Systematic review and meta-analysis of the clinical factors associated with the suicide of psychiatric in-patients
Large, Matthew M., Smith, G. (Glen), Sharma, Swapnil, Nielssen, Olav B. and Singh, Swaran P.. (2011) Systematic review and meta-analysis of the clinical factors associated with the suicide of psychiatric in-patients. Acta Psychiatrica Scandinavica, Vol.124 (No.1). pp. 18-19. ISSN 0001690XFull text not available from this repository.
Official URL: http://dx.doi.org/10.1111/j.1600-0447.2010.01672.x
Objective: To estimate the strength of the associations between the suicide of psychiatric in-patients and demographic, historical, symptomatic, diagnostic and treatment factors. Method: A systematic review and meta-analysis of controlled studies of the suicide of psychiatric in-patients including suicides while on approved or unapproved leave. Results: Factors that were significantly associated with in-patient suicide included a history of deliberate self-harm, 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-patient suicide was weak and did not reach statistical significance after a quantitative correction for publication bias. A high-risk categorization as defined by a combination of retrospectively determined individual risk factors was strongly statistically associated with in-patient suicide (OR = 10.9), with a sensitivity of 64% and a specificity of 85%. Conclusion: Despite the apparently strong association between high-risk categorization and subsequent suicide, the low base rate of inpatient suicide means that predictive value of a high-risk 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-patients than risk assessment.
|Item Type:||Journal Article|
|Subjects:||R Medicine > R Medicine (General)
R Medicine > RC Internal medicine > RC0321 Neuroscience. Biological psychiatry. Neuropsychiatry
|Divisions:||Faculty of Medicine > Warwick Medical School > Mental Health and Wellbeing
Faculty of Medicine > Warwick Medical School
|Library of Congress Subject Headings (LCSH):||Systematic reviews (Medical research), Meta-analysis, Suicide -- Risk factors, Psychotherapy patients -- Health risk assessment|
|Journal or Publication Title:||Acta Psychiatrica Scandinavica|
|Publisher:||Wiley-Blackwell Publishing, Inc.|
|Page Range:||pp. 18-19|
|Access rights to Published version:||Restricted or Subscription Access|
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