Musgrove, R, Carr, MJ, Kapur, N, Chew-Graham, CA, Mughal, F, Ashcroft, DM and Webb, RT (2021) Suicide and other causes of death among working-age and older adults in the year after discharge from in-patient mental healthcare in England: matched cohort study. The British Journal of Psychiatry. 1 - 8. ISSN 0007-1250

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<jats:sec id="S0007125021001768_sec_a1"> <jats:title>Background</jats:title> <jats:p>Evidence for risk of dying by suicide and other causes following discharge from in-patient psychiatric care throughout adulthood is sparse.</jats:p> </jats:sec> <jats:sec id="S0007125021001768_sec_a2"> <jats:title>Aims</jats:title> <jats:p>To estimate risks of all-cause mortality, natural and external-cause deaths, suicide and accidental, alcohol-specific and drug-related deaths in working-age and older adults within a year post-discharge.</jats:p> </jats:sec> <jats:sec id="S0007125021001768_sec_a3" sec-type="methods"> <jats:title>Method</jats:title> <jats:p>Using interlinked general practice, hospital, and mortality records in the Clinical Practice Research Datalink we delineated a cohort of discharged adults in England, 2001–2018. Each patient was matched to up to 20 general population comparator patients. Cumulative incidence (absolute risks) and hazard ratios (relative risks) were estimated separately for ages 18–64 and ≥65 years with additional stratification by gender and practice-level deprivation.</jats:p> </jats:sec> <jats:sec id="S0007125021001768_sec_a4" sec-type="results"> <jats:title>Results</jats:title> <jats:p>The 1-year cumulative incidence of dying post-discharge was 2.1% among working-age adults (95% CI 2.0–2.3) and 14.1% (95% CI 13.6–14.5) among older adults. Suicide risk was particularly elevated in the first 3 months, with hazard ratios of 191.1 (95% CI 125.0–292.0) among working-age adults and 125.4 (95% CI 52.6–298.9) in older adults. Older patients were vulnerable to dying by natural causes within 3 months post-discharge. Risk of dying by external causes was greater among discharged working-age adults in the least deprived areas. Relative risk of suicide in discharged working-age women relative to their general population peers was double the equivalent male risk elevation.</jats:p> </jats:sec> <jats:sec id="S0007125021001768_sec_a5" sec-type="conclusions"> <jats:title>Conclusions</jats:title> <jats:p>Recently discharged adults at any age are at increased risk of dying from external and natural causes, indicating the importance of close monitoring and provision of optimal support to all such patients, particularly during the first 3 months post-discharge.</jats:p> </jats:sec>

Item Type: Article
Additional Information: Copyright © The Author(s), 2021. Published by Cambridge University Press on behalf of the Royal College of Psychiatrists This is an Open Access article, distributed under the terms of the Creative Commons Attribution licence (, which permits unrestricted re-use, distribution, and reproduction in any medium, provided the original work is properly cited.
Subjects: B Philosophy. Psychology. Religion > BF Psychology
R Medicine > RA Public aspects of medicine
R Medicine > RA Public aspects of medicine > RA0421 Public health. Hygiene. Preventive Medicine
R Medicine > RC Internal medicine > RC435 Psychiatry
Divisions: Faculty of Medicine and Health Sciences > School of Medicine
Depositing User: Symplectic
Date Deposited: 22 Dec 2021 12:02
Last Modified: 22 Dec 2021 12:02

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