15 January 2020
- Around 800,000 people die by suicide each year
- Suicide accounts for the most deaths globally in people between the ages of 15-24
- Risk factors change throughout lifetime
A new review of previous studies into suicide worldwide has highlighted the effects of individual and environmental risk factors over a lifetime
A review of studies into suicide risk factors at different stages of peoples’ lives, as well as of the effectiveness of assessment and treatment approaches, has found that while some factors such as genetics and family history play a part in suicide risk throughout life, other factors including clinical depression, substance misuse, lack of social support and economic factors become stronger after adolescence.
Publishing in the New England Journal of Medicine (NEJM), the researchers from the University of Oxford and the Karolinska Institutet, Stockholm, found that among individual risk factors for suicide, depression, bipolar disorder, schizophrenia-spectrum disorders, substance use disorders, epilepsy, and traumatic brain injury each increases the odds of completed suicide by a factor of more than 3 during the course of a lifetime.
The researchers looked at the effectiveness of interventions at a population level to target high-risk groups or individuals, such as restricting access to poisons or firearms, but found that these measures vary in effectiveness by country and culture.
Professor Seena Fazel of Oxford University’s Department of Psychiatry, said: “This is the first evidence synthesis to look at suicide at a population-wide level and through the course of peoples’ lives, which is particularly useful because many risk factors contribute differentially in childhood, adolescence, and adulthood, and we have attempted to identify both replicated factors and their strength.”
“Preventing suicide involves understanding the full picture of contributing factors throughout a lifetime, and there is no simple solution or fix. What we wanted to do in this review was to provide an overview of the latest evidence of how to identify higher risk individuals, and one that could be used in any country.”
The researchers concluded that when assessing and treating suicide risk: a person who presents with suicidal thoughts may be at risk for suicide even if there are few overt symptoms of a psychiatric disorder; suicide risk should be assessed by considering predisposing and precipitating factors; the risk of suicide should be managed through regular follow-up and brief psychological therapy; for persons with symptoms of mental illness, pharmacologic treatment should also be considered; the suicidal person, family members, and those who provide care should all take part in ensuring a safe environment, with removal of the means of suicide such as guns or certain medications; if the risk of suicide is considered to be high or uncertain, the person should be referred immediately to mental health services, and the use of risk-assessment tools should be considered to aid risk stratification and communication among services.
For further information, please contact:
Chris McIntyre in the University of Oxford press office at email@example.com or on +44 (0)1865 270 046
Notes to editors:
The full paper, ‘Suicide,’ can be read in the New England Journal of Medicine.
Oxford University’s Medical Sciences Division is one of the largest biomedical research centres in Europe, with over 2,500 people involved in research and more than 2,800 students. The University is rated the best in the world for medicine and life sciences, and it is home to the UK’s top-ranked medical school. It has one of the largest clinical trial portfolios in the UK and great expertise in taking discoveries from the lab into the clinic. Partnerships with the local NHS Trusts enable patients to benefit from close links between medical research and healthcare delivery.