The DOI matches its Crossref record; 38 of the 38 references it cites were found in a registry or an index.
Risk Factors for Suicide Within a Year of Discharge from Psychiatric Hospital: A Systematic Meta-Analysis
Abstract
BACKGROUND: The increased risk of suicide in the period after discharge from a psychiatric hospital is a well-recognized and serious problem. OBJECTIVE: The aim of this study was to establish the risk factors for suicide in the year after discharge from psychiatric hospitals and their usefulness in categorizing patients as high or low risk for suicide in the year following discharge. METHOD: A systematic meta-analysis of controlled studies of suicide within a year of discharge from psychiatric hospitals. RESULTS: There was a moderately strong association between both a history of self-harm (OR = 3.15) and depressive symptoms (OR = 2.70) and post-discharge suicide. Factors weakly associated with post-discharge suicide were reports of suicidal ideas (OR = 2.47), an unplanned discharge (OR = 2.44), recent social difficulty (OR = 2.23), a diagnosis of major depression (OR = 1.91) and male sex (OR = 1.58). Patients who had less contact with services after discharge were significantly less likely to commit suicide (OR = 0.69). High risk patients were more likely to commit suicide than other discharged patients, but the strength of this association was not much greater than the association with some individual risk factors (OR = 3.94, sensitivity = 0.40, specificity = 0.87). CONCLUSIONS: No factor, or combination of factors, was strongly associated with suicide in the year after discharge. About 3% of patients categorized as being at high risk can be expected to commit suicide in the year after discharge. However, about 60% of the patients who commit suicide are likely to be categorized as low risk. Risk categorization is of no value in attempts to decrease the numbers of patients who will commit suicide after discharge.
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“In two separate meta-analyses, the odds ratios for most risk and protective factors ranged from 1.0 to 2.5 (i.e., rs ~ 0.26–0.57; Franklin et al., 2017) and few exceeded 3.0 (r ~ 0.64; Large et al., 2011).”
From The interpersonal theory of suicide: A systematic review and meta-analysis of a decade of cross-national research. (2017) · cites this paper as Large et al., 2011
In the citing paper
“Studies published after the Troister et al. review found similar predictors (20, 26–28).”
From Using Administrative Data to Predict Suicide After Psychiatric Hospitalization in the Veterans Health Administration System (2020) · cites this paper as [26]
In the citing paper
“But are clinical evaluations any more accurate than structured assessments in predicting subsequent suicides and SRBs? The evidence suggests not.”
From Using Administrative Data to Predict Suicide After Psychiatric Hospitalization in the Veterans Health Administration System (2020) · cites this paper as [26]
In the citing paper
“a meta-analysis of 13 studies examining risk factors for suicide within 12 months of psychiatric hospital discharge found that clinical judgments at discharge were not much stronger predictors of subsequent suicides than were several other social, historical, and clinical variables assessed by patient self-report or extracted from administrative databases (26).”
From Using Administrative Data to Predict Suicide After Psychiatric Hospitalization in the Veterans Health Administration System (2020) · cites this paper as [26]
In the citing paper
“However, contrasting results have been reported, with a higher risk in male patients [41].”
From High depression symptomatology and mental pain characterize suicidal psychiatric patients (2022) · cites this paper as [41]
Citations
Cites
Duval, S., & Tweedie, R. (2000) · Biometrics · doi:10.1111/j.0006-341x.2000.00455.x · Cited by 14,099
Meta-analysis of individual participant data: rationale, conduct, and reporting
Riley, R. D., Lambert, P. C., & Abo-Zaid, G. (2010) · BMJ · doi:10.1136/bmj.c221 · Cited by 1,701
Qualitative Descriptors of Strength of Association and Effect Size
Rosenthal, J. A. (1996) · Journal of Social Service Research · doi:10.1300/j079v21n04_02 · Cited by 992
Suicide Risk in Relation to Psychiatric Hospitalization: Evidence Based on Longitudinal Registers
Qin, P., & Nordentoft, M. (2005) · Archives of General Psychiatry · doi:10.1001/archpsyc.62.4.427 · Cited by 620
Marital status and suicide in the National Longitudinal Mortality Study
Kposowa, A. J. (2000) · Journal of Epidemiology & Community Health · doi:10.1136/jech.54.4.254 · Cited by 524
REHKOPF, D. H., & BUKA, S. L. (2006) · Psychological Medicine · doi:10.1017/s003329170500588x · Cited by 471
Suicide after discharge from psychiatric inpatient care
Goldacre, M., Seagroatt, V, & Hawton, K. (1993) · The Lancet · doi:10.1016/0140-6736(93)91822-4 · Cited by 380
Psychiatric illness and risk factors for suicide in Denmark
Mortensen, P. B., Agerbo, E., Erikson, T., Qin, P., & Westergaard‐Nielsen, N. (2000) · The Lancet · doi:10.1016/s0140-6736(99)06376-x · Cited by 348
An Actuarial Model of Violence Risk Assessment for Persons With Mental Disorders
Monahan, J. T., Steadman, H. J., Robbins, P. C., Appelbaum, P. S., Banks, S. M., Grisso, T., Heilbrun, K., Mulvey, E. P., Roth, L. H., & Silver, E. (2005) · Psychiatric Services · doi:10.1176/appi.ps.56.7.810 · Cited by 255
Substance Use Disorders and Risk for Completed Suicide
Schneider, B. (2009) · Archives of Suicide Research · doi:10.1080/13811110903263191 · Cited by 247
Research works printed but not linked: 1
- Borenstein M, 2005, Copmrehensive Meta-Analysis
Cited by
Sorted by citations
Items 201–234 of 234
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Large, M. M. B. (2012) · The British Journal of Psychiatry · doi:10.1192/bjp.201.5.410
Self-citationBoyce, P. M. (2012) · Australian & New Zealand Journal of Psychiatry · doi:10.1177/0004867412445133
Is Suicide Clinically Preventable? What Is the Evidence?
FAWCETT, J. A. (2014) · Springer eBooks · doi:10.1007/978-3-319-09964-4_8
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Large, M. M. B., & Ryan, C. J. (2014) · Psychiatric Services · doi:10.1176/appi.ps.201300545
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Surgenor, P. W. G. (2015) · The Irish Journal of Psychology · doi:10.1080/03033910.2016.1188135
Role of Negative Mood on Turkish Stock Market: Suicides
Bozkurt, İ. (2016) · Journal of Yaşar University · doi:10.19168/jyu.20236
Om undervisning i selvmordsforebygging ved relevante universitets- og høgskoleutdanninger
Hjelmeland, H., Espeland, B., & Småvik, R. (2014) · Tidsskrift for psykisk helsearbeid · doi:10.18261/issn1504-3010-2014-04-07
The Aggressive Implications of Suicide
Coulacoglou, C., & Saklofske, D. H. (2017) · Elsevier eBooks · doi:10.1016/b978-0-12-802219-1.00015-8
Palao, D. J., Gómez, N. D. P. A., Montoro, M., Guinovart, M., Parra, I., Cebrià, A. I., Aguilar, E., Merodio, I., López‐Solà, C., Armario, A., et al. (2019) · Journal of Depression & Anxiety
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Isometsä, E. T. (2022) · Springer eBooks · doi:10.1007/978-3-030-41319-4_28-1
GALYNKER, I. I. (2023) · Oxford University Press eBooks · doi:10.1093/med/9780197582718.003.0001
Lawrence, O. C., Goncearenco, I., & Ziafat, K. (2023) · Oxford University Press eBooks · doi:10.1093/med/9780197582718.003.0005
(2016) · Wiley eBooks · doi:10.1002/9781394259472.refs
Suiziddrohungen bei Entlassung aus stationär-psychiatrischer Behandlung
Koban, C., & Teismann, T. (2024) · Nervenheilkunde · doi:10.1055/a-2234-1111
Keshky, M. E. S. E. (2024) · SSRN Electronic Journal · doi:10.2139/ssrn.4841950
Baldaçara, L., Calfat, E. L. D. B., Périco, C. D. A.-M., da Rocha, G. A., Leite, V. D. S., Porto, D. M., Grüdtner, R. R., Díaz, A. P., Meleiro, A. M. A. D. S., Corrêa, H., et al. (2024) · Debates em Psiquiatria · doi:10.25118/2763-9037.2024.v14.1256
Addressing suicide risk: A study of dose response in collaborative care
Littl, V., Green, B., Hardy, C., & Fuller, S. (2024) · doi:10.36855/cc2024.1
Validity, Reliability, and Factor Structure of the Suicide Crisis Scale in Turkish.
Gıynaş, F. F., Kızılkurt, Ö. K., Güleç, M. Y., & Güleç, H. (2024) · PubMed Central · doi:10.5152/alphapsychiatry.2024.241564
Diaz‐Carracedo, P., Marín‐Martín, C., Díaz‐Marsá, M., Borges, G. L. G., de la Torre‐Luque, A., Elices, M., Toll, A., Grande, I., Roberto, N., Vázquez, M., et al. (2024) · European Psychiatry · doi:10.1192/j.eurpsy.2024.1759
Menon, V., Balasubramanian, I., Rogers, M. L., Grover, S., Lakdawala, B. M., Ranjan, R., Sarkhel, S., Nebhinani, N., Kallivayalil, R. A., Raghavan, V., et al. (2025) · Archives of Suicide Research · doi:10.1080/13811118.2025.2510506
Rothes, I. (2014) · Portuguese National Funding Agency for Science, Research and Technology (RCAAP Project by FCT) · doi:10.34626/gnvk-wx77
Hensel, L. M., Hamann, J., Schlechter, P., Brieger, P., Spießl, H., Yunusah, M., Pashutina, Y., Spielmann, C., Michna, S. S., Freund, J., et al. (2026) · Psychiatrische Praxis · doi:10.1055/a-2741-8510
Understanding the suicide rate post-discharge from a psychiatric hospital: Time for a rethink
Modini, M., & Large, M. M. B. (2026) · Australasian Psychiatry · doi:10.1177/10398562261425069
Self-citationHeapy, C., Haddock, G., Parkinson, J., & Pratt, D. (2026) · Clinical Psychology & Psychotherapy · doi:10.1002/cpp.70234
Suicide Risk Following Psychiatric Hospitalization: A Narrative Review and Conceptual Synthesis
van Gelderen, E., Marquard, R., Nasef, O. E., Bogue, R. L., & Nestadt, P. S. (2026) · International Journal of Environmental Research and Public Health · doi:10.3390/ijerph23050587
Metacognitive model of suicidality: a study of Iranian inpatients
Asgari, Z., Bagajan, K. Q., Khanpayeh, M., Abdi, M., Hensel, L. M., & Teismann, T. (2026) · Frontiers in Psychiatry · doi:10.3389/fpsyt.2026.1766691
Amaro, A., O’Connor, R. C., Cleare, S., & Beurs, D. P. D. (2026) · Behaviour Research and Therapy · doi:10.1016/j.brat.2026.105093
Wheeler, J., Mildred, H., Broadbear, J. H., Mellor, D. J., Al-Qassab, A., Katz, P., & Rao, S. (2026) · Journal of Psychiatric Research · doi:10.1016/j.jpsychires.2026.06.005
Yalçintaş, E., Taymur, İ., Turan, Ç., Budak, E., & Demirci, H. (2026) · Family Practice · doi:10.1093/fampra/cmag076
Geospatial suicide risk prediction in the State of Maryland and the limits of discernible intentPreprint
Kitchen, C., Belouali, A., Zirikly, A., Nestadt, P. S., Wilcox, H. C., & Kharrazi, H. H. K. (2026) · Research Square · doi:10.21203/rs.3.rs-10832081/v1
Kennedy, G. J., & Rohs, A. (2014) · Cambridge University Press eBooks · doi:10.1017/cbo9781139519502.026
Metadata
- Authors
- Large, M., Sharma, S., Cannon, E., Ryan, C., & Nielssen, O.
- Affiliations
- UNSW Sydney (AU)
- Prince of Wales Hospital (AU)
- The University of Sydney (AU)
- Corresponding author
- Large, Matthew
- Venue
- Australian & New Zealand Journal of Psychiatry
- Publisher
- SAGE Publications
- Published
- 2011-08
- Volume
- 45
- Issue
- 8
- Pages
- 619-628
- ISSN
- 0004-8674 (ISSN-L)
- 1440-1614
- OpenAlex
- W1971677694
- Cited by
- 234
- References
- 36
- Citations by year
- 2026: 11 · 2025: 8 · 2024: 16 · 2023: 15 · 2022: 13 · 2021: 10 · 2020: 23 · 2019: 12 · 2018: 20 · 2017: 14 · 2016: 22 · 2015: 13 · 2014: 24 · 2013: 12 · 2012: 16
- FWCI
- 2.74
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- Australian & New Zealand Journal of 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, psychiatric hospital discharge, suicide risk factors, self-harm history, depressive symptoms, suicidal ideation, major depressive disorder, male sex, risk classification, suicide prevention
- MeSH terms
- Depression, Female, Hospitals, Psychiatric, Humans, Male, Patient Discharge, Risk Factors, Sex Factors, Suicide, Self-Injurious Behavior, Risk Assessment
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