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The results of a systematic review of the international literature on the prevalence of suicidal phenomena in adolescents, including the influence of survey method, gender, and ethnicity are reported. The literature was searched using six electronic databases to identify all population-based studies of self-reported suicidal phenomena; 128 studies were included, comprising 513,188 adolescents. The mean proportion of adolescents reporting they had attempted suicide at some point in their lives was 9.7% (95% CI, 8.5-10.9), and 29.9% (95% CI, 26.1-33.8) of adolescents said they had thought about suicide at some point. Females were significantly more likely than males to report most suicidal phenomena. A lower prevalence of some suicidal phenomena was found for Asian populations. The prevalence of suicidal phenomena varied depending on the terminology used and tended to be higher in studies employing anonymous questionnaires than in studies employing non-anonymous methods (questionnaires or interviews), although most of these differences were not statistically significant.

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The purpose of this study was to ascertain whether adolescents who deliberately harmed themselves or had thoughts of self‐harm differed from other adolescents in terms of help‐seeking, communication and coping strategies. The participants were 6020 15–16 year‐old school pupils who were surveyed using an anonymous self‐report questionnaire. Adolescents with one or more episodes of deliberate self‐harm (DSH) in the previous year were more likely to identify themselves as having serious problems than other adolescents. However, a substantial proportion of adolescents with either DSH or thoughts of self‐harm did not identify themselves as having serious problems. Adolescents with DSH were most likely to feel the need for help but not try to get any; they were less able to talk to family members and teachers and had fewer categories of people who they were able to talk to. Like other adolescents, those with DSH or thoughts of self‐harm were more likely to seek and receive help from their friends than from other sources. They differed from other adolescents in terms of coping strategies they reported employing when faced with difficulties, showing less focus on problems and more avoidant behaviours. The findings have important implications for preventive strategies, including educational programmes on emotional health and coping, and for the clinical care of adolescents identified as at risk or having self‐harmed.

The practice of conducting research online is in its infancy. Consequently there is debate concerning the ethical implications of online data collection. We outline three approaches to online data collection and focus specifically on the issues of consent and anonymity of participants. We conclude that ethical issues raised when planning and implementing online data collection are no different to those raised by more traditional approaches to data collection.

BackgroundThe loss of GPs in the early stages of their careers is contributing to the GP workforce crisis. Recruitment in the UK remains below the numbers needed to support the demand for GP care.AimTo explore the reasons why GPs leave general practice early.Design and settingA mixed methods study using online survey data triangulated with qualitative interviews.MethodParticipants were GPs aged <50 years who had left the English Medical Performers List in the last 5 years (2009–2014). A total of 143 early GP leavers participated in an online survey, of which 21 took part in recorded telephone interviews. Survey data were analysed using descriptive statistics, and qualitative data using thematic analysis techniques.ResultsReasons for leaving were cumulative and multifactorial. Organisational changes to the NHS have led to an increase in administrative tasks and overall workload that is perceived by GP participants to have fundamentally changed the doctor–patient relationship. Lack of time with patients has compromised the ability to practise more patient-centred care, and, with it, GPs’ sense of professional autonomy and values, resulting in diminished job satisfaction. In this context, the additional pressures of increased patient demand and the negative media portrayal left many feeling unsupported and vulnerable to burnout and ill health, and, ultimately, to the decision to leave general practice.ConclusionTo improve retention of young GPs, the pace of administrative change needs to be minimised and the time spent by GPs on work that is not face-to-face patient care reduced.

Although pro-anorexia online support forums and the narratives that occur within them are increasingly the focus of research, none, to date, focuses closely on issues of identity within this online context. Our aim in conducting this study was to examine the presentation of pro-anorexia via an interpretive phenomenological analysis of postings to a pro-anorexia ("pro-ana") online discussion forum. Analysis indicates that pro-anorexic identities are normalized and strengthened through the normalization of participants' pro-ana thoughts and behaviors, and the group bond created through sharing a secret identity. This process renders participants less likely to reveal their pro-ana identity to friends and family in the real world. The implications of our findings are discussed in relation to the theory of identity demarginalization.

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