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.
Overview
Integrity signals
Registry
Cites
Statistics
Verification
Claims the paper makes
Claims other papers make about this one
Each is checked against this paper’s own text: does it say what the citing paper says it does?
In the citing paper
“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
Large, M. M. B., Smith, G., Sharma, S., Nielssen, O. B., & Singh, S. P. (2011) · Acta Psychiatrica Scandinavica · doi:10.1111/j.1600-0447.2010.01672.x · Cited by 228
Self-citationSuicide in recently discharged psychiatric patients: a case-control study
Hunt, I. M., Kapur, N., Webb, R., Robinson, J., Burns, J., Shaw, J., & Appleby, L. (2009) · Psychological Medicine · doi:10.1017/s0033291708003644 · Cited by 212
Mortality and Further Suicidal Behaviour After an Index Suicide Attempt: a 10-Year Study
Gibb, S., Beautrais, A. L., & Fergusson, D. M. (2005) · Australian & New Zealand Journal of Psychiatry · doi:10.1080/j.1440-1614.2005.01514.x · Cited by 204
Mental health service delivery and suicide risk: the role of individual patient and facility factors
Desai, R. A., Dausey, D. J., & Rosenheck, R. A. (2005) · American Journal of Psychiatry · doi:10.1176/appi.ajp.162.2.311 · Cited by 183
Appleby, L., Dennehy, J. A., Thomas, C. S., Faragher, E. B., & Lewis, G. (1999) · The Lancet · doi:10.1016/s0140-6736(98)10014-4 · Cited by 172
Mortality and further suicidal behaviour after an index suicide attempt: a 10-year study
Gibb, S., Beautrais, A. L., & Fergusson, D. M. (2005) · Australian & New Zealand Journal of Psychiatry · doi:10.1111/j.1440-1614.2005.01514.x · Cited by 157
The Suicide Risk of Discharged Psychiatric Patients
Ho, T. (2003) · The Journal of Clinical Psychiatry · doi:10.4088/jcp.v64n0613 · Cited by 142
The Wessex Recent In-Patient Suicide Study, 1
King, E. A., Baldwin, D. S., Sinclair, J., Baker, N. G., Campbell, M. J., & Thompson, C. (2001) · The British Journal of Psychiatry · doi:10.1192/bjp.178.6.531 · Cited by 140
Case register study of suicide risk in mental disorders
Baxter, D. N., & Appleby, L. (1999) · The British Journal of Psychiatry · doi:10.1192/bjp.175.4.322 · Cited by 117
Suicide in Australia: meta‐analysis of rates and methods of suicide between 1988 and 2007
Large, M. M. B., & Nielssen, O. B. (2010) · The Medical Journal of Australia · doi:10.5694/j.1326-5377.2010.tb03580.x · Cited by 98
Self-citationSuicide after Discharge from Psychiatric Inpatient Care: A Case-Control Study in Hong Kong
Yim, P. H. W., Yip, P. S. F., Li, R. H. Y., Dunn, E. L.-W., Yeung, W. S., & Miao, Y. K. (2004) · Australian & New Zealand Journal of Psychiatry · doi:10.1111/j.1440-1614.2004.01299.x · Cited by 83
Review of predictors of suicide within 1 year of discharge from a psychiatric hospital
Troister, T., Links, P. S., & Cutcliffe, J. (2008) · Current Psychiatry Reports · doi:10.1007/s11920-008-0011-8 · Cited by 72
Risk factors for suicide in the immediate post-discharge period
Kan, C.-K., Ho, T.-P., Dong, J. Y. S., & Dunn, E. L. W. (2007) · Social Psychiatry and Psychiatric Epidemiology · doi:10.1007/s00127-006-0153-0 · Cited by 71
Pirkola, S. P., Sohlman, B., & Wahlbeck, K. (2005) · BMC Psychiatry · doi:10.1186/1471-244x-5-32 · Cited by 60
Effect of psychopharmacotherapy on suicide risk in discharged psychiatric inpatients
Modestin, J., & Schwarzenbach, F. A. (1992) · Acta Psychiatrica Scandinavica · doi:10.1111/j.1600-0447.1992.tb01464.x · Cited by 58
SUICIDE FOLLOWING PSYCHIATRIC HOSPITALIZATION
Pokorny, A. D., & Kaplan, H. B. (1976) · The Journal of Nervous and Mental Disease · doi:10.1097/00005053-197602000-00006 · Cited by 52
Holikatti, P., & Grover, S. (2010) · The British Journal of Psychiatry · doi:10.1192/bjp.196.5.415 · Cited by 51
Johansson, L. M., Sundquist, J., Johansson, S. E., & Bergman, B. (1997) · Acta Psychiatrica Scandinavica · doi:10.1111/j.1600-0447.1997.tb00385.x · Cited by 50
Suicide in Psychiatric Patients: Case–Control Study in Singapore
Thong, J. Y., Su, A., Chan, Y. H., & Chia, B. (2008) · Australian & New Zealand Journal of Psychiatry · doi:10.1080/00048670802050553 · Cited by 48
Suicide after Discharge from Psychiatric Inpatient Care: A Case-Control Study in Hong Kong
Yim, P. H. W., Dunn, E. L.-W., Yeung, W. S., et al. (2004) · Australian & New Zealand Journal of Psychiatry · doi:10.1177/000486740403800103 · Cited by 45
Suicide in Association with Psychiatric Hospitalisation
Goldney, R. D., Positano, S., Spence, N. D., & Rosenman, S. J. (1985) · Australian & New Zealand Journal of Psychiatry · doi:10.1080/00048678509161316 · Cited by 41
Early Suicide Following Discharge from a Psychiatric Hospital
McKenzie, I., & Wurr, C. J. (2001) · Suicide and Life-Threatening Behavior · doi:10.1521/suli.31.3.358.24244 · Cited by 33
Are Psychiatrist Characteristics Associated With Postdischarge Suicide of Schizophrenia Patients?
Lee, H., & Lin, H.-C. (2008) · Schizophrenia Bulletin · doi:10.1093/schbul/sbn007 · Cited by 26
Suicide Among Psychiatric Patients: A Case-Control Study
Pirkis, J., Burgess, P. M., & Jolley, D. (2002) · Australian & New Zealand Journal of Psychiatry · doi:10.1046/j.1440-1614.2002.00993.x · Cited by 24
Suicide after discharge from psychiatric inpatient care
Isometsä, E. T., HENRIKSSON, M. M., Heikkinen, M. E., & Lönnqvist, J. K. (1993) · The Lancet · doi:10.1016/0140-6736(93)92913-e · Cited by 21
Duration of Hospitalization and Post Discharge Suicide
Ho, T. (2006) · Suicide and Life-Threatening Behavior · doi:10.1521/suli.2006.36.6.682 · Cited by 21
Hospital characteristics associated with post-discharge suicide of severely depressed patients
Lin, H., Lee, H., Kuo, N., & Chu, C. (2008) · Journal of Affective Disorders · doi:10.1016/j.jad.2008.01.030 · Cited by 18
Completed suicide in discharged psychiatric inpatients
Hoffmann, H., & Modestin, J. (1987) · Social Psychiatry and Psychiatric Epidemiology · doi:10.1007/bf00584011 · Cited by 13
Research works printed but not linked: 1
- Borenstein M, 2005, Copmrehensive Meta-Analysis
Cited by
Sorted by citations
Chu, C., Buchman-Schmitt, J. M., Stanley, I. H., Hom, M. A., Tucker, R. P., Hagan, C. R., Rogers, M. L., Podlogar, M. C., Chiurliza, B., Ringer, F. B., et al. (2017) · Psychological Bulletin · doi:10.1037/bul0000123 · Cited by 1,231
Linehan, M. M., Korslund, K. E., Harned, M. S., Gallop, R. J., Lungu, A., Neacsiu, A. D., McDavid, J., Comtois, K. A., & Murray-Gregory, A. M. (2015) · JAMA Psychiatry · doi:10.1001/jamapsychiatry.2014.3039 · Cited by 714
Suicide Rates After Discharge From Psychiatric Facilities: A Systematic Review and Meta-analysis
Chung, D. T., Ryan, C. J., Hadzi-Pavlovic, D., Singh, S. P., Stanton, C., & Large, M. M. (2017) · JAMA Psychiatry · doi:10.1001/jamapsychiatry.2017.1044 · Cited by 651
Self-citationPredicting suicide following self-harm: systematic review of risk factors and risk scales
Chan, M. K. Y., Bhatti, H., Meader, N., Stockton, S., Evans, J., O'Connor, R. C., Kapur, N., & Kendall, T. (2016) · British Journal of Psychiatry · doi:10.1192/bjp.bp.115.170050 · Cited by 501
Kessler, R. C., Warner, C. H., Ivany, C., Petukhova, M. V., Rose, S., Bromet, E. J., Brown, M., Cai, T., Colpe, L. J., Cox, K. L., et al. (2015) · JAMA Psychiatry · doi:10.1001/jamapsychiatry.2014.1754 · Cited by 447
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
About these checks
Registry, retraction, Cites and statistics results are computed, not judged, with one exception: a printed reference that no index lists is read once by a model before it counts as a citation error. Claims are extracted by a model and kept only when their quote appears verbatim in the text; each cited source is then checked, with a model’s help, for whether it says what the claim relies on. Those verdicts can be wrong — read the claim’s quote and the cited source before relying on one.
Statistics and arithmetic are recomputed, not judged.
Confidence bands are shown only for fields calibrated on our annotated test set. None is calibrated yet, so no band is shown.
What counts as a claim ›How we measure confidence ›How we check this ›
Are you an author, or do you see a problem with this page? Request a review