BACKGROUND: Seasonality in suicide is reported worldwide, and peaks in late spring.Despite the potential connection to the weather, associations between meteorological variables and suicide does not explain seasonality. Studies testing for seasonality while controlling for the weather show patterns that are more complex than a straightforward link between spring-like weather and suicide. METHODS: We tested whether seasonality in suicide was due to meteorological variation (hours of sunshine, rainfall, or temperature) in a novel population (Scotland;-2013. We also sought to further explore the ecological complexity demonstrated in previous work by testing associations at a single location (Tay Road Bridge; 1968-2017. RESULTS:We found peaks in suicidal behavior in June at the bridge, but no seasonality for Scotland as a whole. Seasonality was reduced when we controlled for maximum temperature and hours of sunshine. We found patterns to be dependent upon sex, with stronger seasonal and meteorological effects amongst men. LIMITATIONS: Our study was exploratory and relies on population-level data.CONCLUSIONS: Seasonal and meteorological effects on suicide are dependent upon local and individual context, with significant effects apparent at the Tay Road Bridge and not across Scotland as a whole. Men may be more sensitive to season and weather. In order to determine whether seasonality in suicide is due to meteorological variation, future research should test patterns in small geographical units, in men and women, and for different suicide methods, and seek to identify the social and physical factors which predict variation in patterns.

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a) Objective. We explored relationships between male mortality and the sex ratio. (b) Methods. We tested relationships across 142 societies and in longitudinal data from Scotland. (c) Results. A male-biased sex ratio was associated with reduced mortality by intentional self-harm across 142 societies. This was replicated in longitudinal Scottish data, and men were less likely to die by suicide and assault when there were more men in the population only when levels of unemployment were low. (d) Conclusion. We argue that this is consistent with a theoretical model in which men increase investment in relationships and offspring as 'competition' under a male-biased sex ratio, and that the conflicting results of previous work may stem from divergent effects of the sex ratio on mortality depending upon relative deprivation.

Aims and method Rates of prescriptions of antidepressants and suicide are inversely correlated at an epidemiological level. Less attention has been paid to relationships between other drugs used in mental health and suicide rates. Here we tested relationships between prescriptions of anxiolytics and antipsychotics and suicide rates in Scotland. Results Suicide rates were inversely correlated with prescriptions of antidepressants and antipsychotics over 14 years (2004–2018), and positively with prescriptions of anxiolytics. Clinical implications This illustrates the role of medications used in mental health in suicide prevention, and highlights the importance of identifying causal mechanisms that link anxiolytics with suicide.