What does this research mean for the field?

The incidence of adolescent self-harm-related emergency department visits increased significantly during COVID-19 social distancing and remained elevated above pre-pandemic levels even after restrictions were lifted. Novelty: ClaimNovelty.INCREMENTAL. Consensus alignment: ConsensusAlignment.NEUTRAL.

What question did this study set out to answer?

This study examines changes in adolescent self-harm visits to emergency departments related to social distancing during the COVID-19 pandemic.

July 2, 2026Open Access

Adolescent emergency department visits for self-harm after COVID-19–related social distancing in the Republic of Korea: a 7-year retrospective study

KJKwang Yul JungChung-Ang University

Key Points

This study examines changes in adolescent self-harm visits to emergency departments related to social distancing during the COVID-19 pandemic.
Conducted a retrospective analysis of ED data from January 2017 to December 2023
Included 109,929 adolescent patients aged 10-17 years, with 6,316 (5.75%) presenting with self-harm
Utilized multinomial logistic regression to analyze data across pre-pandemic, pandemic, and post-pandemic periods.
Self-harm incidence increased significantly from 3.6% pre-pandemic to 8.8% during the pandemic (p=0.001)
Post-pandemic incidence decreased modestly to 7.8%, but did not return to pre-pandemic levels
Significant associations were found with self-harm occurring at home, among those with medical-aid insurance, and those with psychiatric problems.

Abstract

Adolescent 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. We 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. We 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. Adolescent 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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