Suicide attempts in Chinese Han patients with schizophrenia: cognitive, demographic, and clinical variables

Dai, Qilong; Wang, Dongmei; Wang, Jiesi; Xu, Huibin; Andriescue, Elena C.; Wu, Hanjing Emily; Xiu, Meihong; Chen, Dachun; Zhang, Xiang Yang

doi:10.1590/1516-4446-2020-0900

Cited by 11 publications

(3 citation statements)

References 37 publications

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“…Our finding indicated that being early in age increased the risk of all outcomes, including aggressiveness with police dispatch or violent crime, aggressiveness without police dispatch, and self-harm or suicide attempts. These results are consistent with the results of previous studies that have explored risk factors with binomial response [11,12,27,28]. The risk of adverse events for violence against others is increased for males, being consistent with those conducted by Fazel et al [29].…”

Section: Discussionsupporting

confidence: 92%

Influencing factors of multiple adverse outcomes among schizophrenia patients using count regression models: a cross-sectional study

et al. 2022

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Background Schizophrenia patients have increased risks of adverse outcomes, including violent crime, aggressiveness, and suicide. However, studies of different adverse outcomes in schizophrenia patients are limited and the influencing factors for these outcomes need clarification by appropriate models. This study aimed to identify influencing factors of these adverse outcomes by examining and comparing different count regression models. Methods This study included schizophrenia patients who had at least one follow-up record in the Guangdong Mental Health Center Network Medical System during 2020. Three types of adverse outcomes were included: a) aggressiveness with police dispatch or violent crime, b) aggressiveness without police dispatch, and c) self-harm or suicide attempts. The incidence density of these adverse outcomes was investigated using the Poisson, negative binomial (NB), zero-inflated Poisson (ZIP), and zero-inflated negative binomial (ZINB) models, accordingly. The best model was chosen based on goodness-of-fit tests. We further analyzed associations between the number of occurrences of adverse outcomes and sociodemographic, clinical factors with the best model. Results A total of 130,474 schizophrenia patients were enrolled. Adverse outcomes rates were reported to be less than 1% for schizophrenia patients in 2020, in Guangdong. The NB model performed the best in terms of goodness-of-fit and interpretation when fitting for the number of occurrences of aggressiveness without police dispatch, whereas the ZINB models performed better for the other two outcomes. Age, sex, and history of adverse outcomes were influencing factors shared across these adverse outcomes. Higher education and employment were protective factors for aggressive and violent behaviors. Disease onset aged ≥ 18 years served as a significant risk factor for aggressiveness without police dispatch, and self-harm or suicide attempts. Family history of mental diseases was a risk factor for self-harm or suicide attempts individually. Conclusions NB and ZINB models were selected for fitting the number of occurrences of adverse outcomes among schizophrenia patients in our studies. Influencing factors for the incidence density of adverse outcomes included both those shared across different types and those individual to specific types. Therefore, comprehensive and customized tools in risk assessment and intervention might be necessary.

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Section: Discussionsupporting

confidence: 92%

Influencing factors of multiple adverse outcomes among schizophrenia patients using count regression models: a cross-sectional study

et al. 2022

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“…Our nding indicated that younger age increased the risk of all outcomes, including aggressiveness with police dispatch or violent crime, aggressiveness without police dispatch, and self-harm or suicide attempts. These results are consistent with the results of other studies that have explored risk factors with binominal response [10,11,27,28]. Males increased the number of adverse events that violence against others and consistent ndings were found in other studies [29].…”

Section: Discussionsupporting

confidence: 92%

Influencing Factors of Multiple Adverse Outcomes Among Schizophrenia Patients Using Count Regression Models: A Cross-Sectional Study

Chen

Tan

Lin

et al. 2021

Preprint

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Background: Schizophrenia patients have increased risks of several adverse outcomes, including violent crime, aggressiveness and suicide. However, studies of different adverse outcomes in the same population are rare and the influencing factors for these outcomes need clarification by appropriate models. This study aimed to identify influencing factors of these adverse outcomes by examining and comparing different count regression models.Methods: This study included schizophrenia patients who had at least once follow-up record in the Guangdong Mental Health Center Network Medical System during 2020. Three types of adverse outcomes including a) aggressiveness with police dispatch or violence crime, b) aggressiveness without police dispatch, and c) self-harm or suicide attempts. First, we investigated the incidence of these adverse outcomes in each type. Second, the Poisson, negative binomial (NB), zero-inflated Poisson (ZIP), and zero-inflated negative binomial (ZINB) regression models were fitted and compared for their intensity. Finally, We analysed associations between these adverse outcomes intensity and sociodemographic, clinical factors with the best model. Results: A total of 130474 schizophrenia patients were selected. Each type of adverse outcomes was reported by less than 1% of schizophrenia patients in 2020. NB regression model is the best model for fitting the number of aggressiveness without police dispatch because of the best goodness of fit and relatively simple interpretation, whereas ZINB models for the other two outcomes. Age, sex, and history of adverse outcomes were influencing factors shared across these adverse outcomes. Higher educational level, employment were protective factors shared between aggressiveness with police dispatch or violent crime , and aggressiveness without police dispatch. Aggressiveness without police dispatch , and self-harm or suicide attempts shared older onset age (≥18 years) as a risk factor. Family history of mental disease was a risk factor of self-harm or suicide attempts individually.Conclusions: NB and ZINB models were selected for fitting the number of adverse outcomes in our studies. Influencing factors for adverse outcomes intensity included both those shared across different types and those individual to specific types. Therefore, combined and customized tools in risk assessment and intervention for different types of these outcomes might be necessary.

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“…Recently, Chang et al ( 68 ) showed that a longer illness duration was one predictor of lifetime suicide attempts in a sample of 263 patients with schizophrenia. Dai et al ( 83 ) replicated this result by comparing 908 patients with schizophrenia with suicide attempts to those without suicide.…”

Section: Suicide Risk Status In Schizophreniamentioning

confidence: 92%

The Importance of Suicide Risk Formulation in Schizophrenia

et al. 2021

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Suicide is a cause of early mortality in nearly 5% of patients with schizophrenia, and 25–50% of patients with schizophrenia attempt suicide in their lifetime. Evidence points to numerous individual, clinical, social, and psychological risk factors for suicide in patients with schizophrenia. Although recognizing suicidal risk factors in schizophrenia is extremely important in suicidal risk assessment, we have recently witnessed a change in suicide risk management that shifts the focus from suicide risk assessment to suicide risk formulation. Suicide risk formulation is dependent on the data gathered in the suicide risk assessment and assigns a level of suicide risk that is indispensable for the choice of treatment and the management of patients with a high suicidal risk. In this article, we extend the suicide risk formulation model to patients with schizophrenia. Suicide risk formulation results from four different areas that help clinicians collect as much information as possible for the management of suicidal risk. The four distinct judgments comprise risk status (the risk relating to the specific group to which the patient belongs), risk state (the risk for the person compared with his baseline or another reference point in the course of his life), available resources (on whom the person can count during a crisis) and foreseeable events (which can exacerbate the crisis). In schizophrenia, the suicide risk formulation model allows the clinician to evaluate in depth the clinical context of the patient, the patient's own history and patient-specific opportunities for better choosing and applying suicide prevention strategies.

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Suicide attempts in Chinese Han patients with schizophrenia: cognitive, demographic, and clinical variables

Cited by 11 publications

References 37 publications

Influencing factors of multiple adverse outcomes among schizophrenia patients using count regression models: a cross-sectional study

Influencing factors of multiple adverse outcomes among schizophrenia patients using count regression models: a cross-sectional study

Influencing Factors of Multiple Adverse Outcomes Among Schizophrenia Patients Using Count Regression Models: A Cross-Sectional Study

The Importance of Suicide Risk Formulation in Schizophrenia

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