Objective: The aim of this study was to examine the impact of the COVID-19 pandemic on completed suicides in Konya, Trkiye, using the psychological autopsy method, and to compare pre- and pandemic cases across demographics, risk factors, and associated causes. Method: This cross-sectional, retrospective case-control study included all completed suicides in Konya, Trkiye, between March 11, 2018, and March 11, 2022. Cases after March 11, 2020, were classified as pandemic. Within the scope of the psychological autopsy method, data were collected from autopsy reports, prosecutor investigation files, medical records, suicide notes, and structured interviews with relatives the deceased. Statistical analyses were conducted using R software (version 4.4.2). Results: During the pandemic, the incidence rate of completed suicides increased by 25%. No significant differences in age or gender distribution were identified; however, the proportion of university graduates was higher in the pandemic group. The overall prevalence of psychiatric disorders and untreated cases increased significantly during the pandemic. Gambling-related debts and substance-related and addictive disorders were found to be more frequent. Firearm suicides showed a non-significant upward trend. Help-seeking before suicide decreased significantly. Most pandemic cases had sleep disturbances (56.93%) and financial loss (44.93%). Discussion: The pandemic period increased the risks associated with suicidal behavior and accentuated context-specific vulnerabilities. The findings indicate that psychiatric patients may be more vulnerable during crises and underscore the importance of support services. Accordingly, strengthening financial support, restricting access to online gambling, and expanding psychoeducational interventions are recommended as priority preventive strategies.
