Last week, researchers from the University of Oxford and the Karolinska Institutet, Stockholm, published a new study on lifetime suicide risk factors in the New England Journal of Medicine (NEJM).

In the 12 months before July 2017, the rate of suicide for university students in England and Wales was 4.7 deaths per 100,000 students, which equates to 95 suicides or about one death every four days. Suicide is the foremost leading cause of death worldwide among persons aged 15 to 24 years of age.

The study differentiates between individual risk factors, such as physical or mental health problems, and environmental risk factors, such as access to firearms or the effects of the media. It also focuses on identifying the various points in people’s lives when they will be more susceptible to these risk factors.

The researchers found that factors such as genetics and family history play a part in suicide risk throughout life, while other factors including depression, substance abuse, lack of social support and financial problems become stronger after adolescence.

The study also looked at specific subgroups to determine the key risk factors for different areas of society including prisoners, military and veteran populations, discharged psychiatric patients, and members of the LGBTQ+ community.

The study finds that depression, bipolar disorder, schizophrenia-spectrum disorders, substance use disorders, epilepsy, and traumatic brain injury are all factors which increase the likelihood of completed suicide by a factor of more than 3 over the course of a lifetime.

Suicide prevention methods were also analysed in the study. It was found that the risk of suicide could be managed through regular follow- up and brief psychological therapy, while 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.

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.”

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