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Research Letter |

Dose-Response Association Between Psychological Distress and Risk of Completed Suicide in the General Population

Steven Bell, PhD1; Tom C. Russ, PhD2; Mika Kivimäki, PhD1; Emmanuel Stamatakis, PhD3; G. David Batty, DSc1
[+] Author Affiliations
1Research Department of Epidemiology and Public Health, University College London, London, England
2Centre for Cognitive Ageing and Cognitive Epidemiology, University of Edinburgh, Edinburgh, Scotland
3Charles Perkins Centre, University of Sydney, Sydney, New South Wales, Australia
JAMA Psychiatry. 2015;72(12):1254-1256. doi:10.1001/jamapsychiatry.2015.2107.
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This pooling of individual-level data from a series of large general population–based cohort studies examines the association between psychological distress and the risk of completed suicide.

Elevated suicide rates in people with clinical depression, as indexed by hospitalizations or use of psychiatric outpatient services, are well documented.1 However, the association between depression across the full range of severity and subsequent suicide risk is unknown. With single-cohort studies insufficiently powered to examine this relation, to our knowledge, we provide the first pooling of individual-level data from a series of large general population–based cohort studies.

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Figure.
Association Between Psychological Distress Score and Risk of Completed Suicide

Multivariable-adjusted hazard ratios (effect estimates are adjusted for the same covariates as in the Table) from an individual participant data meta-analysis of 16 general population-based cohort studies. The predicted hazard ratio is denoted by a solid black line, the 95% CIs by blue dashed lines, and the reference by the horizontal black dashed line. GHQ-12 indicates 12-item General Health Questionnaire.

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