Suicide Risk in Relation to Psychiatric Hospitalization: Evidence Based on Longitudinal Registers
Abstract
BACKGROUND: Persons with a history of admission to a psychiatric hospital are at high risk for suicide, but little is known about how this is influenced by factors related to psychiatric hospitalization. OBJECTIVE: To explore suicide risk according to time since admission, diagnosis, length of hospital treatment, and number of prior hospitalizations. DESIGN: Nested case-control design. SETTING: Individual data are drawn from various Danish longitudinal registers. PARTICIPANTS: All 13 681 male and 7488 female suicides committed in Denmark from January 1, 1981, to December 31, 1997, and 423 128 population control subjects matched for sex, age, and calendar time of suicide. Main Outcome Measure Risk of suicide is estimated by conditional logistic regression. Data are adjusted for socioeconomic factors. RESULTS: This study demonstrates that there are 2 sharp peaks of risk for suicide around psychiatric hospitalization, one in the first week after admission and another in the first week after discharge; suicide risk is significantly higher in patients who received less than the median duration of hospital treatment; affective disorders have the strongest impact on suicide risk in terms of its effect size and population attributable risk; and suicide risk associated with affective and schizophrenia spectrum disorders declines quickly after treatment and recovery, while the risk associated with substance abuse disorders declines relatively slower. This study also indicates that an admission history increases suicide risk relatively more in women than in men; and suicide risk is substantial for substance disorders and for multiple admissions in women but not in men. CONCLUSIONS: Suicide risk peaks in periods immediately after admission and discharge. The risk is particularly high in persons with affective disorders and in persons with short hospital treatment. These findings should lead to systematic evaluation of suicide risk among inpatients before discharge and corresponding outpatient treatment, and family support should be initiated immediately after the discharge.
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Patients who are psychiatrically hospitalized for a suicide attempt or suicidal ideation are at very high risk for suicide following discharge, with rates of suicide shortly postdischarge more than 100 times greater than the rate in the general population.
“Patients who are psychiatrically hospitalized for a suicide attempt or suicidal ideation (SI) are at very high risk for suicide following discharge [1 -3], with rates of suicide shortly postdischarge more than 100 times greater than the rate in the general population [4].”
From Feasibility and utility of positive psychology exercises for suicidal inpatients (2014) · cites this paper as [4]
The rate of suicide attempts in the first 3 months following discharge is higher than the next 5 years combined.
“with the rate of suicide attempts in the first 3 months following discharge being higher than the next 5 years combined.”
From A pilot study using frequent inpatient assessments of suicidal thinking to predict short-term postdischarge suicidal behavior (2021) · cites this paper as [3]
The weeks following discharge from psychiatric hospitalization are the highest-risk period for suicide attempts.
“The weeks following discharge from psychiatric hospitalization are the highest-risk period for suicide attempts.”
From A pilot study using frequent inpatient assessments of suicidal thinking to predict short-term postdischarge suicidal behavior (2021) · cites this paper as [3]
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- Authors
- Qin, P., & Nordentoft, M.
- Affiliations
- Aarhus University (DK)
- Bispebjerg Hospital (DK)
- Venue
- Archives of General Psychiatry
- Publisher
- American Medical Association (AMA)
- Published
- 2005-04-01
- Volume
- 62
- Issue
- 4
- Pages
- 427
- ISSN
- 0003-990X (ISSN-L)
- OpenAlex
- W2008236384
- Cited by
- 620
- References
- 27
- Citations by year
- 2026: 14 · 2025: 9 · 2024: 18 · 2023: 30 · 2022: 21 · 2021: 38 · 2020: 37 · 2019: 40 · 2018: 33 · 2017: 46 · 2016: 42 · 2015: 42 · 2014: 39 · 2013: 39 · 2012: 32
- FWCI
- 21.99
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- Archives of General Psychiatry (publishedVersion)
- PubMed (publishedVersion)
- Topics
- Social Sciences › Psychology › Clinical Psychology › Suicide and Self-Harm Studies
- Social Sciences › Psychology › Clinical Psychology › Psychiatric care and mental health services
- Social Sciences › Sociology and Political Science › Homicide, Infanticide, and Child Abuse
- Keywords
- suicide risk, psychiatric hospitalization, hospital discharge, mood disorders, schizophrenia spectrum disorders, substance use disorders, prior hospitalization, sex differences, suicide prevention, family support
- MeSH terms
- Mental Disorders, Cause of Death, Denmark, Female, Hospitalization, Hospitals, Psychiatric, Humans, Length of Stay, Longitudinal Studies, Male, Patient Readmission, Registries, Risk Factors, Schizophrenia, Schizophrenic Psychology, Sex Factors, Suicide, Logistic Models, Case-Control Studies, Mood Disorders, Substance-Related Disorders
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