title: The timing of general population and patient suicide in England, 1997-2012.
abstract: BACKGROUND
  There have been conflicting findings on temporal variation in suicide risk and few have examined the phenomenon in clinical populations. The study investigated seasonal and other temporal patterns using national data.
  
  
  METHODS
  Data on 73,591 general population and 19,318 patient suicide deaths in England between 1997 and 2012 were collected through the National Confidential Inquiry into Suicide examining suicide rates in relation to month of the year, day of the week, and individual days of national or religious significance.
  
  
  RESULTS
  Suicide incidence fell over successive months of the year and there was evidence of an overall spring peak. Monday was associated with the highest suicide rates and in the patient population this effect appeared to be more pronounced in those aged over 50 or those who lived alone. Suicide risk was significantly lower during Christmas, particularly for women. There was a peak in suicide on New Year's Day in the general population. Other 'special days' were not associated with a change in suicide incidence.
  
  
  CONCLUSIONS
  We were limited to identifying associations between the variables investigated and were unable to explore causal mechanisms. We did not carry out comprehensive multi-variable adjustment in our regression models.
  
  
  CONCLUSIONS
  There is substantial seasonal and temporal variation in suicide deaths, and there appears to be some evidence in the clinical as well as the general population in England. Clinical services should be aware of the risk of suicide just after the weekend, especially in people who live alone, and the potential need for closer supervision during this period.
authors.affiliation: Manchester Medical School, The University of Manchester, UK.
authors.forename: Brendan
authors.initials: B
authors.lastname: Cavanagh
authors.affiliation: Centre for Mental Health and Safety, Institute of Brain, Behaviour and Mental Health, The University of Manchester, UK. Electronic address: saied.a.ibrahim@manchester.ac.uk.
authors.forename: Saied
authors.initials: S
authors.lastname: Ibrahim
authors.affiliation: Centre for Mental Health and Safety, Institute of Brain, Behaviour and Mental Health, The University of Manchester, UK.
authors.forename: Alison
authors.initials: A
authors.lastname: Roscoe
authors.affiliation: Centre for Mental Health and Safety, Institute of Brain, Behaviour and Mental Health, The University of Manchester, UK.
authors.forename: Harriet
authors.initials: H
authors.lastname: Bickley
authors.affiliation: Centre for Mental Health and Safety, Institute of Brain, Behaviour and Mental Health, The University of Manchester, UK.
authors.forename: David
authors.initials: D
authors.lastname: While
authors.affiliation: Centre for Mental Health and Safety, Institute of Brain, Behaviour and Mental Health, The University of Manchester, UK.
authors.forename: Kirsten
authors.initials: K
authors.lastname: Windfuhr
authors.affiliation: Centre for Mental Health and Safety, Institute of Brain, Behaviour and Mental Health, The University of Manchester, UK.
authors.forename: Louis
authors.initials: L
authors.lastname: Appleby
authors.affiliation: Centre for Mental Health and Safety, Institute of Brain, Behaviour and Mental Health, The University of Manchester, UK; Manchester Mental Health and Social Care Trust, Manchester, UK.
authors.forename: Nav
authors.initials: N
authors.lastname: Kapur
mesh_terms: D000328:Adult; D000367:Age Factors; D004739:England / Q000453:epidemiology; D005260:Female; D006693:Holidays / Q000706:statistics & numerical data; D006801:Humans; D015994:Incidence; D008297:Male; D008875:Middle Aged; D012621:Seasons; D016728:Self-Injurious Behavior / Q000453:epidemiology; D012847:Single Person / Q000706:statistics & numerical data; D013405:Suicide / Q000706:statistics & numerical data* / Q000639:trends
keywords: Mental health; Seasonal variation; Suicide; Suicide timing; Temporal patterns