Identifying clinical risk factors correlate with suicide attempts in patients with first episode major depressive disorder

被引:18
作者
Li, Xiao-Yan [1 ]
Tabarak, Serik [2 ,3 ,4 ]
Su, Xiu-Ru [1 ]
Qin, Zengchang [6 ]
Chai, Yuan [6 ]
Zhang, Shunyu [6 ]
Wang, Ke-Qiang [1 ]
Guan, Heng-Yong [1 ]
Lu, Shu-Lan [1 ]
Chen, Ying-Nan [1 ]
Chen, Hong-Mei [1 ]
Zhao, Long [1 ]
Lu, Yan-Xin [1 ]
Li, Su-Xia [4 ,5 ]
Zhang, Xiang-Yang [7 ,8 ]
机构
[1] Rong Jun Hosp, Baoding 071000, Hebei, Peoples R China
[2] Peking Univ, Peking Tsinghua Ctr Life Sci, Beijing, Peoples R China
[3] Peking Univ, McGovern Inst Brain Res, PKU IDG, Beijing, Peoples R China
[4] Peking Univ, Natl Inst Drug Dependence, Beijing Key Lab Drug Dependence, Beijing, Peoples R China
[5] Peking Univ, Sch Basic Med Sci, Dept Pharmacol, Hlth Sci Ctr, Beijing, Peoples R China
[6] Beihang Univ, Sch Automat Sci & Elect Engn, Intelligent Comp & Machine Learning Lab, Beijing 100191, Peoples R China
[7] Chinese Acad Sci, Inst Psychol, CAS Key Lab Mental Hlth, 16 Lincui Rd, Beijing 100101, Peoples R China
[8] Univ Chinese Acad Sci, Dept Psychol, Beijing, Peoples R China
关键词
Major depressive disorder; Suicide attempt; Risk factor; Machine learning; XG-boost; TOWER-OF-BABEL; 1ST-EPISODE PSYCHOSIS; MENTAL-DISORDERS; FOLLOW-UP; BEHAVIOR; NOMENCLATURE; PREDICTORS; MODEL; OPUS;
D O I
10.1016/j.jad.2021.08.028
中图分类号
R74 [神经病学与精神病学];
学科分类号
摘要
Background: Major depressive disorder (MDD) is the most common mental disorder associated with suicide attempts. When a patient first visits the clinic, clinicians are often expected to make concrete diagnose about acute suicidal risk. However, the timeliness of suicide attempts correlates with patients with MDD has not been tested. Methods: We divided 1718 first-episode and untreated MDD outpatients into those who did not have suicide attempts (non-attempts), recent suicide attempters (<= 14 days before assessment) and long - dated suicide attempters (> 30 days before assessment). Positive Symptom Scale of Positive and Negative Syndrome Scale (PANSS), the 17-item Hamilton Depression Scale, 14 - item Hamilton Anxiety Scale, and clinical global impression of severity scale (CGI-S) was assessed. Body mass index, some glycolipid metabolism and thyroid hormone parameters were measured. A gradient-boosted decision trees statistical model was used to generate equally weighted classification for distinguishing recent and long - dated suicide attempters from non-attempts. Results: The classifier identified higher excitement, hostility, anxiety, depression symptoms and higher free thyroxine (FT4) as risk factors for recent suicide attempters with an estimated accuracy of 87% (sensitivity, 59.1%; specificity, 61.2 %). For long - dated suicide attempters' risk factors, single status, higher anxiety and hostility symptoms, higher LDLC and lower BMI, the estimated accuracy was 88% (sensitivity, 52.8%; specificity, 49.6%). Conclusions: Risk factors for suicide attempt among patients with MDD can be identified by integrating demographic, clinical, and biological variables as early as possible during the first time see a doctor.
引用
收藏
页码:264 / 270
页数:7
相关论文
共 32 条
[1]  
American Association of Suicidology (AAS), 2019, WARN SIGNS SUIC
[2]  
Bahls Saint-Clair, 2004, Braz. J. Psychiatry, V26, P41, DOI 10.1590/S1516-44462004000100012
[3]  
Baskin HJ., 2002, Endocrine practice : official journal of the American College of Endocrinology and the American Association of Clinical Endocrinologists, V8, P457, DOI 10.4158/1934-2403-8.6.457
[4]   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
[5]   Suicidal behaviour and mortality in first-episode psychosis: the OPUS trial [J].
Bertelsen, Mette ;
Jeppesen, Pia ;
Petersen, Lone ;
Thorup, Anne ;
Ohlenschlaeger, Johan ;
Le Quack, Phuong ;
Christensen, Torben Ostergaard ;
Krarup, Gertrud ;
Jorgensen, Per ;
Nordentoft, Merete .
BRITISH JOURNAL OF PSYCHIATRY, 2007, 191 :S140-S146
[7]   Warning signs for suicide within a week of healthcare contact in Veteran decedents [J].
Britton, Peter C. ;
Ilgen, Mark A. ;
Rudd, M. David ;
Conner, Kenneth R. .
PSYCHIATRY RESEARCH, 2012, 200 (2-3) :395-399
[8]  
Caruana R., 2006, EMPIRICAL COMP SUPER
[9]   Suicide risk in major affective disorder: Results from a national survey in China [J].
Chen, Lin ;
Liu, Yan-Hong ;
Zheng, Qi-Wen ;
Xiang, Yu-Tao ;
Duan, Yan-ping ;
Yang, Fu-de ;
Wang, Gang ;
Fang, Yi-Ru ;
Lu, Zheng ;
Yang, Hai-Chen ;
Hu, Jian ;
Chen, Zhi-Yu ;
Huang, Yi ;
Sun, Jing ;
Wang, Xiao-Ping ;
Li, Hui-Chun ;
Zhang, Jin-Bei ;
Chen, Da-Fang ;
Si, Tian-Mei .
JOURNAL OF AFFECTIVE DISORDERS, 2014, 155 :174-179
[10]  
Conwell Y, 1996, AM J PSYCHIAT, V153, P1001