Meta-analysis of suicide rates among psychiatric in-patients

Acta Psychiatr Scand. 2015 Mar;131(3):174-84. doi: 10.1111/acps.12383. Epub 2015 Jan 5.

Abstract

Objective: To examine factors associated with the number of psychiatric admissions per in-patient suicide and the suicide rate per 100,000 in-patient years in psychiatric hospitals.

Method: Random-effects meta-analysis was used to calculate pooled estimates, and meta-regression was used to examine between-sample heterogeneity.

Results: Forty-four studies published between 1945 and 2013 reported a total of 7552 in-patient suicides. The pooled estimate of the number of admissions per suicide calculated using 39 studies reporting 150 independent samples was 676 (95% CI: 604-755). Recent studies tended to report higher numbers of admissions per suicide than earlier studies. The pooled estimate of suicide rates per 100,000 in-patient years calculated using 27 studies reporting 95 independent samples was 147 (95% CI: 138-156). Rates of suicide per 100,000 in-patient years tended to be higher in more recent samples, in samples from regions with a higher whole of population suicide rate, in samples from settings with a shorter average length of hospital stay and in studies using coronial records to define suicide.

Conclusion: Rates of in-patient suicide in psychiatric hospitals vary remarkably and are disturbingly high. Further research might clarify the extent to which patient factors and the characteristics of in-patient facilities contribute to the unacceptable mortality in psychiatric hospitals.

Keywords: in-patients; psychiatric hospitals; suicide.

Publication types

  • Meta-Analysis

MeSH terms

  • Hospitals, Psychiatric / statistics & numerical data
  • Humans
  • Inpatients / statistics & numerical data
  • Mental Disorders / epidemiology*
  • Mental Disorders / psychology*
  • Regression Analysis
  • Risk Factors
  • Suicide / psychology*
  • Suicide / statistics & numerical data*