Suicide Risk on Christmas Eve, Christmas Day, New Year's Day, and Valentine's Day: A Systematic Review and Meta-analysis

Ta-Chuan Yeh¹Tien-Wei Hsu²Yu-Chen Kao³Trevor Thompson⁴Brendon Stubbs⁵Andre F Carvalho⁶Fu-Chi Yang¹Ping-Tao Tseng⁷CHIH-WEI HSU⁸Chia-Ling Yu⁹Yu-Kang Tu^10*Chih-Sung Liang^3*

• ¹Tri-Service General Hospital, Taipei City, Taiwan
• ²E-Da Hospital, Yanchao District, Taiwan
• ³Tri-Service General Hospital Beitou Branch, Taipei City, Taiwan
• ⁴University of Greenwich, London, United Kingdom
• ⁵King's College London, London, United Kingdom
• ⁶Deakin University, Melbourne, Australia
• ⁷National Sun Yat-sen University, Kaohsiung, Taiwan
• ⁸Kaohsiung Chang Gung Memorial Hospital, Niaosong District, Taiwan
• ⁹Linkou Chang Gung Memorial Hospital, Taoyuan, Taiwan
• ¹⁰National Taiwan University, Taipei City, Taiwan

Objective: Holidays are times of celebration of family and loved ones which can be difficult for some people. This study assessed the risk of suicide on Christmas Eve, Christmas Day, New Year’s Day, and Valentine’s Day. Methods: We searched four major electronic databases. The primary outcome was suicide deaths, and the secondary outcome was self-harm and suicide-related behaviors (SHSB). For each holiday, we calculated the risk ratio (RR) compared to regular days and the proportion of annual suicides. Results: We included 28 studies (n=2186094). The proportion of annual suicides was 0.23% (95% confidence interval, 0.17%, 0.28%; number of studies [k]=11) on Christmas Eve, 0.24% (0.19%, 0.29%; k=17) on Christmas Day, 0.39% (0.31%, 048%; k=16) on New Year’s Days, and 0.27% (0.24%, 0.30%; k=5) on Valentine’s Day. Compared to regular days, suicide risk was 17% lower (RR=0.83; 0.72, 0.96) on Christmas Day and 33% higher on New Year’s Day (RR=1.33; 1.06, 1.65) with no significant difference for Christmas Eve or Valentine’s Day. This pattern of lower suicide risk on Christmas and higher risk on New Year’s Day was consistent across countries. Regarding SHSB, the proportions were 0.19% on Christmas Eve, 0.21% on Christmas Day, 0.29% on New Year’s Day, and 0.23% on Valentine’s Day, corresponding to a lower risk on Christmas Eve (RR=0.74; 0.57, 0.96; k=5) and a higher risk on New Year’s Day (RR=1.17; 1.03, 1.34; k=6), but no significant difference on Christmas Day or Valentine’s Day. Conclusion: Our study suggests that only New Year’s Day appears to be a temporal hotspot for suicide across most countries. Systemic Review Registration: Open Science Framework (osf.io/7zx3d)