Changes in the proportion of suicides attributed to work-related problems before, during, and after the COVID-19 pandemic in Japan.

OBJECTIVES: To examine changes in suicides attributed to work-related problems in Japan before, during, and after the COVID-19 pandemic, with attention to sex differences. METHODS: Monthly suicide data from January 2017 to February 2026 were obtained from the Ministry of Health, Labour and Welfare of Japan. The study period was divided into four phases: pre-emergency period (January 2017-March 2020), COVID-19 period (April 2020-December 2021), COVID-19 period after classification change (January 2022-May 2023), and post-COVID-19 period (June 2023-February 2026). Negative binomial regression models including the logarithm of monthly total suicides as an offset were used to examine the proportion of suicides attributed to work-related problems among all suicides according to period and sex. Supplementary analyses examined within-period temporal trends. RESULTS: During the study period, 188,178 suicides were recorded, including 20,822 recorded as involving work-related problems. In the offset model, among men, the proportion of suicides attributed to work-related problems was lower during the COVID-19 period than during the pre-emergency period (incidence rate ratio [IRR], 0.920; 95% confidence interval [CI], 0.859-0.986), but higher during the COVID-19 period after classification change (IRR, 1.389; 95% CI, 1.297-1.486) and the post-COVID-19 period (IRR, 1.261; 95% CI, 1.184-1.342). The relative change was more positive among women during the COVID-19 period and the post-COVID-19 period. CONCLUSIONS: Work-related problems were more frequently represented in suicide statistics after the onset of the COVID-19 pandemic in Japan, although part of the increase after 2022 may reflect the revision of official classification.