OBJECTIVE Postdischarge from inpatient psychiatry is the highest risk period for suicide, thus better understanding the predictors of death by suicide during this time is critical for improving mortality rates after inpatient psychiatric treatment. As such, we sought to determine whether there were predictable patterns in suicide ideation in hospitalized psychiatric patients. METHOD We examined a sample of 2,970 adult's ages 18-87 admitted to an extended length of stay (LOS) inpatient psychiatric hospital. We used group-based trajectory modeling via the SAS macro PROC TRAJ to quantitatively determine four suicide ideation groups: nonresponders (i.e., high suicide ideation throughout treatment), responders (i.e., steady improvement in suicide ideation across treatment), resolvers (i.e., rapid improvement in suicide ideation across treatment), and no-suicide ideation (i.e., never significant suicide ideation in treatment). Next, we compared groups to clinical and suicide-specific outcomes, including death by suicide. RESULTS Resolvers were the most likely to die by suicide postdischarge relative to all other suicide ideation groups. Resolvers also demonstrated significant improvement in all clinical outcomes from admission to discharge. CONCLUSION There are essential inpatient psychiatry clinical implications from this work, including that clinical providers should not be lulled into a false sense of security when hospitalized adults rapidly improve in terms of suicide ideation. Instead, inpatient psychiatric treatment teams should increase caution regarding the patient's risk level and postdischarge treatment planning. (PsycInfo Database Record (c) 2022 APA, all rights reserved).

中文翻译：

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错误的安全感：快速改善是自杀身亡的危险信号。

目的 精神科住院出院后是自杀风险最高的时​​期，因此更好地了解这段时间自杀死亡的预测因素对于提高住院精神科治疗后的死亡率至关重要。因此，我们试图确定住院精神病患者的自杀意念是否存在可预测的模式。方法 我们检查了 2,970 名年龄在 18-87 岁之间的成年人的样本，这些成年人入住了延长住院时间 (LOS) 的精神病院。我们通过 SAS 宏 PROC TRAJ 使用基于组的轨迹建模来定量确定四个自杀意念组：无反应者（即在整个治疗过程中自杀意念高）、反应者（即在整个治疗过程中自杀意念稳步改善）、解决者（即快速治疗期间自杀意念的改善），和无自杀意念（即在治疗中从未有过明显的自杀意念）。接下来，我们将各组与临床和自杀特异性结果进行比较，包括自杀死亡。结果 与所有其他自杀意念组相比，解决者出院后最有可能死于自杀。解决者还表现出从入院到出院的所有临床结果都有显着改善。结论 这项工作对住院精神病学有重要的临床意义，包括当住院的成年人在自杀意念方面迅速改善时，临床提供者不应陷入虚假的安全感。相反，住院精神科治疗团队应提高对患者风险水平和出院后治疗计划的谨慎态度。（PsycInfo 数据库记录 (c) 2022 APA，保留所有权利）。