ArticleBMC emergency medicine2026
Adolescent emergency department visits for self-harm after COVID-19-related social distancing in the Republic of Korea: a 7-year retrospective study.
Article in BMC emergency medicine, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
backgroundAdolescent suicide is a major public health concern and self-harm-related emergency department (ED) visits are key predictors. Although social distancing during and after the pandemic likely affected the incidence of self-harm, few studies have explored these changes. We examined the variations in the incidence of adolescent self-harm-related ED visits before, during, and after social distancing.
methodsWe conducted a retrospective analysis of data from the ED‑Based Injury In‑Depth Surveillance registry in the Republic of Korea from January 2017 to December 2023. Injured patients aged 10 - 17 years were included in this study. The incidence rate of self-harm was recorded quarterly. Data on demographic, pre-hospital, and clinical characteristics were compared across three periods: pre-pandemic; pandemic; and post-pandemic, using data from Quarter 1 of 2020 (when social distancing was implemented) and Quarter 2 of 2022 (when it was fully lifted) as reference points. Multinomial logistic regression analyses were performed for each group to evaluate the association with changes in the incidence of self-harm.
resultsWe included 109,929 adolescent patients with injuries, 6,316 (5.75%) of whom presented with self-harm. The incidence of self-harm increased significantly during the pandemic (from 3.6% to 8.8%), although this immediate increase was attenuated to borderline significance in a sensitivity analysis incorporating seasonal variation, and decreased modestly after social distancing was lifted (to 7.8%). Self-harm occurring at home, among individuals with medical-aid insurance, and in those with psychiatric problems was significantly associated with these overall changes.
conclusionsAdolescent self-harm increased with the onset of the pandemic and social distancing, followed by a modest relative decline in incidence after the restrictions were lifted; however, the absolute number of self-harm presentations did not return to pre-pandemic levels. This suggests that social distancing measures may have had a greater impact on adolescents, whose daily lives largely revolve around home and school environments.
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