Suicidal risk following hospital discharge: a review
Abstract
LEARNING OBJECTIVES: After participating in this activity, learners should be better able to:• Evaluate risk of suicide and suicide attempts following psychiatric hospitalization• Assess the relationship between suicide attempts and completed suicides BACKGROUND: Suicidal risks among psychiatric patients appear to be especially high soon after hospitalization. Given the importance of such outcomes, and the lack of recent reviews of post-discharge suicide attempt risks, we evaluated reported findings on the risk of suicide and attempts following psychiatric hospitalization. METHODS: With systematic, computerized searching, we identified 48 studies (1964-2017) involving 1,700,785 subjects. Follow-up was limited to ≥12 months after discharge from psychiatric hospitalization to avoid inflation of annualized rates due to shorter exposure times. RESULTS: The overall observed pooled, annualized rate of completed suicide was 241 (confidence interval, 238-243) per 100,000 person-exposure years in 41 studies, and for attempts, 722 (698-746) in 13 studies. In six studies (64,848 subjects) reporting on both suicides and attempts, the ratio of annualized rates for attempts/completed suicides was 8.79 (6.63-12.0). Among all 48 studies, cumulative distribution of suicidal events included 26.4% (25.9-26.9) within the initial month, 40.8% (40.2-41.4) within 3 months, and 73.2% (72.7-73.7) within 12 months of discharge. CONCLUSIONS: Among patients recently discharged from psychiatric hospitalization, rates of suicide deaths and attempts were far higher than in the general population or even in unselected clinical samples of comparable patients, with a strong inverse association with time post-discharge. Improved monitoring and care of patients discharged from psychiatric hospitalization are needed, ideally with detailed planning and implementation of aftercare prior to discharge.
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Suicide risk is particularly high during hospitalization and at discharge.
“Findings have shown that suicide risk is particularly high during hospitalization and at discharge [37].”
From High depression symptomatology and mental pain characterize suicidal psychiatric patients (2022) · cites this paper as [37]
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- Authors
- Forte, A., Buscajoni, A., Fiorillo, A., Pompili, M., & Baldessarini, R. J.
- Affiliations
- Harvard University (US)
- Corresponding author
- Forte, Alberto
- Venue
- Harvard Review of Psychiatry
- Published
- 2019-07
- Volume
- 27
- Issue
- 4
- Pages
- 209-216
- ISSN
- 1067-3229 (ISSN-L)
- 1465-7309
- OpenAlex
- W2968807553
- Cited by
- 150
- References
- 71
- Citations by year
- 2026: 12 · 2025: 22 · 2024: 21 · 2023: 11 · 2022: 50 · 2021: 14 · 2020: 16 · 2019: 3
- FWCI
- 3.27
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- Harvard Review of Psychiatry (publishedVersion)
- PubMed (publishedVersion)
- Archivio Istituzionale della Ricerca - Università degli Studi della Campania "Luigi Vanvitelli" (submittedVersion)
- IRIS Research product catalog (Sapienza University of Rome) (submittedVersion)
- 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, suicide attempts, suicide mortality, psychiatric hospitalization, hospital discharge, post-discharge follow-up, aftercare planning, psychiatric inpatients
- MeSH terms
- Hospitals, Psychiatric, Humans, Patient Discharge, Risk Factors, Suicide
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