 pandemic will be associated with an increase in suicides, but evidence supporting a link between pandemics and suicide is limited. Using data from the three influenza pandemics of the 20th century, we aimed to investigate whether an association exists between influenza deaths and suicide deaths.
Design
Time series analysis.
Setting
Sweden.
Participants
Deaths from influenza and suicides extracted from the Statistical Yearbook of Sweden for 1910–1978, covering three pandemics (the Spanish influenza, the Asian influenza and the Hong Kong influenza).
Main outcome measures
Annual suicide rates in Sweden among the whole population, men and women. Non-linear autoregressive distributed lag models was implemented to explore if there is a short-term and/or long-term relationship of increases and decreases in influenza death rates with suicide rates during 1910–1978.
Results
Between 1910 and 1978, there was no evidence of either short-term or long-term significant associations between influenza death rates and changes in suicides (β coefficients of 0.00002, p=0.931 and β=0.00103, p=0.764 for short-term relationship of increases and decreases in influenza death rates, respectively, with suicide rates, and β=−0.0002, p=0.998 and β=0.00211, p=0.962 for long-term relationship of increases and decreases in influenza death rates, respectively, with suicide rates). The same pattern emerged in separate analyses for men and women.
Conclusions
We found no evidence of short-term or long-term association between influenza death rates and suicide death rates across three 20th century pandemics.
Article activity feed
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SciScore for 10.1101/2020.12.10.20244699: (What is this?)
Please note, not all rigor criteria are appropriate for all manuscripts.
Table 1: Rigor
Institutional Review Board Statement not detected. Randomization not detected. Blinding not detected. Power Analysis not detected. Sex as a biological variable 18] The yearbooks were produced by Statistics Sweden, a governmental agency responsible for the official statistics in Sweden, with a history of population statistics going back to the 18th century.[17] For each year from 1910 to 1978, we retrieved information on the total population of Sweden, the number of deaths by influenza (if death cause was indicated as “influenza”) and the number of suicides (if death cause was indicated as “suicide”), as well as the corresponding data separately for men and women. Table 2: Resources
Software and Algorithms Se… SciScore for 10.1101/2020.12.10.20244699: (What is this?)
Please note, not all rigor criteria are appropriate for all manuscripts.
Table 1: Rigor
Institutional Review Board Statement not detected. Randomization not detected. Blinding not detected. Power Analysis not detected. Sex as a biological variable 18] The yearbooks were produced by Statistics Sweden, a governmental agency responsible for the official statistics in Sweden, with a history of population statistics going back to the 18th century.[17] For each year from 1910 to 1978, we retrieved information on the total population of Sweden, the number of deaths by influenza (if death cause was indicated as “influenza”) and the number of suicides (if death cause was indicated as “suicide”), as well as the corresponding data separately for men and women. Table 2: Resources
Software and Algorithms Sentences Resources To select the optimal number of lags (i.e., how far in the past the dependency among measurements is examined) to be used in the NARDL for dependent and independent variables, we applied the varsoc command in STATA using the minimal values of Akaike Information Criterion, Schwarz’s Bayesian information criterion (SBIC), and the Hannan and Quinn information criterion information criteria. STATAsuggested: (Stata, RRID:SCR_012763)1 (StataCorp LLC, College Station, TX, USA). StataCorpsuggested: (Stata, RRID:SCR_012763)Results from OddPub: Thank you for sharing your data.
Results from LimitationRecognizer: We detected the following sentences addressing limitations in the study:A shared sense of belonging and focus, social connectedness and a “pulling together effect” may be one such factor.[1,24] Limitations: The study used the Swedish historical public death records and we had no means of verifying the causes of death. The coverage and precision of these records is likely to have improved over time for both variables. To guard against effects of changes in the recording of causes of death, we created a series of dummy variables for each corresponding period but no significant effects of those were found. If there were some other time-varying factors that could affect the coverage and precision of death records, apart from the official changes in registration system, this might have biased our results, in particular if such factors differentially affected the quality of recording deaths due to influenza and suicide. As we did not have access to data with higher temporal resolution than yearly data, that could affect our results if the time sequence of association between changes in influenza death and suicide differ from the chosen time interval. A multitude of factors may vary that impact the resilience of the society with regards to the effect of a pandemic. Such factors may also vary over time and place. However, the fact that we observed no clear associaionts between influenza and suicide deaths across pandemics, which challenged society with various degrees of lockdown, economic effects and health care supply issues, does support the stability...
Results from TrialIdentifier: No clinical trial numbers were referenced.
Results from Barzooka: We did not find any issues relating to the usage of bar graphs.
Results from JetFighter: We did not find any issues relating to colormaps.
Results from rtransparent:- Thank you for including a conflict of interest statement. Authors are encouraged to include this statement when submitting to a journal.
- Thank you for including a funding statement. Authors are encouraged to include this statement when submitting to a journal.
- No protocol registration statement was detected.
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SciScore for 10.1101/2020.12.10.20244699: (What is this?)
Please note, not all rigor criteria are appropriate for all manuscripts.
Table 1: Rigor
Institutional Review Board Statement not detected. Randomization not detected. Blinding not detected. Power Analysis not detected. Sex as a biological variable 18] The yearbooks were produced by Statistics Sweden, a governmental agency responsible for the official statistics in Sweden, with a history of population statistics going back to the 18th century.[17] For each year from 1910 to 1978, we retrieved information on the total population of Sweden, the number of deaths by influenza (if death cause was indicated as “influenza”) and the number of suicides (if death cause was indicated as “suicide”), as well as the corresponding data separately for men and women. Table 2: Resources
Software and Algorithms Sen… SciScore for 10.1101/2020.12.10.20244699: (What is this?)
Please note, not all rigor criteria are appropriate for all manuscripts.
Table 1: Rigor
Institutional Review Board Statement not detected. Randomization not detected. Blinding not detected. Power Analysis not detected. Sex as a biological variable 18] The yearbooks were produced by Statistics Sweden, a governmental agency responsible for the official statistics in Sweden, with a history of population statistics going back to the 18th century.[17] For each year from 1910 to 1978, we retrieved information on the total population of Sweden, the number of deaths by influenza (if death cause was indicated as “influenza”) and the number of suicides (if death cause was indicated as “suicide”), as well as the corresponding data separately for men and women. Table 2: Resources
Software and Algorithms Sentences Resources To select the optimal number of lags (i.e., how far in the past the dependency among measurements is examined) to be used in the NARDL for dependent and independent variables, we applied the varsoc command in STATA using the minimal values of Akaike Information Criterion, Schwarz’s Bayesian information criterion (SBIC), and the Hannan and Quinn information criterion information criteria. STATAsuggested: (Stata, RRID:SCR_012763)All statistical analyses were performed using STATA version 15.1 (StataCorp LLC, College Station, TX, USA). StataCorpsuggested: (Stata, RRID:SCR_012763)Results from OddPub: Thank you for sharing your data.
Results from LimitationRecognizer: We detected the following sentences addressing limitations in the study:
A shared sense of belonging and focus, social connectedness and a “pulling together effect” may be one such factor.[1,24] Limitations The study used the Swedish historical public death records and we had no means of verifying the causes of death. The coverage and precision of these records is likely to have improved over time for both variables. To guard against effects of changes in the recording of causes of death, we created a series of dummy variables for each corresponding period but no significant effects of those were found. If there were some other time-varying factors that could affect the coverage and precision of death records, apart from the official changes in registration system, this might have biased our results, in particular if such factors differentially affected the quality of recording deaths due to influenza and suicide. As we did not have access to data with higher temporal resolution than yearly data, that could affect our results if the time sequence of association between changes in influenza death and suicide differ from the chosen time interval. A multitude of factors may vary that impact the resilience of the society with regards to the effect of a pandemic. Such factors may also vary over time and place. However, the fact that we observed no clear associaionts between influenza and suicide deaths across pandemics, which challenged society with various degrees of lockdown, economic effects and health care supply issues, does support the stability ...
Results from TrialIdentifier: No clinical trial numbers were referenced.
Results from Barzooka: We did not find any issues relating to the usage of bar graphs.
Results from JetFighter: We did not find any issues relating to colormaps.
About SciScore
SciScore is an automated tool that is designed to assist expert reviewers by finding and presenting formulaic information scattered throughout a paper in a standard, easy to digest format. SciScore checks for the presence and correctness of RRIDs (research resource identifiers), and for rigor criteria such as sex and investigator blinding. For details on the theoretical underpinning of rigor criteria and the tools shown here, including references cited, please follow this link.
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