Trends in national suicide rates for Scotland and for England & Wales, 1960-2008.
BACKGROUND
Suicide rates in Scotland have increased markedly relative to those in England in recent decades.


OBJECTIVE
To compare changing patterns of suicide risk in Scotland with those in England & Wales, 1960-2008.


METHODS
For Scotland and for England & Wales separately, we obtained national data on suicide counts and population estimates. Gender-specific, directly age-standardised rates were calculated.


RESULTS
We identified three distinct temporal phases: 1960-1967, when suicide rates in England & Wales were initially higher than in Scotland, but then converged; 1968-1991, when male suicide rates in Scotland rose slightly faster than in England & Wales; and 1992-2008, when there was a marked divergence in national trends. Much of the recent divergence in rates is attributable to the rise in suicide among young men and deaths by hanging in Scotland. Introduction of the 'undetermined intent' category in 1968 had a significant impact on suicide statistics across Great Britain, but especially so in Scotland.


CONCLUSIONS
Differences in temporal patterns in suicide risk between the countries are complex. Reversal of the divergent trends may require a change in the perception of hanging as a 'painless' method of suicide.
Centre for Suicide Prevention, University of Manchester, Manchester Academic Health Science Centre, Manchester, UK.
Pearl L H
PL
Mok
Navneet
N
Kapur
Kirsten
K
Windfuhr
Alastair H
AH
Leyland
Louis
L
Appleby
Stephen
S
Platt
Roger T
RT
Webb
D000293:Adolescent; D000328:Adult; D017677:Age Distribution; D000368:Aged; D001237:Asphyxia / Q000401:mortality / Q000523:psychology; D002423:Cause of Death / Q000639:trends*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D012042:Registries; D012606:Scotland / Q000453:epidemiology; D017678:Sex Distribution; D012959:Socioeconomic Factors; D013405:Suicide / Q000706:statistics & numerical data / Q000639:trends*; D006113:United Kingdom / Q000453:epidemiology; D055815:Young Adult