David Gunnell's research while affiliated with University of Bristol and other places
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Publications (811)
Objective:
Research from Western countries suggests that there is an increase in mortality in parents bereaved by the death of a child. Few studies have investigated this issue in a non-Western context. We explored the impact of the death of a child on parental mortality in Taiwan.
Method:
By linking population-based national registers, we follo...
Objective:
The COVID-19 pandemic has affected the mental health of populations around the world, but few longitudinal studies of its impact on suicidal thoughts and behaviors have been published especially from low- and middle-income countries.
Methods:
This is a prospective cohort study of 1,385 first-year students from 5 Universities in Mexico...
Evidence from high-income countries suggests that the impact of COVID-19 on suicide and self-harm has been limited, but evidence from low- and middle-income countries is lacking. Using data from a hospital-based self-poisoning register (January 2019–December 2021) and data from national records (2016–2021) of suicide in Sri Lanka, we aimed to asses...
Background:
Emotional dysregulation may be a risk factor for disordered eating and self-harm in young people, but few prospective studies have assessed these associations long-term, or considered potential mediators. We examined prospective relationships between childhood emotional dysregulation and disordered eating and self-harm in adolescence;...
Introduction
There was and still is much speculation about the COVID-19 pandemic impact on suicide rates. We aimed to assess the effect of the COVID-19 pandemic on suicide rates around the world.
Methods
We sourced real-time suicide data from countries or countries areas through a systematic internet search (official websites of Ministries of heal...
The COVID-19 pandemic has harmed many people's mental health globally. Whilst the evidence generated thus far from high-income countries regarding the pandemic's impact on suicide rates is generally reassuring, we know little about its influence on this outcome in lower- and middle-income countries or among marginalised and disadvantaged people. Th...
Background
There are widespread concerns that the COVID-19 pandemic may increase suicides. Few studies have analysed effects beyond the pandemic's early months or examined changes in known suicide risk factors.
Methods
Using time series models fit with Poisson regression, we analysed monthly police-reported suicides in Ecuador from January 2015 to...
We investigated the impact of the COVID-19 pandemic on call volumes and call characteristics using data from a national crisis helpline. Data were extracted for 215,066 calls to Taiwan’s national suicide prevention hotline (January 2018–May 2020). We used negative binomial regression to investigate changes in the weekly number of calls during the e...
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.
Methods
We identified suicide data from official pu...
Suicide is an increasing contributing cause of mortality in middle-aged adults; however, knowledge to guide prevention is limited. This first systematic review and meta-analysis of studies on midlife suicide has provided an overview of published research on this issue and synthesized the evidence on socioeconomic and physical and mental health fact...
Background
While suicide rates in high- and middle-income countries appeared stable in the early stages of the pandemic, we know little about within-country variations. We sought to investigate the impact of COVID-19 on suicide in Mexico’s 32 states and to identify factors that may have contributed to observed variations between states.
Methods
In...
Background:
Ongoing concern for the unique mental health challenges faced by university students has been magnified by the disruption of the global COVID-19 pandemic since March 2020.
Aims:
This study aimed to investigate changes in mental health and wellbeing outcomes for UK university students since the pandemic began, and to examine whether m...
Background
The COVID-19 pandemic and its consequences may affect population mental health and suicide risk.
Aims
To explore the experiences among suicidal individuals who made calls to a suicide prevention hotline and to identify factors and psychological responses that may influence suicide risk.
Method
We identified 60 recorded calls to Taiwan’s...
Objective
We investigated recent trends in youth suicide and their associations with societal and psychological factors in Taiwan.
Methods
Suicide data (1971-2019) for 10-24-year-olds were extracted from Taiwan’s national cause-of-death data files. We investigated changes in trends in youth suicide rates, societal factors (GDP per capita, GINI inde...
Purpose
There is growing interest in the concept of ‘deaths of despair’ (DoD)—defined as deaths from three causes: suicide, drug poisoning, and alcohol-related conditions—as a more comprehensive indicator of the impact of psychological distress on mortality. The purpose of this study is to investigate the degree of commonality in trends and geograp...
There is widespread concern over the potential impact of the COVID-19 pandemic on suicide and self-harm globally, particularly in low- and middle-income countries (LMIC) where the burden of these behaviours is greatest. We synthesised the evidence from the published literature on the impact of the pandemic on suicide and self-harm in LMIC. This rev...
Background
Emotional dysregulation may be a risk factor for disordered eating and self-harm in young people, but few prospective studies have assessed these associations long-term, or considered potential mediators. We examined prospective relationships between childhood emotional dysregulation and disordered eating and self-harm in adolescence; an...
Objective:
The COVID-19 pandemic has had a complex impact on risks of suicide and non-fatal self-harm worldwide with some evidence of increased risk in specific populations including women, young people, and people from ethnic minority backgrounds. This review aims to systematically address whether SARS-CoV-2 infection and/or COVID-19 disease conf...
Domestic violence (DV) is a violation of human rights with adverse intergenerational consequences on physical and mental health. Clinical and psychosocial correlates of DV have been documented internationally, but evidence from South Asia is limited, especially among men. This is a nested cross-sectional study of the control population (N = 856) of...
Background
There has been substantial discussion as to whether the mental health and socio-economic consequences of the COVID-19 pandemic might impact suicide rates. Although India accounts for the largest proportion of global suicides, the early impacts of the COVID-19 pandemic on suicide rates in this country are unknown.
Methods
National Crime...
Background
Evidence on the impacts of the pandemic on healthcare presentations for self-harm has accumulated rapidly. However, existing reviews do not include studies published beyond 2020.
Aims
To systematically review evidence on health services utilisation for self-harm during the COVID-19 pandemic.
Methods
A comprehensive search of multiple d...
Background: While suicide rates in high- and middle-income countries appeared stable in the early stages of the pandemic, we know little about within-country variations. We sought to investigate the impact of COVID-19 on suicide in Mexico’s 32 states and to identify factors that may have contributed to observed variations between states.
Methods: I...
Background:
Over 90% of youth suicide deaths occur in low- and middle-income countries. Despite this relatively little is known about risk factors in this context.
Aims:
Investigate risk factors for deliberate self-harm (non-fatal) in young people in rural Sri Lanka.
Methods:
A prospective cohort study of 22,401 individuals aged 12-18 years wi...
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...
Background
: When students experience serious mental health difficulties, universities face the dilemma of deciding whether to notify trusted others such as parents. This study investigates the key factors underpinning students’ decisions to opt-out of a ‘consent to contact’, which would allow their university to notify an emergency contact of thei...
Background
A National Clinical Programme for the Management of Hospital-Presenting Self-Harm (NCP-SH) was introduced in Ireland in 2014. This involved the development of a model of care to standardise the management of self-harm in emergency departments, to be delivered by dedicated clinical nurse specialists. The core components of the programme w...
Background
Teachers are at heightened risk of poor mental health and well-being, which is likely to impact on the support they provide to students, and student outcomes. We conducted a cluster randomised controlled trial, to test whether an intervention to improve mental health support and training for high school teachers led to improved mental he...
There was a highly publicised cluster of at least ten suicides in South Wales, United Kingdom, in 2007–2008. We carried out a qualitative descriptive study using cross-case thematic analysis to investigate the experiences and narratives of eight individuals who lived in the area where the cluster occurred and who survived an episode of near-fatal s...
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.
Method
Using data from England's National Child Mortality Database (NCMD) the characteristics and rates...
Background
: The COVID-19 pandemic has had an impact on the mental health of healthcare and social care workers, and its potential effect on suicidal thoughts and behaviour is of particular concern.
Methods
: This systematic review identified and appraised the published literature that has reported on the impact of COVID-19 on suicidal thoughts an...
Background
Health and Safety Executive data show that teachers are at heightened risk of mental health difficulties, yet few studies have attempted to address this. Poor teacher mental health may impact on the quality of support provided to young people, who also report increased mental health difficulties themselves.
Objective
To test the effecti...
There is widespread concern over the potential impact of the COVID-19 pandemic on suicide and self-harm globally, particularly in low- and middle-income countries (LMIC) where the burden of these behaviours is greatest. We synthesised the evidence from the published literature on the impact of the pandemic on suicide and self-harm in LMIC.
This rev...
Background
Education is inversely associated with cardiovascular disease (CVD). Several mediators of this have been established; however, a proportion of the protective effect remains unaccounted for. Mental health is a proposed mediator, but current evidence is mixed and subject to bias from confounding factors and reverse causation. Mendelian ran...
Background
There is increasing evidence that domestic violence is an important risk factor for suicidal behaviour. The level of risk of domestic violence (DV) and its contribution to the overall burden of suicidal behaviour has not been quantified in South Asia, where 37% of suicide deaths globally occur. We examined the association between DV and...
Emerging data from high and upper-middle-income countries indicate that suicide rates generally did not increase during the initial months of the COVID-19 pandemic, yet the pandemic’s impact on suicide is complex. We discuss the nuances of this relationship, how it may evolve over time, and describe the specific steps that governments and societies...
Background
Schools in the UK increasingly have to respond to anxiety, depression and conduct disorder as key causes of morbidity in children and young people.
Objective
The objective was to assess the comparative effectiveness of educational setting-based interventions for the prevention of anxiety, depression and conduct disorder in children and...
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...
Background
Google Trends data are increasingly used by researchers as an indicator of population mental health, but few studies have investigated the validity of this approach during a public health emergency.
Methods
Relative search volumes (RSV) for the topics depression, anxiety, self-harm, suicide, suicidal ideation, loneliness, and abuse were...
Background
There is widespread concern over the impact of public health measures, such as lockdowns, associated with COVID-19 on mental health, including suicide. High-quality evidence from low-income and middle-income countries, where the burden of suicide and self-harm is greatest, is scarce. We aimed to determine the effect of the pandemic on ho...
Introduction
Pesticide ingestion is a leading method for suicide worldwide. Paraquat is a highly lethal herbicide when ingested. We assessed the impact of the first-stage ban on the import and production of paraquat (from February 2018) on suicides by pesticide poisoning in Taiwan.
Methods
Suicide data by method (pesticide vs. non-pesticide), pest...
Background: The COVID-19 pandemic has caused considerable morbidity, mortality and disruption to people’s lives around the world. There are concerns that rates of suicide and suicidal behaviour may rise during and in its aftermath. Our living systematic review synthesises findings from emerging literature on incidence and prevalence of suicidal beh...
Aims
Self-harm and eating disorders are often comorbid in clinical samples but their co-occurrence in the general population is unclear. Given that only a small proportion of individuals who self-harm or have disordered eating present to clinical services, and that both self-harm and eating disorders are associated with substantial morbidity and mo...
Background: Few studies have investigated whether means accessibility is related to the spatial distribution of suicide. Aims: To examine the hypothesis that indicators of the accessibility to specific suicide methods were associated with method-specific suicide rates in Taipei City, Taiwan. Method: Smoothed standardized mortality ratios for method...
[This corrects the article DOI: 10.1371/journal.pone.0242437.].
Abstract Background Empirical evidence supporting the distinction between suicide attempt (SA) and non-suicidal self-harm (NSSH) is lacking. Although NSSH is a risk factor for SA, we do not currently know whether these behaviours lie on a continuum of severity, or whether they are discrete outcomes with different aetiologies. We conducted this expl...
Summary
Background
The COVID-19 pandemic is having profound mental health consequences for many people. Concerns have been expressed that, at their most extreme, these consequences could manifest as increased suicide rates. We aimed to assess the early effect of the COVID-19 pandemic on suicide rates around the world.
Methods
We sourced real-time s...
Objective
The loss of a friend or family member to suicide, i.e., surviving suicide, can be devastating. Yet, little is known regarding the support received by survivors of suicide. We aimed to examine the characteristics of survivors of suicide who sought counseling from a Danish volunteer organization.
Method
Data on all users of the Danish Netw...
Background
The occurrence of early childhood adversity is strongly linked to later self-harm, but there is poor understanding of how this distal risk factor might influence later behaviours. One possible mechanism is through an earlier onset of puberty in children exposed to adversity, since early puberty is associated with an increased risk of ado...
Background
Self-harm and eating disorders are often comorbid in clinical samples but their co-occurrence in the general population is unclear. Given that only a small proportion of individuals who self-harm or have disordered eating present to clinical services, and that both self-harm and eating disorders are associated with substantial morbidity...
Purpose:
The long-term consequences of parental emigration on offspring self-harm risk is unknown.
Methods:
We investigated the association between experiencing parental emigration in childhood with hospital presentations for self-poisoning in adulthood using a hospital case-control study. Cases were adult self-poisoning patients (≥18 year olds)...
Background: Google Trends data are increasingly used by researchers as an indicator of population mental health, but few studies have investigated the validity of this approach.
Methods: Relative search volumes (RSV) for the topics depression, anxiety, self-harm, suicide, suicidal ideation, loneliness, and abuse were obtained from Google Trends. We...
Intentional pesticide ingestion is a common method of suicide, accounting for up to one-fifth of all suicides worldwide. The importance of intentional ingestion of pesticides was initially recognized in Asia and the Western Pacific but it is also a problem in Latin America, the Eastern Mediterranean, and in Africa. Organophosphate pesticides are re...
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...
Background
Individuals attending emergency departments following self-harm have increased risks of future self-harm. Despite the common use of risk scales in self-harm assessment, there is growing evidence that combinations of risk factors do not accurately identify those at greatest risk of further self-harm and suicide.
Aims
To evaluate and comp...
Background
Reducing suicides is a key Sustainable Development Goal target for improving global health. Highly hazardous pesticides are among the leading causes of death by suicide in low-income and middle-income countries. National bans of acutely toxic highly hazardous pesticides have led to substantial reductions in pesticide-attributable suicide...
Background
People who present to hospital following self-harm are at high risk of suicide. Despite this, there are considerable variations in the management of this group across hospitals and the factors influencing such variations are not well understood.
Aims
The aim of this study was to identify the specific hospital and individual factors asso...
Introduction
Adverse childhood experiences (ACE) have been recognized as an important risk factor for suicidal behaviour among adults, but evidence from low and middle-income countries is lacking. This study explored associations between ACE and hospital admission due to non-fatal self-poisoning in Sri Lanka.
Methods
This was a case-control study....
Aims. Early puberty is associated with an increased risk of self-harm in adolescent females but results for males are inconsistent. This may be due to the use of subjective measures of puber- tal timing, which may be biased. There is also limited evidence for the persistence of pubertal timing effects beyond adolescence, particularly in males. The...
Background:
We aimed to identify groups of children presenting distinct perinatal adversity profiles and test the association between profiles and later risk of suicide attempt.
Methods:
Data were from the Québec Longitudinal Study of Child Development (QLSCD, N = 1623), and the Avon Longitudinal Study of Parents and Children (ALSPAC, N = 5734)....
Background
Biological markers of suicide risk have the potential to inform prevention and treatment efforts. It has recently been hypothesised that inflammation may influence mood and in turn suicide risk. We investigated the association between indicators of systemic inflammation and suicide in a large cohort of Taiwanese adults.
Methods
White bl...
Background: The coronavirus disease 2019 (COVID-19) pandemic is the largest acute public health emergency of this century. Government intervention to contain the virus focuses on non-pharmacological approaches such as physical distancing/lockdown (stay-at-home orders). As the situation develops, the impact of these measures on mental health and cop...
Background:
There is increasing evidence that domestic violence (DV) is an important risk factor for suicidal behaviour. The level of risk and its contribution to the overall burden of suicidal behaviour among men and women has not been quantified in South Asia. We carried out a large case-control study to examine the association between DV and se...
Background: Education is inversely associated with cardiovascular disease. Several mediators for this association have been established but a significant proportion of the protective effect remains unaccounted for. Mental health is a proposed mediator, but current evidence is mixed and subject to bias from confounding factors and reverse causation....
Background: The COVID-19 pandemic has caused morbidity and mortality, as well as, widespread disruption to people’s lives and livelihoods around the world. Given the health and economic threats posed by the pandemic to the global community, there are concerns that rates of suicide and suicidal behaviour may rise during and in its aftermath. Our liv...
Background
: This paper investigates whether declines in suicide by insecticide poisoning in India following a national ban on endosulfan in 2011were associated with changes in other methods of suicide and total suicide rates.
Method
: Method-specific suicide rates between 2001-2014 were calculated using National Crime Records Bureau (NCRB) data b...
PurposeInternet use is common among people with suicidal feelings and a considerable amount of suicide help material is available online. Despite attempts to promote formal help sites (e.g. governmental and charity sector) in internet search results, users’ evaluation of these sites is lacking. This study, therefore, aimed to explore distressed use...