ArticleJournal of psychiatric research2023
Risk of suicide attempts and self-harm after 1.4 million general medical hospitalizations of men with mental illness.
Article in Journal of psychiatric research, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 3 papers.
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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.
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Who cites it
3 citing papers in PubMed, 5 citations in OpenAlex.
- Individual- and population-level associations of mental disorders with intentional self-harm.European psychiatry : the journal of the Association of European Psychiatrists · 2026Article
- Clinical Education: Evaluating Depression in Patient Request for Termination of Medical Care.Journal of clinical psychology in medical settings · 2026Review
- Considerations and Challenges When Using Clinical and Vital Record Review for Suicide Research.Journal of patient safety · 2025Article
Corrections and comments
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Authors and funding
4 authors at 2 institutions in 1 country.
Funding
Abstract
backgroundThe short-term risk of suicide after medical hospital discharge is four times higher among men compared with women. As previous work has identified female-specific antecedents of suicide-related behavior after medical hospitalization of women with serious mental illness, we examined predictors among a similar population of men with multimorbidity.
methodsClassification and regression tree (CART) models were developed and validated using electronic health records (EHRs) from 1,423,161 medical (non-psychiatric) hospitalizations of men ≥ 18-years-old with an existing diagnosis of a depressive disorder, bipolar disorder, or chronic psychosis. Hospitalizations occurred between 2009 and 2017. Risk groups were evaluated using an independent testing set. The primary outcome was readmission within one year associated with ICD-9 or -10 code for self-harm or attempt.
resultsThe 1-year readmission rate for intentional self-harm and suicide attempt was 3.9% (55,337/1,423,161 hospitalizations). The classification model discriminated risk with area under the curve (AUC) 0.73 (Confidence Interval [95%CI] 0.68-0.74), accuracy 0.82 (95%CI 0.71-0.83), sensitivity 82.6% (95%CI 81.2-84), and specificity 83.1% (95%CI 81.7-84.5). Strongest predictors were medical comorbidity, prior self-harm, age, and prior hospitalization. Men with greater medical comorbidity burden and prior self-harm were at highest risk (Odds Ratio [OR] 3.10, 95%CI 3.02-3.18), as were men < 62-years-old with few medical comorbidities (OR 1.11 95%CI 1.08-1.13). LIMITATIONS: The study focused on medical hospitalizations for suicide attempt and thus captured only severe attempts resulting in hospitalization.
conclusionsAfter medical hospitalization, men with serious mental illness experienced a high risk of self-harm (1:25 hospitalizations). Risk was particularly elevated among younger patients without prior medical conditions and older patients with medical comorbidity and prior self-harm.
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