Link between paediatric suicidal poisonings and school calendar: a national French Poison Centres study

Calls to French Poison Centres reflected the observed increase in attempted suicides during the COVID-19 pandemic, especially among adolescent girls and young women. We aim to investigate, through French Poison Centres data, another poorly documented (particularly in France) characteristic of paediatric suicidal behaviours: the influence of school holiday periods on their frequency.

We performed a retrospective descriptive study of the weekly number of suicidal self-poisonings managed by French Poison Centres in patients under the age of 18 in mainland France from 1 January 2017 to 31 December 2024. For comparison, weekly adult cases over the same period were also counted.

Prior to (2017-2019), during (2020-2021) and following (2022-2024) the pandemic, a substantial fluctuation was observed in the weekly number of paediatric self-poisonings throughout each year. However, there was a notable synchronization in the low points between years, despite an overall increase of 79% in the annual numbers between the pre- and post-COVID-19 periods. These lower parts corresponded to weeks of school closure, planned holidays and not lockdowns. The sustained increase in annual cases affected girls (+90%) much more than boys (+27%), and the link with the school calendar was only valid for girls.Over the same eight-year period, neither an annual increase in cases nor a link with school holidays was observed among adults.

Without overlooking the numerous factors outside the school environment that influence young people's mental health, including the growing importance of their digital social life, our findings also suggest the existence of school-specific stressors to which girls may be particularly vulnerable. Although we cannot here identify and quantify the endogenous (self-esteem, pressure related to academic performance, etc.) and exogenous (bullying, relationships with teachers, etc.) components of these stressors, the link to French pupils' low scores on numerous indicators from international studies on student well-being, with a pronounced gender disparity, seems worth considering.

At the French national level, our findings illustrate both the persistence of the "COVID-19 effect" of increased paediatric suicidal poisonings, particularly in girls, after the pandemic; and the strong association between these attempts and school time, specifically among girls and regardless of the pandemic.