{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,11,12]],"date-time":"2026-11-12T12:44:17Z","timestamp":1794487457829,"version":"4.9.1"},"reference-count":98,"publisher":"SAGE Publications","issue":"8","license":[{"start":{"date-parts":[[2025,6,27]],"date-time":"2025-06-27T00:00:00Z","timestamp":1750982400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"},{"start":{"date-parts":[[2025,6,27]],"date-time":"2025-06-27T00:00:00Z","timestamp":1750982400000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["Aust N Z J Psychiatry"],"published-print":{"date-parts":[[2025,8]]},"abstract":"<jats:sec>\n                    <jats:title>Background:<\/jats:title>\n                    <jats:p>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.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods:<\/jats:title>\n                    <jats:p>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.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results:<\/jats:title>\n                    <jats:p>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 \u2a7d30, age \u2a7e65, 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.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion:<\/jats:title>\n                    <jats:p>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.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1177\/00048674251348372","type":"journal-article","created":{"date-parts":[[2025,6,27]],"date-time":"2025-06-27T06:22:03Z","timestamp":1751005323000},"page":"679-691","update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":19,"title":["Meta-analysis of risk factors for suicide after psychiatric discharge and meta-regression of the duration of follow-up"],"prefix":"10.1177","volume":"59","author":[{"ORCID":"https:\/\/orcid.org\/0009-0008-3003-7855","authenticated-orcid":false,"given":"Allyson","family":"Tai","sequence":"first","affiliation":[{"name":"Discipline of Psychiatry &amp; Mental Health, University of New South Wales, Sydney, NSW, Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7228-8750","authenticated-orcid":false,"given":"Hannah","family":"Pincham","sequence":"additional","affiliation":[{"name":"Discipline of Psychiatry &amp; Mental Health, University of New South Wales, Sydney, NSW, Australia"},{"name":"Mental Health Services, Prince of Wales Hospital, Randwick, NSW, Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6422-7576","authenticated-orcid":false,"given":"Ashna","family":"Basu","sequence":"additional","affiliation":[{"name":"Discipline of Psychiatry &amp; Mental Health, University of New South Wales, Sydney, NSW, Australia"},{"name":"Mental Health Services, Prince of Wales Hospital, Randwick, NSW, Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0194-7426","authenticated-orcid":false,"given":"Matthew","family":"Large","sequence":"additional","affiliation":[{"name":"Discipline of Psychiatry &amp; Mental Health, University of New South Wales, Sydney, NSW, Australia"},{"name":"Mental Health Services, Prince of Wales Hospital, Randwick, NSW, Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"179","published-online":{"date-parts":[[2025,6,27]]},"reference":[{"key":"e_1_3_2_2_1","doi-asserted-by":"publisher","DOI":"10.1001\/jamapsychiatry.2023.5512"},{"key":"e_1_3_2_3_1","doi-asserted-by":"publisher","DOI":"10.1111\/acps.12990"},{"key":"e_1_3_2_4_1","doi-asserted-by":"publisher","DOI":"10.1136\/bmj.322.7282.334"},{"key":"e_1_3_2_5_1","doi-asserted-by":"publisher","DOI":"10.1007\/BF02195984"},{"key":"e_1_3_2_6_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(98)10014-4"},{"key":"e_1_3_2_7_1","doi-asserted-by":"publisher","DOI":"10.1007\/BF02195974"},{"key":"e_1_3_2_8_1","doi-asserted-by":"publisher","DOI":"10.1037\/0022-006X.57.2.309"},{"key":"e_1_3_2_9_1","doi-asserted-by":"publisher","DOI":"10.1176\/ajp.142.5.559"},{"key":"e_1_3_2_10_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1600-0447.1987.tb05628.x"},{"key":"e_1_3_2_11_1","doi-asserted-by":"publisher","DOI":"10.1176\/appi.ps.201200026"},{"key":"e_1_3_2_12_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.schres.2014.05.010"},{"key":"e_1_3_2_13_1","doi-asserted-by":"publisher","DOI":"10.1001\/archpsyc.1985.01790240073007"},{"issue":"11","key":"e_1_3_2_14_1","first-page":"14","article-title":"Suicide in schizophrenia: The Iowa record linkage study","volume":"46","author":"Black DW","year":"1985","unstructured":"Black DW, Winokur G, Warrack G (1985b) Suicide in schizophrenia: The Iowa record linkage study. Journal of Clinical Psychiatry 46(11 II): 14\u201317.","journal-title":"Journal of Clinical Psychiatry"},{"key":"e_1_3_2_15_1","unstructured":"Borenstein M Hedges L Higgins J et al. (2022) Comprehensive meta-analysis version 2 Engelwood. NJ Biostat. Available at: https:\/\/meta-analysis.com"},{"key":"e_1_3_2_16_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1600-0447.1993.tb03377.x"},{"key":"e_1_3_2_17_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00127-017-1377-x"},{"issue":"2","key":"e_1_3_2_18_1","article-title":"Shorter- and longer-term risk for suicide among male us military veterans in the year after discharge from psychiatric hospitalization","volume":"82","author":"Britton PC","year":"2021","unstructured":"Britton PC, Ilgen MA, Bohnert KM, et al. (2021) Shorter- and longer-term risk for suicide among male us military veterans in the year after discharge from psychiatric hospitalization. Journal of Clinical Psychiatry 82(2): 19M13228.","journal-title":"Journal of Clinical Psychiatry"},{"key":"e_1_3_2_19_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.schres.2009.04.006"},{"key":"e_1_3_2_20_1","doi-asserted-by":"publisher","DOI":"10.3109\/08039480903274431"},{"key":"e_1_3_2_21_1","doi-asserted-by":"publisher","DOI":"10.1001\/jamanetworkopen.2023.36767"},{"key":"e_1_3_2_22_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ajp.2022.103399"},{"key":"e_1_3_2_23_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jad.2019.03.079"},{"key":"e_1_3_2_24_1","doi-asserted-by":"publisher","DOI":"10.1093\/intqhc\/mzaa093"},{"key":"e_1_3_2_25_1","doi-asserted-by":"publisher","DOI":"10.1136\/bmjopen-2018-023883"},{"key":"e_1_3_2_26_1","doi-asserted-by":"publisher","DOI":"10.1001\/jamapsychiatry.2017.1044"},{"key":"e_1_3_2_27_1","doi-asserted-by":"publisher","DOI":"10.1111\/sltb.12499"},{"key":"e_1_3_2_28_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0920-9964(00)00003-7"},{"issue":"5","key":"e_1_3_2_29_1","article-title":"Suicide risk factors in patients recently discharged from a psychiatric hospital: A case-control study","volume":"80","author":"Deisenhammer EA","year":"2019","unstructured":"Deisenhammer EA, Behrndt EM, Kemmler G, et al. (2019) Suicide risk factors in patients recently discharged from a psychiatric hospital: A case-control study. Journal of Clinical Psychiatry 80(5): 18m12702.","journal-title":"Journal of Clinical Psychiatry"},{"key":"e_1_3_2_30_1","doi-asserted-by":"publisher","DOI":"10.1136\/bmj.312.7046.1580"},{"key":"e_1_3_2_31_1","doi-asserted-by":"publisher","DOI":"10.1176\/appi.ajp.162.2.311"},{"issue":"4","key":"e_1_3_2_32_1","article-title":"Incidence and predictors of suicide attempts and suicide deaths among individuals recently hospitalized for a mental disorder: A population-based study","volume":"83","author":"Enns JS","year":"2022","unstructured":"Enns JS, Mota NP, Bolton JM, et al. (2022) Incidence and predictors of suicide attempts and suicide deaths among individuals recently hospitalized for a mental disorder: A population-based study. Journal of Clinical Psychiatry 83(4): E1\u2013E6.","journal-title":"Journal of Clinical Psychiatry"},{"key":"e_1_3_2_33_1","doi-asserted-by":"publisher","DOI":"10.1097\/00005053-197406000-00003"},{"issue":"4","key":"e_1_3_2_34_1","first-page":"148","article-title":"Risk factors for suicide in adults: Systematic review and meta-analysis of psychological autopsy studies","volume":"25","author":"Favril L","year":"2022","unstructured":"Favril L, Yu R, Uyar A, et al. (2022) Risk factors for suicide in adults: Systematic review and meta-analysis of psychological autopsy studies. BMJ Mental Health 25(4): 148\u2013155.","journal-title":"BMJ Mental Health"},{"key":"e_1_3_2_35_1","doi-asserted-by":"publisher","DOI":"10.1097\/01.yic.0000194376.80707.00"},{"key":"e_1_3_2_36_1","doi-asserted-by":"publisher","DOI":"10.1192\/bjp.114.509.443"},{"key":"e_1_3_2_37_1","doi-asserted-by":"publisher","DOI":"10.1016\/0165-0327(79)90007-7"},{"key":"e_1_3_2_38_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jad.2020.10.009"},{"key":"e_1_3_2_39_1","doi-asserted-by":"publisher","DOI":"10.1037\/bul0000084"},{"issue":"5","key":"e_1_3_2_40_1","article-title":"High scores on the Montgomery-Asberg Depression Rating Scale and psychotic symptoms predict suicide: A prospective cohort study of psychiatric acute ward patients","volume":"83","author":"Fredriksen KJ","year":"2022","unstructured":"Fredriksen KJ, Gjestad R, Walby FA, et al. (2022) High scores on the Montgomery-Asberg Depression Rating Scale and psychotic symptoms predict suicide: A prospective cohort study of psychiatric acute ward patients. Journal of Clinical Psychiatry 83(5): 21m14018.","journal-title":"Journal of Clinical Psychiatry"},{"key":"e_1_3_2_41_1","doi-asserted-by":"publisher","DOI":"10.1136\/bmj.311.7001.357"},{"key":"e_1_3_2_42_1","doi-asserted-by":"publisher","DOI":"10.1136\/jech.51.4.430"},{"key":"e_1_3_2_43_1","doi-asserted-by":"publisher","DOI":"10.1016\/0140-6736(93)91822-4"},{"key":"e_1_3_2_44_1","doi-asserted-by":"publisher","DOI":"10.1001\/archpsyc.1991.01810290030004"},{"key":"e_1_3_2_45_1","doi-asserted-by":"publisher","DOI":"10.1111\/acps.13620"},{"key":"e_1_3_2_46_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.genhosppsych.2022.04.012"},{"key":"e_1_3_2_47_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0165-0327(02)00311-7"},{"issue":"2","key":"e_1_3_2_48_1","article-title":"Suicide immediately after discharge from psychiatric inpatient care: A cohort study of nearly 2.9 million discharges","volume":"80","author":"Haglund A","year":"2019","unstructured":"Haglund A, Lysell H, Larsson H, et al. (2019) Suicide immediately after discharge from psychiatric inpatient care: A cohort study of nearly 2.9 million discharges. Journal of Clinical Psychiatry 80(2): 18m12172.","journal-title":"Journal of Clinical Psychiatry"},{"key":"e_1_3_2_49_1","doi-asserted-by":"publisher","DOI":"10.3390\/ijerph15071299"},{"key":"e_1_3_2_50_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00127-014-0860-x"},{"key":"e_1_3_2_51_1","doi-asserted-by":"publisher","DOI":"10.4088\/JCP.v64n0613"},{"key":"e_1_3_2_52_1","doi-asserted-by":"publisher","DOI":"10.1521\/suli.2006.36.6.682"},{"key":"e_1_3_2_53_1","doi-asserted-by":"publisher","DOI":"10.1007\/BF00584011"},{"key":"e_1_3_2_54_1","doi-asserted-by":"publisher","DOI":"10.1177\/070674378302800407"},{"key":"e_1_3_2_55_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jad.2024.02.075"},{"key":"e_1_3_2_56_1","doi-asserted-by":"publisher","DOI":"10.1017\/S0033291708003644"},{"key":"e_1_3_2_57_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jpsychires.2020.05.008"},{"key":"e_1_3_2_58_1","doi-asserted-by":"publisher","DOI":"10.1111\/bdi.12237"},{"key":"e_1_3_2_59_1","doi-asserted-by":"publisher","DOI":"10.1192\/bjp.2021.19"},{"key":"e_1_3_2_60_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00127-006-0153-0"},{"key":"e_1_3_2_61_1","doi-asserted-by":"publisher","DOI":"10.1016\/S2215-0366(22)00077-3"},{"key":"e_1_3_2_62_1","doi-asserted-by":"publisher","DOI":"10.3389\/fpsyt.2020.00390"},{"key":"e_1_3_2_63_1","doi-asserted-by":"publisher","DOI":"10.1001\/jamapsychiatry.2014.1754"},{"key":"e_1_3_2_64_1","doi-asserted-by":"publisher","DOI":"10.1080\/136515001300374849"},{"key":"e_1_3_2_65_1","doi-asserted-by":"publisher","DOI":"10.4088\/JCP.09l05404blu"},{"key":"e_1_3_2_66_1","doi-asserted-by":"publisher","DOI":"10.4088\/JCP.v66n0506"},{"key":"e_1_3_2_67_1","doi-asserted-by":"publisher","DOI":"10.1017\/S0033291717002537"},{"key":"e_1_3_2_68_1","doi-asserted-by":"publisher","DOI":"10.3109\/00048674.2011.590465"},{"key":"e_1_3_2_69_1","doi-asserted-by":"publisher","DOI":"10.1093\/schbul\/sbn007"},{"key":"e_1_3_2_70_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jad.2008.01.030"},{"key":"e_1_3_2_71_1","doi-asserted-by":"publisher","DOI":"10.1176\/appi.ps.201200413"},{"key":"e_1_3_2_72_1","doi-asserted-by":"publisher","DOI":"10.1521\/suli.31.3.358.24244"},{"key":"e_1_3_2_73_1","doi-asserted-by":"publisher","DOI":"10.1111\/acps.13221"},{"key":"e_1_3_2_74_1","unstructured":"Metreau E Young KE Eapen SG (2024) World Bank Country Classifications by Income Level for 2024-2025. Available at: https:\/\/blogs.worldbank.org\/en\/opendata\/world-bank-country-classifications-by-income-level-for-2024-2025 (accessed 1 December 2024)."},{"key":"e_1_3_2_75_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1600-0447.1992.tb01464.x"},{"key":"e_1_3_2_76_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jclinepi.2009.06.005"},{"key":"e_1_3_2_77_1","doi-asserted-by":"publisher","DOI":"10.1176\/ajp.142.6.680"},{"issue":"1","key":"e_1_3_2_78_1","first-page":"52","article-title":"Empirical indicators of near-term suicide risk","volume":"11","author":"Motto JA","year":"1990","unstructured":"Motto JA, Bostrom A (1990) Empirical indicators of near-term suicide risk. Crisis 11(1): 52\u201359.","journal-title":"Crisis"},{"key":"e_1_3_2_79_1","doi-asserted-by":"publisher","DOI":"10.1111\/acps.13629"},{"key":"e_1_3_2_80_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1600-0447.1995.tb09595.x"},{"key":"e_1_3_2_81_1","doi-asserted-by":"publisher","DOI":"10.1001\/jamapsychiatry.2016.2035"},{"key":"e_1_3_2_82_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.psychres.2012.09.039"},{"key":"e_1_3_2_83_1","doi-asserted-by":"publisher","DOI":"10.1186\/1471-244X-5-32"},{"key":"e_1_3_2_84_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jad.2019.07.048"},{"key":"e_1_3_2_85_1","doi-asserted-by":"publisher","DOI":"10.1001\/archpsyc.1983.01790030019002"},{"key":"e_1_3_2_86_1","doi-asserted-by":"publisher","DOI":"10.1097\/00005053-197602000-00006"},{"key":"e_1_3_2_87_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jadr.2023.100506"},{"key":"e_1_3_2_88_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.schres.2008.12.023"},{"key":"e_1_3_2_89_1","doi-asserted-by":"publisher","DOI":"10.1017\/S0033291715001804"},{"key":"e_1_3_2_90_1","doi-asserted-by":"publisher","DOI":"10.1176\/appi.ps.201800024"},{"key":"e_1_3_2_91_1","doi-asserted-by":"publisher","DOI":"10.1300\/J079v21n04_02"},{"key":"e_1_3_2_92_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1440-1819.2011.02205.x"},{"key":"e_1_3_2_93_1","doi-asserted-by":"publisher","DOI":"10.1097\/00005053-197411000-00005"},{"key":"e_1_3_2_94_1","doi-asserted-by":"publisher","DOI":"10.1097\/00005053-199901000-00003"},{"key":"e_1_3_2_95_1","doi-asserted-by":"publisher","DOI":"10.1001\/jama.283.15.2008"},{"key":"e_1_3_2_96_1","doi-asserted-by":"publisher","DOI":"10.4088\/JCP.v63n0602"},{"key":"e_1_3_2_97_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jad.2020.02.014"},{"key":"e_1_3_2_98_1","unstructured":"Wells GA Shea B O\u2019Connell D et al. (2021) The Newcastle-Ottawa Scale (NOS) for Assessing the Quality of Nonrandomised Studies in Meta-Analyses. Available at: www.ohri.ca\/programs\/clinical_epidemiology\/oxford.asp"},{"key":"e_1_3_2_99_1","doi-asserted-by":"publisher","DOI":"10.1177\/000486740403800103"}],"container-title":["Australian &amp; New Zealand Journal of Psychiatry"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/journals.sagepub.com\/doi\/pdf\/10.1177\/00048674251348372","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/journals.sagepub.com\/doi\/full-xml\/10.1177\/00048674251348372","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/journals.sagepub.com\/doi\/pdf\/10.1177\/00048674251348372","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,9,15]],"date-time":"2026-09-15T05:21:52Z","timestamp":1789449712000},"score":1,"resource":{"primary":{"URL":"https:\/\/journals.sagepub.com\/doi\/10.1177\/00048674251348372"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,6,27]]},"references-count":98,"journal-issue":{"issue":"8","published-print":{"date-parts":[[2025,8]]}},"alternative-id":["10.1177\/00048674251348372"],"URL":"https:\/\/doi.org\/10.1177\/00048674251348372","relation":{},"ISSN":["0004-8674","1440-1614"],"issn-type":[{"value":"0004-8674","type":"print"},{"value":"1440-1614","type":"electronic"}],"subject":[],"published":{"date-parts":[[2025,6,27]]}}}