Abstract
During the pandemic, deaths associated with mental health deterioration due to social stress have contributed to excess mortality. The purpose of the study is to evaluate changes in mortality from causes associated with social stress during the pandemic in Moscow. The analysis is based on the Rosstat statistics and RFS-EMIAS database (Medical death certificates issued by the Moscow health institutions) in 2019-2020. Deaths from mental disorders and suicides during the maximum and minimum excess mortality in Moscow in 2020 were compared to 2019 (May and December, when mortality exceeded the 2019 indicators by 57.2% and 56.7%, and July with the 7.1%) excess. First, the excess mortality from mental disorders in these months was almost entirely due to disorders related to alcohol and drug abuse. Second, alcohol and drug abuse also results in deaths from poisoning. This necessitates a joint evaluation of deaths associated with alcohol and drugs (from mental disorders and poisoning). The evaluation shows that excess deaths from alcohol abuse in men in May 2020 compared to May 2019 equaled to 65%, falling down to 52.3% in July, followed by its maximum (2.5-fold) in December. Females show a steady increase: 52.9%, 76.5% and 2.1-fold, respectively. Distribution by sex of the total deaths associated with drug addiction (mental disorders and poisoning) was reversed: a steady increase in males (55.4% in May, 67% in July and 2.1-fold in December) and a significant decrease in females: 63.6%, 31.6% and 2.7-fold, respectively. Third, the pandemic has paradoxically affected deaths from suicide (including hangings, falls and undetermined intent poisoning). In men, excess deaths equaled to zero in May, 1.2% in July and decreased by 20.6% in December. The female excess suicidal mortality increased: 13.5%, 30.6% and 36.7%, respectively. Thus, the male reaction to social stress caused by the pandemic was passive (alcohol and drug abuse), while the female reaction was aggravated by suicides.
Key messages
During the pandemic, deaths associated with mental health deterioration due to social stress contributed to excess mortality. Alcohol and drug abuse results in deaths not only due to mental disorders.
Alcohol and drug abuse as a manifestation of social stress due to the COVID-19 pandemic
