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. 2023 Jun 29;73(732):e478-e485.
doi: 10.3399/BJGP.2022.0589. Print 2023 Jul.

Recent GP consultation before death by suicide in middle-aged males: a national consecutive case series study

Faraz Mughal  1 , Lana Bojanić  2 , Cathryn Rodway  2 , Jane Graney  2 , Saied Ibrahim  2 , Leah Quinlivan  3 , Sarah Steeg  4 , Su-Gwan Tham  2 , Pauline Turnbull  2 , Louis Appleby  2 , Roger T Webb  3 , Nav Kapur  5
Affiliations

Recent GP consultation before death by suicide in middle-aged males: a national consecutive case series study

Faraz Mughal et al. Br J Gen Pract. .

Abstract

Background: Reducing suicide risk in middle-aged males (40-54 years) is a national priority. People have often presented to their GP within 3 months before suicide thus highlighting an opportunity for early intervention.

Aim: To describe the sociodemographic characteristics and identify antecedents in middle-aged males who recently consulted a GP before dying by suicide.

Design and setting: This study was a descriptive examination of suicide in a national consecutive sample of middle-aged males in 2017 in England, Scotland, and Wales.

Method: General population mortality data were obtained from the Office for National Statistics and National Records of Scotland. Information was collected about antecedents considered relevant to suicide from data sources. Logistic regression examined associations with final recent GP consultation. Males with lived experience were consulted during the study.

Results: In 2017, a quarter (n = 1516) of all suicide deaths were in middle-aged males. Data were attained on 242 males: 43% had their last GP consultation within 3 months of suicide; and a third of these males were unemployed and nearly half were living alone. Males who saw a GP recently before suicide were more likely to have had recent self-harm and work-related problems than males who had not. Having a current major physical illness, recent self-harm, presenting with a mental health problem, and recent work-related issues were associated with having a last GP consultation close to suicide.

Conclusion: Clinical factors were identified that GPs should be alert to when assessing middle-aged males. Personalised holistic management may have a role in preventing suicide in these individuals.

Keywords: family practice; general practice; general practitioners; men; primary health care; suicide.

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Conflict of interest statement

Faraz Mughal was a member of the updated 2022 National Institute for Health and Care Excellence (NICE) clinical guideline on self-harm and co-chairs the International Association for Suicide Prevention special interest group in suicide prevention in primary care. Louis Appleby chairs the National Suicide Prevention Strategy Advisory Group at the Department of Health and Social Care in England; Nav Kapur is a member of the Group and is supported by Greater Manchester Mental Health NHS Foundation Trust. Nav Kapur chaired the 2022 NICE guideline development group for depression in adults and was a topic expert member for the NICE suicide prevention guideline. Nav Kapur chaired the guideline development group for the NICE guidelines on the longer-term management of self-harm 2011, and was a topic advisor on the 2022 NICE guideline on self-harm. The other authors have declared no competing interests.

Comment in

References

    1. Office for National Statistics Suicides in England and Wales: 2021 registrations. 2022. https://www.ons.gov.uk/peoplepopulationandcommunity/birthsdeathsandmarri... (accessed 21 Apr 2023).
    1. Wong PW, Chan WS, Chen EY, et al. Suicide among adults aged 30–49: a psychological autopsy study in Hong Kong. BMC Public Health. 2008;8:147. - PMC - PubMed
    1. Mallon S, Galway K, Rondon-Sulbaran J, et al. When health services are powerless to prevent suicide: results from a linkage study of suicide among men with no service contact in the year prior to death. Prim Health Care Res Dev. 2019;20:e80. - PMC - PubMed
    1. National Confidential Inquiry into Suicide and Safety in Mental Health Suicide by middle-aged men. 2021 https://documents.manchester.ac.uk/display.aspx?DocID=55305 (accessed 21 Apr 2023).
    1. HM Government Preventing suicide in England: fourth progress report of the cross-government outcomes strategy to save lives. 2019 https://assets.publishing.service.gov.uk/government/uploads/system/uploa... (accessed 21 Apr 2023).