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The British Journal of Psychiatry (2004) 185: 385-393
© 2004 The Royal College of Psychiatrists

Factors influencing the development and amelioration of suicidal thoughts in the general population

Cohort study

D. Gunnell, PhD and R. Harbord, MSc

Department of Social Medicine, University of Bristol, London

N. Singleton, MSc

Social Survey Division, Office for National Statistics, London

R. Jenkins, MD

WHO Collaborating Centre, Institute of Psychiatry, London, UK

G. Lewis, PhD

Division of Psychiatry, University of Bristol, Bristol, UK

Correspondence: David Gunnell, Department of Social Medicine, University of Bristol, Canynge Hall, Whiteladies Road, Bristol BS8 2PR, UK. Tel: 0117 9287253; fax: 0117 9287204; e-mail: D.J.Gunnell{at}Bristol.ac.uk

Declaration of interest None. Funding detailed in Acknowledgements.

Background The incidence of suicidal thoughts in the British population is unknown.

Aims To determine the factors associated with the development of, and recovery from, suicidal thoughts.

Method An 18-month follow-up survey investigated 2404 of the adults who took part in the second National Psychiatric Morbidity Survey.

Results The annual incidence of suicidal thoughts was 2.3%. Incidence was highest in women and among 16- to 24-year-olds. Increased incidence was associated with not being in a stable relationship, low levels of social support and being unemployed. Fifty-seven per cent of those with suicidal thoughts at baseline had recovered by the 18-month follow-up interview.

Conclusions Risk factors for suicidal thoughts are similar to those for completed suicide, although the age and gender patterning is different. Fewer than 1 in 200 people who experience suicidal thoughts go on to complete suicide. Further study into explanations for the differences in the epidemiology of suicidal thoughts and suicide is crucial to understanding the pathways (protective and precipitating) linking suicidal thoughts to completed suicide and should help inform effective prevention of suicide.




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