David Gunnell
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Articles by David Gunnell
Evaluating Population-Level Interventions and Exposures for Suicide Prevention
The difference in difference (DID) design is a quasi-experimental research design that researchers often use to study causal relationships in public health settings where randomized controlled trials (RCTs) are infeasible or unethical. However, causal inference poses many challenges in DID designs. In this article, we review key features of DID designs with an emphasis on public health policy research.
Suicide numbers during the first 9-15 months of the COVID-19 pandemic compared with pre-existing trends: An interrupted time series analysis in 33 countries
Summary Background Predicted increases in suicide were not generally observed in the early months of the COVID-19 pandemic. However, the picture may be changing and patterns might vary across demographic groups. We aimed to provide a timely, granular picture of the pandemic's impact on suicides globally.
The impact of the COVID-19 pandemic on student mental health and wellbeing in UK university students: a multiyear cross-sectional analysis
Descriptive statistics Two thousand six hundred and thirty-seven students completed the 2019 survey (response rate = 2637/26,102: 10%), 3693 students completed the 2020 survey (response rate = 3693/27,513: 13%), and 2772 students competed the 2021 survey (response rate = 2772/29,536: 9%). Respondent characteristics are presented in . The majority of respondents in all three years were female, ranging from 63.2% (2021) to 69.4% (2019), and approximately 80% were aged 24 or younger.
Self-harm and suicide during and after opioid agonist treatment among primary care patients in England: a cohort study
Summary Background The first 4 weeks after initiation and cessation of opioid agonist treatment for opioid dependence are associated with an increased risk of all-cause mortality and overdose. We aimed to investigate whether the rate of self-harm and suicide among people who were prescribed opioid agonist treatment differs during initiation, cessation, and the remainder of time on and off treatment.
Child Suicide Rates During the COVID-19 pandemic in England
Abstract Background There is concern about the impact of COVID-19, and the control measures to prevent the spread, on children’s mental health. The aim of this work was to identify if there had been a rise of childhood suicide during the COVID pandemic; using data from England’s National Child Mortality Database (NCMD). Method Child suicide rates between April to December 2020 were compared with those in 2019 using negative binomial regression models, and characteristics compared.
Pesticide surveillance and deaths by suicide
1 WHO and Food and Agriculture Organization of the United Nations Preventing suicide: a resource for pesticide registrars and regulators. These bans are a potentially cost-effective and affordable intervention for reducing suicide deaths in countries with a high burden of suicide deaths attributable to pesticides. 2 Lee YY Chisholm D Eddleston M et al.
Mental health of children and young people during pandemic
News & Views Mental health of...
Risk of neuropsychiatric and cardiovascular adverse events following treatment with varenicline and nicotine replacement therapy in the UK Clinical Practice Research Datalink: a case-cross‐over study - Thomas - - Addiction - Wiley Online Library
Abstract Background and aims Varenicline and nicotine replacement therapy (NRT) are the most commonly used medications to quit smoking. Given their widespread use, monitoring adverse risks remains important. This study aimed to estimate the neuropsychiatric and cardiovascular risks associated with varenicline and NRT as used in routine UK care. Design Case–cross‐over study.
Trends in suicide during the covid-19 pandemic
News & Views Trends in suicide...
Gender difference in suicide in Taiwan over a century: a time trend analysis in 1905-1940 and 1959-2012
Gender difference in suicide in Taiwan over a century: a time trend analysis in 1905–1940 and 1959–2012 http://orcid.org/0000-0003-1005-163XYi-Han Chang1,2, David Gunnell3,4, Chia-Yueh Hsu5,6,7, Shu-Sen Chang1,5,8, Andrew Tai-Ann Cheng9,10 1Institute of Health Behaviors and Community Sciences, College of Public Health, National Taiwan University, Taipei, Taiwan 2Institute of Health Policy and Management, College of Public Health, National Taiwan University, Taipei, Taiwan 3Population Health...
Gender difference in suicide in Taiwan over a century: a time trend analysis in 1905-1940 and 1959-2012
Gender difference in suicide in Taiwan over a century: a time trend analysis in 1905–1940 and 1959–2012 http://orcid.org/0000-0003-1005-163XYi-Han Chang1,2, David Gunnell3,4, Chia-Yueh Hsu5,6,7, Shu-Sen Chang1,5,8, Andrew Tai-Ann Cheng9,10 1 Institute of Health Behaviors and Community Sciences, College of Public Health, National Taiwan University, Taipei, Taiwan 2 Institute of Health Policy and Management, College of Public Health, National Taiwan University, Taipei, Taiwan 3 Population...
Suicide risk and prevention during the COVID-19 pandemic
David Gunnell David Gunnell Affiliations National Institute for Health Research Biomedical Research Centre, University Hospitals Bristol NHS Foundation Trust and University of Bristol, Bristol BS8 2PS, UK Search for articles by this author Louis Appleby Louis Appleby Affiliations Centre for Mental Health and Safety, National Institute for Health Research Greater Manchester Patient Safety Translational Research Centre, Manchester Academic Health Sciences Centre, University of Manchester and...
Impact of 2008 global economic crisis on suicide: time trend study in 54 countries
Shu-Sen Chang, research assistant professor,1,2,3 David Stuckler, senior research leader,4,5 Paul Yip, professor,1,6 and David Gunnell, professor2 Shu-Sen Chang 1HKJC Centre for Suicide Research and Prevention, The University of Hong Kong, Hong Kong Jockey Club Building for Interdisciplinary Research, 5 Sassoon Road, Pokfulam, Hong Kong SAR, China 2School of Social and Community Medicine, University of Bristol, Bristol, UK 3Ju Shan Hospital, Taoyuan, Taiwan David Stuckler 4Department of...
Suicide and the media: reporting could cost lives
Intended for healthcare professionals Toggle navigation The BMJ logo Toggle top menu News & Views Suicide and the media:...
The relationship between physical activity, mental wellbeing and symptoms of mental health disorder in adolescents: a cohort study
Abstract Background Mental illness is a worldwide public health concern. In the UK, there is a high prevalence of mental illness and poor mental wellbeing among young people. The aim of this study was to investigate whether physical activity is associated with better mental wellbeing and reduced symptoms of mental health disorder in adolescents.
Preventing suicide through pesticide regulation
1 WHO Preventing suicide. A global imperative. World Health Organization, Geneva 2014 Restriction of access to highly lethal and commonly used suicide methods is one of the few proven approaches available to governments to reduce overall suicide rates. , In high-income countries, the approach has largely focused on restricting the sales of, or withdrawing, medicines that are commonly taken in fatal overdoses, restricting access to guns, and making high-risk locations (such as bridges) safer.
Suicide and suicide risk
Abstract Although recent years have seen large decreases in the overall global rate of suicide fatalities, this trend is not reflected everywhere. Suicide and suicidal behaviour continue to present key challenges for public policy and health services, with increasing suicide deaths in some countries such as the USA.
Pathways between early‐life adversity and adolescent self‐harm: the mediating role of inflammation in the Avon Longitudinal Study of Parents and Children
Abstract Background Adverse childhood experiences (ACEs) such as physical and emotional abuse are strongly associated with self‐harm, but mechanisms underlying this relationship are unclear. Inflammation has been linked to both the experience of ACEs and self‐harm or suicide in prior research. This is the first study to examine whether inflammatory markers mediate the association between exposure to ACEs and self‐harm.
New standard of proof for suicide at inquests in England and Wales
Louis Appleby, professor of psychiatry1, Pauline Turnbull, project director1, Nav Kapur, professor of psychiatry and population health12, David Gunnell, professor of epidemiology3, Keith Hawton, professor of psychiatry4 1National Confidential Inquiry into Suicide and Safety in Mental Health (NCISH), Centre for Mental Health and Safety, School of Health Sciences, University of Manchester, Manchester, UK 2Greater Manchester Mental Health NHS Foundation Trust, Manchester, UK 3Centre for Academic...
Prevalence of non-suicidal self-harm and service contact in England, 2000-14: repeated cross-sectional surveys of the general population
Summary Background The number of people presenting to hospital emergency departments after self-harming has increased in England. However, most people who self-harm do not present to hospitals, so whether this rise reflects an increase in the prevalence of self-harm in the community is unknown. Also unknown is whether the prevalence of non-suicidal self-harm (NSSH) or suicidal self-harm, or both, has increased. We aimed to establish temporal trends in the prevalence of NSSH in England.
In-utero and perinatal influences on suicide risk: a systematic review and meta-analysis
Summary Background Adverse in-utero and perinatal conditions might contribute to an increased suicide risk throughout the lifespan; however, existing evidence is sparse and contradictory. We aimed to investigate in-utero and perinatal exposures associated with suicide, suicide attempt, and suicidal ideation.
Trends in Mood and Anxiety Symptoms and Suicide-Related Outcomes Among U.S. Undergraduates, 2007-2018: Evidence From Two National Surveys
Poor mental health among young adults in higher education is a growing concern. In recent years, the visibility of racism has sharply risen. Vicarious discrimination is defined as the secondhand witnessing of racism, and given society's increased accessibility to social media and the Internet, addressing indirect violence is urgently needed to inform anti-racism and mental health efforts.
Occupation-specific suicide risk in England: 2011–2015 | The British Journal of Psychiatry | Cambridge Core
Ben Windsor-Shellard (a1) and David Gunnell (a2) (a1) Head of Lifestyle and Risk Factors Analysis, Health Analysis and Life Events, Office for National Statistics, UK (a2) Professor of Epidemiology, Population Health Sciences, Bristol Medical School, University of Bristol; and National Institute of Health Research Biomedical Research Centre at the University Hospitals Bristol National Health Service Foundation Trust and the University of Bristol, UK DOI: https://doi.org/10.1192/bjp.2019.69...
Pesticides and suicide prevention - why research needs to be put into practice
As many as 800,000 people around the world die every year by suicide, with 76% of these deaths in low and middle income countries like India and China. Between 110,000 and 168,000 people die from self-poisoning using pesticides – the same pesticides which are banned in wealthier countries due to human health and environmental concerns. In many lower income countries, suicide rates are higher in rural than urban communities.
Adolescent mental health in crisis
Universities UK recently reported a fivefold increase in the number of students disclosing mental health conditions since 2007 (from 9675 in 2007-8 to 57 305 in 2017-18) and growing pressures on student mental health services, despite only a modest rise in student numbers.1 A growing number of UK and international studies show that affective disorders in young people are rising substantially, particularly among girls and young women.2 A recent UK analysis reported a 68% increase in hospital...
Simpson's Paradox, Lord's Paradox, and Suppression Effects are the same phenomenon - the reversal paradox
Of the three paradoxes, suppression effects within multiple regression are probably the least recognised amongst clinical and epidemiological researchers, though the suppression phenomenon has been extensively discussed by statisticians [32–34] and methodologists from the social sciences [35, 36].
The government must ban paraquat
After years of debate, the Council of Agriculture in October announced its intention to ban two pesticide products that contain the weed killer paraquat. According to the council’s schedule, the ban on the sale and use of the pesticides is to become effective in February 2019. We applaud this important and life-saving change in policy.
Prevention of suicide with regulations aimed at restricting access to highly hazardous pesticides: a systematic review of the international evidence
We identified 27 relevant studies21, 22, 24, 25, 26, 27, 28, 29, 30, 31, 32, 33, 34, 35, 36, 37, 38, 39, 40, 41, 42, 43, 44, 45, 46, 47, 48 describing the effect of pesticide regulations in five LMIC (Bangladesh, Colombia, India, Jordan and Sri Lanka) and 11 HIC (Denmark, Finland, Germany, Greece, Hungary, Ireland, Japan, South Korea, Taiwan, UK, and USA; table 1table 1, figurefigure).
Effect of barriers on the Clifton suspension bridge, England, on local patterns of suicide: implications for prevention
Abstract We assessed the effect of the installation of barriers on the Clifton suspension bridge, Bristol, England, in 1998 on local suicides by jumping. Deaths from this bridge halved from 8.2 per year (1994–1998) to 4.0 per year (1999–2003; P=0.008). Although 90% of the suicides from the bridge were by males, there was no evidence of an increase in male suicide by jumping from other sites in the Bristol area after the erection of the barriers.
Preventing deaths from pesticide self-poisoning-learning from Sri Lanka's success
WHO estimates that over 800?000 people die by suicide each year, with the majority of these deaths occurring in low-income and middle-income countries (LMICs).1 During the late 1990s and early 2000s an estimated 35% of suicides, or 300?000 deaths, were due to intentional pesticide self-poisoning.2 These numbers have since fallen,3 but WHO still considers pesticide self-poisoning to be one of the three most important means of global suicide.1In order to achieve further reductions, prevention...
Navigating an unfamiliar world: how parents of young people who self-harm experience support and treatment
Self-harm in young people is a common reason for contact with clinical services. However, there is little research focusing on parents’ perspectives of care following self-harm. The aim of this study was to explore parents’ experiences of treatment and support for the young person and for themselves. A qualitative design was used to explore parents’ perspectives. Semi-structured narrative interviews were conducted across the UK with 37 parents of young people who had self-harmed.
Suicide in England and Wales 1861-2007: a time-trends analysis
Background Suicide is one of the leading causes of premature mortality worldwide. Few studies have assessed long-term trends or sex differences in its incidence over time. We have investigated the age-, sex- and method-specific trends in suicide in England and Wales from 1861 to 2007. Methods Overall age-standardized suicide rates using the European Standard Population and age-, sex- and method-specific rates were calculated for ages ?15 years from 1861 to 2007.
Secular trends in antidepressant prescribing in the UK, 1975-1998
Background We have examined secular trends in age? and sex?specific prescribing of antidepressants to determine whether these mirror changes in other population measures of mental health. Method An analysis was carried out of age? and sex?specific rates of antidepressant prescribing by a representative sample or panel of UK general practitioners (GPs) in the period 1975–1998.
Interventions for self-harm in children and adolescents
You have accessRestricted access Interventions for self-harm in children and adolescents Keith Hawton, Katrina G. Witt, Tatiana L. Taylor Salisbury, Ella Arensman, David Gunnell, Ellen Townsend, Kees van Heeringen, Philip Hazell BJPsych Advances Sep 2016, 22 (5) 286; DOI: 10.1192/apt.22.5.286
Unemployment and initiation of psychotropic medication: a case-crossover study of 2 348 552 Norwegian employees
Competing interests All authors confirm that the recommendations for the Conduct, Reporting, Editing and Publication of Scholarly Work in Medical Journals (ICMJE Recommendations 2013) were followed.
Impact of 2008 global economic crisis on suicide: time trend study in 54 countries
Research Impact of 2008 global...
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