Evidence map›Paper›PMID 35514090›Full record

ArticleEpidemiology and psychiatric sciences2022

Suicide and death by other causes among patients with a severe mental illness: cohort study comparing risks among patients discharged from inpatient care

R Musgrove, M J Carr, N Kapur, C A Chew-Graham, F Mughal, D M Ashcroft, R T Webb

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In one paragraph

Article in Epidemiology and psychiatric sciences, 2022. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 4 papers.

0numbers the graph read from it
0cells of the map it votes in
4citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

4 citing papers in PubMed.

  1. Article
  2. Survival following psychiatric diagnoses in early adulthood.The Australian and New Zealand journal of psychiatry · 2025
    Article
  3. Article
  4. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

7 authors.

R MusgroveNIHR Greater Manchester Patient Safety Translational Research Centre, Centre for Mental Health and Safety, Manchester Academic Health Science Centre, The University of Manchester, Manchester, UK.ORCID https://orcid.org/0000-0003-1227-2057
M J CarrNIHR Greater Manchester Patient Safety Translational Research Centre, Centre for Pharmacoepidemiology and Drug Safety, Manchester Academic Health Science Centre, The University of Manchester, Manchester, UK.
N KapurNIHR Greater Manchester Patient Safety Translational Research Centre, Centre for Mental Health and Safety, Manchester Academic Health Science Centre, The University of Manchester and Greater Manchester Mental Health NHS Foundation Trust, Manchester, UK.
C A Chew-GrahamSchool of Medicine, Keele University, Keele, UK.
F MughalSchool of Medicine, Keele University, Keele, UK; NIHR Greater Manchester Patient Safety Translational Research Centre, University of Manchester, Manchester, UK and Unit of Academic Primary Care, University of Warwick, Coventry, UK.ORCID https://orcid.org/0000-0002-5437-5962
D M AshcroftNIHR Greater Manchester Patient Safety Translational Research Centre, Centre for Pharmacoepidemiology and Drug Safety, Manchester Academic Health Science Centre, The University of Manchester, Manchester, UK.
R T WebbNIHR Greater Manchester Patient Safety Translational Research Centre, Centre for Mental Health and Safety, Manchester Academic Health Science Centre, The University of Manchester, Manchester, UK.

Funding

Department of Health PSTRC-2016-003NIHR Applied Research Collaboration, West MidlandsNIHR Doctoral FellowshipNIHR Greater Manchester Patient Safety Translational Research Centre
6 · The paper itself

Abstract

aimsPeople diagnosed with a severe mental illness (SMI) are at elevated risk of dying prematurely compared to the general population. We aimed to understand the additional risk among people with SMI after discharge from inpatient psychiatric care, when many patients experience an acute phase of their illness.

methodsIn the Clinical Practice Research Datalink (CPRD) GOLD and Aurum datasets, adults aged 18 years and older who were discharged from psychiatric inpatient care in England between 2001 and 2018 with primary diagnoses of SMI (schizophrenia, bipolar disorder, other psychoses) were matched by age and gender with up to five individuals with SMI and without recent hospital stays. Using survival analysis approaches, cumulative incidence and adjusted hazard ratios were estimated for all-cause mortality, external and natural causes of death, and suicide. All analyses were stratified by younger, middle and older ages and also by gender.

resultsIn the year after their discharge, the risk of dying by all causes examined was higher than among individuals with SMI who had not received inpatient psychiatric care recently. Suicide risk was 11.6 times (95% CI 6.4-20.9) higher in the first 3 months and remained greater at 2-5 years after discharge (HR 2.3, 1.7-3.2). This risk elevation remained after adjustment for self-harm in the 6 months prior to the discharge date. The relative risk of dying by natural causes was raised in the first 3 months (HR 1.6, 1.3-1.9), with no evidence of elevation during the second year following discharge.

conclusionsThere is an additional risk of death by suicide and natural causes for people with SMI who have been recently discharged from inpatient care over and above the general risk among people with the same diagnosis who have not recently been treated as an inpatient. This mortality gap shows the importance of continued focus, following discharge, on individuals who require inpatient care.

Indexed as

Mental DisordersSuicideAdultCohort StudiesHumansInpatientsPatient Dischargecommunity mental healthEpidemiologyinpatient psychiatryschizophreniasuicide

Identifiers

PMID35514090
PMCPMC7612694

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