Identifying long-term and imminent suicide predictors in a general population and a clinical sample with machine learning

被引:9
作者
Balbuena, Lloyd D. [1 ]
Baetz, Marilyn [2 ]
Sexton, Joseph Andrew [3 ]
Harder, Douglas [4 ]
Feng, Cindy Xin [5 ]
Boctor, Kerstina [1 ]
LaPointe, Candace [4 ]
Letwiniuk, Elizabeth [4 ]
Shamloo, Arash [1 ]
Ishwaran, Hemant [6 ]
John, Ann [7 ]
Brantsaeter, Anne Lise [8 ]
机构
[1] Univ Saskatchewan, Dept Psychiat, Saskatoon, SK, Canada
[2] Univ Saskatchewan, Coll Med, Saskatoon, SK, Canada
[3] Diakonhjemmet Hosp, Oslo, Norway
[4] Saskatchewan Hlth Author, Mental Hlth & Addict Serv, Saskatoon, SK, Canada
[5] Dalhousie Univ, Dept Community Hlth & Epidemiol, Halifax, NS, Canada
[6] Univ Miami, Div Biostat, Miami, FL USA
[7] Swansea Univ, Swansea Univ Med Sch, Swansea, W Glam, Wales
[8] Norwegian Inst Publ Hlth, Dept Environm Hlth, Oslo, Norway
关键词
suicide; machine learning; prediction; primary prevention; secondary prevention; MENTAL-HEALTH; PREVENTION STRATEGIES; SOCIAL DETERMINANTS; NICOTINE DEPENDENCE; PERCEIVED NEED; HELP-SEEKING; RISK-FACTORS; SMOKING; ASSOCIATION; NORWAY;
D O I
10.1186/s12888-022-03702-y
中图分类号
R749 [精神病学];
学科分类号
100205 ;
摘要
Background Machine learning (ML) is increasingly used to predict suicide deaths but their value for suicide prevention has not been established. Our first objective was to identify risk and protective factors in a general population. Our second objective was to identify factors indicating imminent suicide risk. Methods We used survival and ML models to identify lifetime predictors using the Cohort of Norway (n=173,275) and hospital diagnoses in a Saskatoon clinical sample (n=12,614). The mean follow-up times were 17 years and 3 years for the Cohort of Norway and Saskatoon respectively. People in the clinical sample had a longitudinal record of hospital visits grouped in six-month intervals. We developed models in a training set and these models predicted survival probabilities in held-out test data. Results In the general population, we found that a higher proportion of low-income residents in a county, mood symptoms, and daily smoking increased the risk of dying from suicide in both genders. In the clinical sample, the only predictors identified were male gender and older age. Conclusion Suicide prevention probably requires individual actions with governmental incentives. The prediction of imminent suicide remains highly challenging, but machine learning can identify early prevention targets.
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页数:11
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共 83 条
[1]   Permutation importance: a corrected feature importance measure [J].
Altmann, Andre ;
Tolosi, Laura ;
Sander, Oliver ;
Lengauer, Thomas .
BIOINFORMATICS, 2010, 26 (10) :1340-1347
[2]  
Amini P, 2016, IRAN J PUBLIC HEALTH, V45, P1179
[3]  
Arnett DK, 2019, CIRCULATION, V140, pE596, DOI [10.1161/CIR.0000000000000678, 10.1161/CIR.0000000000000677, 10.1016/j.jacc.2019.03.009, 10.1016/j.jacc.2019.03.010]
[4]   Independent Association of Chronic Smoking and Abstinence With Suicide [J].
Balbuena, Lloyd ;
Tempier, Raymond .
PSYCHIATRIC SERVICES, 2015, 66 (02) :186-192
[5]   Health inequalities and welfare state regimes: theoretical insights on a public health 'puzzle' [J].
Bambra, Clare .
JOURNAL OF EPIDEMIOLOGY AND COMMUNITY HEALTH, 2011, 65 (09) :740-745
[6]   Denial of illness in schizophrenia as a disturbance of self-reflection, self-perception and insight [J].
Bedford, Nicholas J. ;
David, Anthony S. .
SCHIZOPHRENIA RESEARCH, 2014, 152 (01) :89-96
[7]   Prediction Models for Suicide Attempts and Deaths: A Systematic Review and Simulation [J].
Belsher, Bradley E. ;
Smolenski, Derek J. ;
Pruitt, Larry D. ;
Bush, Nigel E. ;
Beech, Erin H. ;
Workman, Don E. ;
Morgan, Rebecca L. ;
Evatt, Daniel P. ;
Tucker, Jennifer ;
Skopp, Nancy A. .
JAMA PSYCHIATRY, 2019, 76 (06) :642-651
[8]   NCD Countdown 2030: worldwide trends in non-communicable disease mortality and progress towards Sustainable Development Goal target 3.4 [J].
Bennett, James E. ;
Stevens, Gretchen A. ;
Mathers, Colin D. ;
Bonita, Ruth ;
Rehm, Jurgen ;
Kruk, Margaret E. ;
Riley, Leanne M. ;
Dain, Katie ;
Kengne, Andre Pascal ;
Chalkidou, Kalipso ;
Beagley, Jessica ;
Kishore, Sandeep P. ;
Chen, Wanqing ;
Saxena, Shekhar ;
Bettcher, Douglas W. ;
Grove, John T. ;
Beaglehole, Robert ;
Ezzati, Majid .
LANCET, 2018, 392 (10152) :1072-1088
[9]   The Social Determinants of Health: It's Time to Consider the Causes of the Causes [J].
Braveman, Paula ;
Gottlieb, Laura .
PUBLIC HEALTH REPORTS, 2014, 129 :19-31
[10]   The Zero Suicide Model: Applying Evidence-Based Suicide Prevention Practices to Clinical Care [J].
Brodsky, Beth S. ;
Spruch-Feiner, Aliza ;
Stanley, Barbara .
FRONTIERS IN PSYCHIATRY, 2018, 9