Understanding how suicide rates vary across age, sex, and geography is essential to designing effective prevention strategies. We examined long-term trends in suicide mortality across European countries over three decades, with a focus on age-specific trajectories.

Using the WHO mortality database, we computed annual sex- and age-specific suicide rates (10–14 to 85+ age groups) from 1990 to 2022, for the most populous European countries, and aggregated rates for the EU-27 and four geographical areas (North, West, South, and Centre-East Europe). We also calculated percentage differences across four time periods (1990–1994, 2000–2004, 2010–2014, and 2020–2022), according to data availability.

Suicide rates increased with age, peaking in older individuals (85+) in most countries (e.g., 82.0/100,000 in France in 2020–2022, 77.1/100,000 in Germany among males, in 2020), except in the UK and Northern Europe, where rates peaked at middle age (∼22/100,000 at 45–49, in 2020). EU-27 suicide rates in 2020 ranged from 5.5/100,000 (age 15–19) to 58.2/100,000 (85+) among males, and from 2.6 (15–19) to 8.6/100,000 (85+) among females. Male suicide rates were 3 to 8 times higher than female rates across all ages. While overall rates declined since 1990 in most countries, youth suicide increased after 2010 in Western (e.g., +12%, girls 15–19), Southern (+24.5%, girls 15–19), and Northern (+44%, girls 15–19 and 20–24) Europe. Rates among young and middle-aged adults recently rose in Spain, the UK, and Northern Europe, while they declined in Eastern Europe after the 1990s.

Despite overall declines, our findings highlight marked heterogeneity in sex- and age-specific trends in suicide mortality across Europe. These patterns call for age-tailored prevention strategies that address evolving psychosocial stressors and structural determinants across the lifespan.

Depression severity is a well-established risk factor for suicidal ideation, but the extent to which sociodemographic and employment-related factors contribute independently remains unclear.

Complete data from doctors (N = 4055) presenting to National Health Service Practitioner Health (NHS-PH) in 2022–2023 were used to test the hypothesis that depression severity is the largest determinant of suicide ideation risk (defined by Patient Health Questionnaire 9 (PHQ-9) question 9 score) among doctors.

Using PHQ-8 score (PHQ-9, excluding the item on suicide ideation) as a proxy for depression severity, the case–control discriminatory capacity of receiver operating characteristic curves (AUCs) were evaluated for (a) a univariable model studying modified PHQ-9 alone as the predictor of severe suicide ideation; and (b) a multivariable model integrating modified PHQ-9 and multiple sociodemographic and employment factors as the predictor of severe suicide ideation. Models were compared both descriptively and through a likelihood ratio test.

The univariable model using depression severity alone as the predictor of severe suicide ideation yielded an AUC of 0.921. The addition of sociodemographic and employment factors improved the fit significantly (likelihood ratio test with (χ2(14) = 50.26, P < 0.001), amended AUC 0.930). Having both a disability and a relationship status of ‘no partner’ was significantly independently associated with suicide ideation in the multivariable model.

In this national cohort of doctors, depression severity was strongly associated with suicidal ideation. However, disability and lack of a partner were also independently linked to increased risk, suggesting that suicidal ideation is not solely driven by symptom severity. Social and functional factors may help identify higher-risk individuals and inform targeted support.

Suicide involves an act of volition on the part of the deceased, making it unlike deaths from physical disorders such as cancer or stroke. The latter occur passively and often despite the efforts of the patient to stay alive. Yet when there is a suicide, clinicians involved may often be blamed and families may often feel guilt. This contrasts with the default response of praise and thanks to clinicians following treatment preceding deaths from physical disorders.

Comparative standardized mortality rate (SMR) data are analyzed to demonstrate the impact of developments in care over the past two decades in the United Kingdom (UK), and similar United States (USA) SMR data are noted. The evidence is reviewed regarding our ability to predict who will die by suicide, when and where to target intervention, and practical and effective prevention methods.

Data from the UK are presented that reflects the relative lack of impact of prevention efforts on suicide mortality rates when compared to the reductions seen in various physical disorders. This narrative review comments on the causes and consequences of this difference.

The challenge for psychiatry is that SMR data suggest that we have been unable to significantly reduce suicide SMR unlike that for physical disorders. This needs to be fully acknowledged and the biased assumption of blame needs to stop. The focus needs to be on evidence-based interventions that do work, such as medications, psychological treatments, psychological interventions, and suicide prevention research.

Suicides in children and young people are a major public health concern. Prevention of Future Death (PFD) reports are an underutilised resource detailing coroners’ concerns which, if actioned, are believed to be able to prevent future deaths. Research has investigated common themes for suicide during 2021 and 2022 but there are no published studies that thematically analyse these reports for children alone.

To identify key themes raised by coroners from PFD reports published between 2015 and 2023 for children who have died by suicide.

PFD reports for suicides in children were downloaded from the Courts and Tribunals Judiciary website. Descriptive statistics were collated from reports. Reports (n = 37) were analysed using inductive content analysis to determine primary and sub-themes using QSR NVIVO 14 Qualitative Analysis software.

Reports came from 30 coroners’ areas, with most reports being sent to government departments and NHS Trusts/Clinical Commissioning Groups. The qualitative analysis resulted in six primary themes being identified: service provision, staffing and resourcing, communication, multiple services involved in care, accessing services and access to harmful content and environment. Furthermore, 23 sub-themes were identified such as standard operating procedures/processes not being followed or being inadequate, a lack of specialist services and a disconnect between integrated services. A quarter of reports were on children diagnosed with autism, and there were specific issues highlighted in concerns relating to services and staffing for children with neurodiverse conditions.

The key findings from this report highlight themes raised by coroners relating to deaths of children by suicide. This included themes around service provision, staffing and resourcing of mental health services and communication between services and families. Children with neurodiversity, including autism, appear to be of particular concern.

Eating disorders are severe psychiatric conditions associated with high mortality rates, particularly among young people. These disorders often co-occur with self-harm and suicidal ideation, yet the temporal dynamics between these variables remain poorly understood.

This study aims to elucidate the longitudinal associations between symptoms of body dissatisfaction and disordered eating, self-harm and suicidal ideation using structural equation modelling.

Repeated measures of these phenotypes were used to construct a hypothetical model that includes cross-path analyses within and between the variables in two cohorts: the Twins Early Development Study (TEDS; ages 16, 21 and 26 years; N = 5196), representing a general population sample, and the COVID-19 Psychiatry and Neurological Genetics study (COPING; data collected between June 2020 and July 2021; N = 490), which focused on individuals with a history of anxiety or depression. In the TEDS cohort, symptoms of disordered eating, self-harm and suicidal ideation showed limited continuity across adolescence and young adulthood, with peak symptom severity at age 21 years.

Cross-domain associations revealed that both self-harm and suicidal ideation at age 21 years were more strongly associated with disordered eating at 26 years than the reverse. In contrast, the COPING cohort exhibited greater stability in symptoms over time but showed minimal cross-domain effects.

The effects of self-harm and suicidal ideation on disordered eating in early adulthood are stronger than the influence of disordered eating on suicidality.