Commentary: Thomas & Gunnell's paper

This paper 1 is an interesting and unusual data set that raises a number of questions, only some of which are answerable. Life expectancy has steadily increased from 1900 to 2000, while infant mortality has also steadily improved. Suicide rates have not kept pace with this general improvement in health by showing similar linear decreases. If we disregard the major reductions in suicide rates in both world wars, more pronounced for males than females, we can say that male rates rose steadily from 1863 to 1905, but had returned to 1905 levels by 1937 during the Great Depression. Since then, however, the reduction in the male rates has been steady and sustained. Female rates rose gradually from 1863 to 1967, with smaller decreases during the world wars, and have fallen fairly steadily since then. The progressive increase in suicide rates in the earlier period is not easy to account for in terms of what is known about risk factors for suicide.