Dr Dee Knipe

Research Topic: Understanding the association of low socioeconomic position with increased suicidal behaviour in Sri Lanka

Roughly 800,000 people die by suicide each year, and a disproportionally high number (76%) of these suicides occur in the low and middle income countries (LMIC). Suicide in these countries differs from that of high income countries (HIC), with higher rates in young people (especially young women) and a narrower overall male to female ratio (1.6 LMIC vs. 3.5 HIC).

Social factors such as poverty & education play an important role in suicide & my PhD found that measures of low socioeconomic position (SEP), such as low levels of education, fewer material assets & insecure occupations, increased the risk of suicide & attempted suicide in Sri Lanka. The policy implications of these findings are unclear. The proposed fellowship work has 4 main areas:

  • Disseminating findings to academic & non-academic audiences
  • Building networks to develop impact opportunities & future research collaborations
  • Understand the policy implications of PhD findings by conducting an in country workshop
  • Understand the association between family/household structure & suicidal behaviour

Mentors: Dr Helen Lambert, Professor David Gunnell, Dr Chris Metcalf


Knipe, D.W., Chang, S-S, Dawson, A, Eddleston, M, Konradsen, F, Metcalfe, C & Gunnell, D. Suicide prevention through means restriction: impact of the 2008-2011 pesticide restrictions on suicide in Sri Lanka. PLoS ONE. 2017 (in press)

Knipe, D.W., Gunnell, D, Pieris, R, Priyadarshana, C, Weerasinghe, M, Pearson, M, Jayamanne, S, Dawson, AH, Mohamed, F, Gawarammana, I, Hawton, K, Konradsen, F, Eddleston, M & Metcalfe, C Is socioeconomic position associated with risk of attempted suicide in rural Sri Lanka? A cross sectional study of 165,000 individuals. BMJOpen. 2017 (in press)

Nielsen E, Padmanathan P and Knipe DW. Commit* to change? A call to end the publication of the phrase ‘commit* suicide’. Wellcome Open Res, 2016. 1:21

Knipe, D.W., Padmanathan, P, Mutuwatte, L, Metcalfe, C & Gunnell, D. Regional variation in suicide rates in Sri Lanka between 1955 and 2011: a spatial and temporal analysis. BMC Public Health, 2016. 17: p.193.

Taylor, A.K., D.W. Knipe, and K.H. Thomas, Railway suicide in England and Wales 2000–2013: a time-trends analysis. BMC Public Health, 2016. 16(1): p. 1-7.

Knipe, D.W., C. Jayasumana, S. Siribaddana, et al, Feasibility of hair sampling to assess levels of organophosphate metabolites in rural areas of Sri Lanka. Environ Res, 2016. 147: p. 207-211.

Knipe, D.W., Pesticide exposure in Sri Lanka. International Journal of Epidemiology, 2016. 45(2): p. 327-32

Thomas, K.H., R.M. Martin, D.W. Knipe, et al, Risk of neuropsychiatric adverse events associated with varenicline: systematic review and meta-analysis. BMJ, 2015. 350: p. h1109.

Knipe, D.W., R. Carroll, K.H. Thomas, et al, Association of socio-economic position and suicide/attempted suicide in low and middle income countries in South and South-East Asia – a systematic review. BMC Public Health, 2015. 15(1): p. 1055.

Knipe, D.W., M. Pearson, R. Borgstrom, et al, Challenges and opportunities of a paperless baseline survey in Sri Lanka. BMC Res Notes, 2014. 7: p. 452.

Knipe, D.W., C. Metcalfe, R. Fernando, et al, Suicide in Sri Lanka 1975-2012: age, period and cohort analysis of police and hospital data. BMC Public Health, 2014. 14(1): p. 839.