ImportanceChanges in suicide rates after a nationwide trauma may be different from changes in psychiatric symptoms or general distress after such events. However, very few studies have examined short-term suicide-related reactions after such an event.ObjectiveTo evaluate the short-term outcome of the events in Israel on October 7, 2023, a large-scale terror attack and unfolding war, on changes in suicidality as reflected in percentages of suicide-related calls in relation to all calls to a national mental health first aid helpline, the Israeli Association for Emotional First Aid (ERAN).Design, Setting and ParticipantsThe data included all interactions via the various ERAN helpline services between January 1, 2022, and December 31, 2023.ExposuresThe October 7, 2023, terror attack on Israel.Mean Outcomes and MeasuresChanges in the numbers of overall calls and suicide-related calls to the ERAN helpline using an interrupted time-series analysis.ResultsA total of 602 323 calls were received by the ERAN helpline. The number of calls reflecting psychological distress in the 3 months before October 7, 2023, was 67 555 compared with 89 445 calls in the 3 months after. Analysis indicated that overall calls increased significantly on October 7 (β = 2089.16; 95% CI, 1918.97-2259.35). In addition, the daily trajectory of all calls changed significantly after October 7 (β = −22.77; 95% CI, −33.37 to −12.16), such that there was a decrease in the number of calls per day (β = −11.34; SE = 1.213; t = −9.35; P < .001). The number of suicide-related calls in the 3 months before October 7 was 1887, whereas 1663 suicide-related calls were registered in the 3 months after. Analysis showed that there were no changes in the daily number of suicide-related calls from before October 7 (β = −0.001; 95% CI, −0.005 to 0.03) or on October 7 (β = −0.22; 95% CI, −3.69 to 3.25). Therefore, the percentage of suicide-related calls decreased significantly on October 7 (β = −1.42; 95% CI, −1.92 to −0.92) and gradually increased in the following period (β = 0.016; 95% CI, 0.006-0.026).Conclusions and RelevanceThe findings of this cohort study suggest that although short-term emotional distress increased after national trauma, the percentage of suicide-related calls decreased. These results support previous studies suggesting that suicidality is not one of the immediate reactions to such traumas.

中文翻译：

---

自杀倾向在恐怖袭击和战争后拨打全国求助热线


重要性全国性创伤后自杀率的变化可能与此类事件后精神症状或一般痛苦的变化不同。然而，很少有研究检查此类事件后与自杀相关的短期反应。目的评估 2023 年 10 月 7 日以色列事件的短期结果，即大规模恐怖袭击和正在展开的战争，对自杀倾向变化的影响，反映在与自杀相关的电话占全国心理健康急救热线以色列情绪急救协会 （ERAN） 的所有电话的百分比。设计、设置和参与者数据包括 2022 年 1 月 1 日至 2023 年 12 月 31 日期间通过各种 ERAN 帮助热线服务进行的所有互动。暴露2023 年 10 月 7 日对以色列的恐怖袭击。平均结果和措施使用中断时间序列分析，ERAN 帮助热线的总电话和自杀相关电话数量的变化。结果ERAN 帮助热线共接到 602 323 个电话。2023 年 10 月 7 日之前 3 个月内反映心理困扰的电话数量为 67 555 个，而之后 3 个月内为 89 445 个。分析表明，10 月 7 日的总呼叫量显著增加（β = 2089.16;95% CI，1918.97-2259.35）。此外，10 月 7 日之后，所有呼叫的每日轨迹发生了显著变化（β = −22.77;95% CI，−33.37 至 −12.16），因此每天的呼叫数量有所减少（β = −11.34;SE = 1.213;t = −9.35;P < .001）。10 月 7 日之前 3 个月内与自杀相关的电话数量为 1887 个，而之后 3 个月内登记的与自杀相关的电话数量为 1663 个。 分析显示，与 10 月 7 日之前（β = -0.001;95% CI，-0.005 至 0.03）或 10 月 7 日（β = -0.22;95% CI，-3.69 至 3.25）相比，每日自杀相关电话数量没有变化。因此，10 月 7 日自杀相关电话的百分比显着下降（β = -1.42;95% CI，-1.92 至 -0.92），并在接下来的时期逐渐增加（β = 0.016;95% CI，0.006-0.026）。结论和相关性这项队列研究的结果表明，尽管在国家创伤后短期情绪困扰增加，但与自杀相关的电话的百分比有所下降。这些结果支持了以前的研究，表明自杀并不是对此类创伤的直接反应之一。