Suicidal behavior during the Covid-19 pandemic: Results from cross-sectional surveys of Brazilian adults from 2020 to 2022

This study aimed to analyze the predictive capacity of fear of Covid-19, anxiety and depressive symptoms, and the variable pandemic year on suicidal behaviors in the years 2020, 2021, and 2022. The total sample consisted of 7,735 adults from all regions of the country and over 1.300 Brazilian cities, with an average age of 34 years. The research instruments used were the Fear of Covid-19 Scale (FCV-19S), the Generalized Anxiety Disorder Scale (GAD-7), the Patient Health Questionnaire Scale (PHQ-9), and a question assessing the absence, presence of suicidal ideation, and suicide planning or attempts. Data analysis was conducted using multinomial logistic regression. The main findings showed that fear of Covid-19 (severe [OR = 0.696]), anxiety (mild [OR = 2.183], moderate [OR = 2.436], and severe [OR = 2.757]), and depression (mild [OR = 2.831], moderate [OR = 4.769], and severe [OR = 10.660]) were statistically significant in relation to suicidal ideation. As for suicide planning and attempts, predictors included year (2022 [OR = 1.297]), fear of Covid-19 (moderate [OR = 0.614] and severe [OR = 0.445]), anxiety (mild [OR = 2.253], moderate [OR = 2.988], and severe [OR = 3.577]), and depression (mild [OR = 3.021], moderate [OR = 8.189], and severe [OR = 40.363]). In conclusion, the effects of the pandemic need to continue to be monitored, as mental health surveillance data are crucial in guiding effective policies aimed at suicidal behavior, ### Competing Interest Statement The authors have declared no competing interest. ### Clinical Trial Institutional review board or ethics committee that approved the study: National Commission of Research Ethics (CONEP) Approval number: 3.955.180 We obtained written form of consent and the data were analyzed anonymously ### Funding Statement The author(s) received no specific funding for this work. ### Author Declarations I confirm all relevant ethical guidelines have been followed, and any necessary IRB and/or ethics committee approvals have been obtained. Yes The details of the IRB/oversight body that provided approval or exemption for the research described are given below: This research was approved by the National Commission of Research Ethics (CONEP, registration: 3.955.180). I confirm that all necessary patient/participant consent has been obtained and the appropriate institutional forms have been archived, and that any patient/participant/sample identifiers included were not known to anyone (e.g., hospital staff, patients or participants themselves) outside the research group so cannot be used to identify individuals. Yes I understand that all clinical trials and any other prospective interventional studies must be registered with an ICMJE-approved registry, such as ClinicalTrials.gov. I confirm that any such study reported in the manuscript has been registered and the trial registration ID is provided (note: if posting a prospective study registered retrospectively, please provide a statement in the trial ID field explaining why the study was not registered in advance). Yes I have followed all appropriate research reporting guidelines, such as any relevant EQUATOR Network research reporting checklist(s) and other pertinent material, if applicable. Yes Data cannot be shared publicly because of ethical compromises in front of the National Commission of Research Ethics. Data are available under formal request for researchers who meet the criteria for access to confidential data by contacting the corresponding author via e-mail at andre.faro.ufs@gmail.com.