TY - JOUR
AU - A. Tai
AU - H. Pincham
AU - A. Basu
AU - M. Large
A1 - 
AB - BACKGROUND: Rates of suicide following discharge from psychiatric hospitals are extraordinarily high in the first week post-discharge and then decline steeply over time. The aim of this meta-analysis is to evaluate the strength of risk factors for suicide after psychiatric discharge and to investigate the association between the strength of risk factors and duration of study follow-up. METHODS: A PROSPERO-registered meta-analysis of observational studies was performed in accordance with PRISMA guidelines. Post-discharge suicide risk factors reported five or more times were synthesised using a random-effects model. Mixed-effects meta-regression was used to examine whether the strength of suicide risk factors could be explained by duration of study follow-up. RESULTS: Searches located 83 primary studies. From this, 63 risk estimates were meta-analysed. The strongest risk factors were previous self-harm (odds ratio = 2.75, 95% confidence interval = [2.37, 3.19]), suicidal ideation (odds ratio = 2.15, 95% confidence interval = [1.73, 2.68]), depressive symptoms (odds ratio = 1.84, 95% confidence interval = [1.48, 2.30]), and high-risk categorisation (odds ratio = 7.65, 95% confidence interval = [5.48, 10.67]). Significantly protective factors included age ⩽30, age ⩾65, post-traumatic stress disorder, and dementia. The effect sizes for the strongest post-discharge suicide risk factors did not decline over longer periods of follow-up. CONCLUSION: The effect sizes of post-discharge suicide risk factors were generally modest, suggesting that clinical risk factors may have limited value in distinguishing between high-risk and low-risk groups. The highly elevated rates of suicide immediately after discharge and their subsequent decline remain unexplained.
AD - Discipline of Psychiatry & Mental Health, University of New South Wales, Sydney, NSW, Australia.; Mental Health Services, Prince of Wales Hospital, Randwick, NSW, Australia.
AN - 40576057
BT - Aust N Z J Psychiatry
C5 - Healthcare Disparities
CP - 8
DA - Aug
DO - 10.1177/00048674251348372
DP - NLM
ET - 20250627
IS - 8
JF - Aust N Z J Psychiatry
LA - eng
N2 - BACKGROUND: Rates of suicide following discharge from psychiatric hospitals are extraordinarily high in the first week post-discharge and then decline steeply over time. The aim of this meta-analysis is to evaluate the strength of risk factors for suicide after psychiatric discharge and to investigate the association between the strength of risk factors and duration of study follow-up. METHODS: A PROSPERO-registered meta-analysis of observational studies was performed in accordance with PRISMA guidelines. Post-discharge suicide risk factors reported five or more times were synthesised using a random-effects model. Mixed-effects meta-regression was used to examine whether the strength of suicide risk factors could be explained by duration of study follow-up. RESULTS: Searches located 83 primary studies. From this, 63 risk estimates were meta-analysed. The strongest risk factors were previous self-harm (odds ratio = 2.75, 95% confidence interval = [2.37, 3.19]), suicidal ideation (odds ratio = 2.15, 95% confidence interval = [1.73, 2.68]), depressive symptoms (odds ratio = 1.84, 95% confidence interval = [1.48, 2.30]), and high-risk categorisation (odds ratio = 7.65, 95% confidence interval = [5.48, 10.67]). Significantly protective factors included age ⩽30, age ⩾65, post-traumatic stress disorder, and dementia. The effect sizes for the strongest post-discharge suicide risk factors did not decline over longer periods of follow-up. CONCLUSION: The effect sizes of post-discharge suicide risk factors were generally modest, suggesting that clinical risk factors may have limited value in distinguishing between high-risk and low-risk groups. The highly elevated rates of suicide immediately after discharge and their subsequent decline remain unexplained.
PY - 2025
SN - 0004-8674 (Print); 0004-8674
SP - 679
EP - 691+
ST - Meta-analysis of risk factors for suicide after psychiatric discharge and meta-regression of the duration of follow-up
T1 - Meta-analysis of risk factors for suicide after psychiatric discharge and meta-regression of the duration of follow-up
T2 - Aust N Z J Psychiatry
TI - Meta-analysis of risk factors for suicide after psychiatric discharge and meta-regression of the duration of follow-up
U1 - Healthcare Disparities
U3 - 10.1177/00048674251348372
VL - 59
VO - 0004-8674 (Print); 0004-8674
Y1 - 2025
ER -