{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,17]],"date-time":"2026-08-17T19:09:31Z","timestamp":1786993771046,"version":"build-2736575974"},"reference-count":53,"publisher":"Wiley","issue":"1","license":[{"start":{"date-parts":[[2011,1,25]],"date-time":"2011-01-25T00:00:00Z","timestamp":1295913600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Acta Psychiatr Scand"],"published-print":{"date-parts":[[2011,7]]},"abstract":"<jats:p>Large M, Smith G, Sharma S, Nielssen O, Singh SP. Systematic review and meta\u2010analysis of the clinical factors associated with the suicide of psychiatric in\u2010patients.<\/jats:p><jats:p><jats:bold>Objective:\u2002<\/jats:bold> To estimate the strength of the associations between the suicide of psychiatric in\u2010patients and demographic, historical, symptomatic, diagnostic and treatment factors.<\/jats:p><jats:p><jats:bold>Method:\u2002<\/jats:bold> A systematic review and meta\u2010analysis of controlled studies of the suicide of psychiatric in\u2010patients including suicides while on approved or unapproved leave.<\/jats:p><jats:p><jats:bold>Results:\u2002<\/jats:bold> Factors that were significantly associated with in\u2010patient suicide included a history of deliberate self\u2010harm, hopelessness, feelings of guilt or inadequacy, depressed mood, suicidal ideas and a family history of suicide. Patients suffering from both schizophrenia and depressed mood appeared to be at particular risk. The association between suicidal ideas and in\u2010patient suicide was weak and did not reach statistical significance after a quantitative correction for publication bias. A high\u2010risk categorization as defined by a combination of retrospectively determined individual risk factors was strongly statistically associated with in\u2010patient suicide (OR\u2003=\u200310.9), with a sensitivity of 64% and a specificity of 85%.<\/jats:p><jats:p><jats:bold>Conclusion:\u2002<\/jats:bold> Despite the apparently strong association between high\u2010risk categorization and subsequent suicide, the low base rate of in\u2010patient suicide means that predictive value of a high\u2010risk categorization is below 2%. The development of safer hospital environments and improved systems of care are more likely to reduce the suicide of psychiatric in\u2010patients than risk assessment.<\/jats:p>","DOI":"10.1111\/j.1600-0447.2010.01672.x","type":"journal-article","created":{"date-parts":[[2011,1,25]],"date-time":"2011-01-25T06:06:46Z","timestamp":1295935606000},"page":"18-19","source":"Crossref","is-referenced-by-count":193,"title":["Systematic review and meta\u2010analysis of the clinical factors associated with the suicide of psychiatric in\u2010patients"],"prefix":"10.1111","volume":"124","author":[{"given":"M.","family":"Large","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"G.","family":"Smith","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"S.","family":"Sharma","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"O.","family":"Nielssen","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"S. 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