Effects of the COVID-19 pandemic on suicide attempts in a rural region in Germany, a 5-year observational study

•The COVID-19 pandemic and containment measures did not increase the occurrence of suicide attempts in the study population.•The pandemic had a significant impact on the dynamics of suicide attempts.•A pronounced influence on the occurrence of suicide attempts was found across age- and sex-related subgroups.•The pandemic and associated interventions may have had a negative impact on suicidality, particularly among older patients.