Suicide more likely in frequent-attenders at GPs

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26 Mar 2014

Patients who visited their GP more than twice per month over a year were 12 times more likely to die by suicide, new research by The University of Manchester has found.

Professor Louis Appleby

People who did not attend were also at increased risk, with those who did not consult their GPs at all in a year just under 70% more likely to die by suicide than those who did attend. 

These non-attenders were more likely to be younger and male than other people who died by suicide. 

Patients receiving multiple mental health drugs and specific drug combinations such as benzodiazepines with antidepressants were also more likely to die by suicide, reflecting treatment difficulties or the severity of their illness.  

Researchers from The University of Manchester’s National Confidential Inquiry into Suicide and Homicide by People with Mental Illness (NCISH) carried out the report looking at suicides in England over 10 years between 2002 and 2011, which was commissioned by the Healthcare Quality Improvement Partnership as part of the Clinical Outcome Review Programmes.

The report, Suicide in Primary Care in England: 2002-2011 published today (26 March 2014)  found that there was an increased risk with increasing GP consultations, particularly in the 2 to 3 months prior to suicide.  The highest risk was among patients who consulted with their GP more than 24 times in the year prior to suicide.  Mental illness was frequently unrecognised in those who died by suicide.

Professor Louis Appleby, from The University of Manchester who led the research said: “We have identified that frequent attendance can be a marker for risk, as can receiving different kinds of mental health drugs. GPs could therefore use frequent attendance and a need to change or add drugs as flags to help alert them to possible risks. Alerts of this kind are used in other areas of primary care practice.  

“Non-attendance is hard to tackle but adding items on mental health to the NHS Health Check – offered to people aged between 40 and 74 – is a logical step.” 

The research looked at 2,384 patients who died by suicide over 10 years and matched these with 46,899 living patients with similar characteristics such as age, gender and GP practice – up to 20 control patients per patient who died by suicide.

Information on all patients was obtained from a national patient database, the Clinical Practice Research Datalink and deceased patients were identified by linking with the National Statistics (ONS) mortality dataset.

ENDS

Notes for editors

Copies of the full report are available on request.
For further information or to request an interview, please contact Alison Barbuti, Media Relations Officer Faculty of Medical and Human Sciences The University of Manchester Tel. +44 (0)161 275 8383 Mobile 07887 561 318 Email: alison.barbuti@manchester.ac.uk 

The University of Manchester

 
The University of Manchester, a member of the Russell Group, is one of the largest and most popular universities in the UK. It has 20 academic schools and hundreds of specialist research groups undertaking pioneering multi-disciplinary teaching and research of worldwide significance. According to the results of the 2008 Research Assessment Exercise, The University of Manchester is one of the country’s major research institutions, rated third in the UK in terms of ‘research power’. The University has an annual income of £807 million and is ranked 40th in the world and fifth in the UK for the quality of its teaching and impact of its research.
 
Health Quality Improvement Partnership (HQIP)
 
The Healthcare Quality Improvement Partnership (HQIP) is led by a consortium of the Academy of Medical Royal Colleges, the Royal College of Nursing and National Voices. HQIP’s aim is to promote quality improvement, and it hosts the contract to manage and develop the Clinical Outcome Review Programmes, one of which is the National Confidential Inquiry into Suicide and Homicide by People with Mental Illness (NCISH), funded by NHS England, the Scottish Government, NHS Wales, the Northern Ireland Department of Health, Social Services and Public Health (DHSSPS) and the State of Jersey. The programmes, which encompass confidential enquiries, are designed to help assess the quality of healthcare, and stimulate improvement in safety and effectiveness by systematically enabling clinicians, managers and policy makers to learn from adverse events and other relevant data. More details can be found at: www.hqip.org.uk/clinical-outcome-review-programmes-2/

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