A multivariate study of predictors of repeat parasuicide

Colman, Ian; Newman, Stephen C.; Schopflocher, Don; Bland, Roger; Dyck, Ronald J.

doi:10.1111/j.1600-0447.2003.00282.x

Cited by 47 publications

(66 citation statements)

References 34 publications

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“…These include socio-demographic factors such as age (Christiansen and Jensen, 2007;Corcoran et al, 2004), unemployment (Tejedor et al, 1999), not being married (Kreitman and Foster, 1991) or low educational level (Christiansen and Jensen, 2007) which have been associated with repetition of suicidal behaviour (Osvath et al, 2003). Clinical factors include lethality of the index attempt (Gibb et al, 2005), poor physical health (Colman et al, 2004), and mental illness or psychiatric comorbidity, which has been noted to be a risk factor for repetition in studies on parasuicides (Colman et al, 2004;Osvath et al, 2003), non-fatal suicidal behaviours (Kapur et al, 2006) and SAs among inpatients (Spiessl et al, 2002).…”

Section: Introductionmentioning

confidence: 99%

“…To date, most studies addressing the prediction of suicide re-attempts have used no measures of predictive accuracy (Bille-Brahe et al, 1997;Cedereke and Ojehagen, 2005;Colman et al, 2004;Morton, 1993;Sidley et al, 1999), limiting the clinical utility of their findings (Galfalvy et al, 2008). However, when the precision of the prediction is measured, the results are disappointing, finding roughly 39% sensitivity and 86% specificity in a study of socio-demographic risk factors of parasuicide (Kreitman and Foster, 1991), 28% sensitivity and 99% specificity in a sample of children after deliberate self-harm (Chitsabesan et al, 2003), or 85e94% sensitivity and 26e38% specificity when assessing self-harm in emergency settings (Cooper et al, 2007).…”

Section: Introductionmentioning

confidence: 99%

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Distinguishing the relevant features of frequent suicide attempters

López-Castromán

Perez‐Rodriguez

Jaussent

et al. 2011

Journal of Psychiatric Research

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a b s t r a c tBackground: In spite of the high prevalence of suicide behaviours and the magnitude of the resultant burden, little is known about why individuals reattempt. We aim to investigate the relationships between clinical risk factors and the repetition of suicidal attempts. Methods: 1349 suicide attempters were consecutively recruited in the Emergency Room (ER) of two academic hospitals in France and Spain. Patients were extensively assessed and demographic and clinical data obtained. Data mining was used to determine the minimal number of variables that blinded the rest in relation to the number of suicide attempts. Using this set, a probabilistic graph ranking relationships with the target variable was constructed. Results: The most common diagnoses among suicide attempters were affective disorders, followed by anxiety disorders. Risk of frequent suicide attempt was highest among middle-aged subjects, and diminished progressively with advancing age of onset at first attempt. Anxiety disorders significantly increased the risk of presenting frequent suicide attempts. Pathway analysis also indicated that frequent suicide attempts were linked to greater odds for alcohol and substance abuse disorders and more intensive treatment. Conclusions: Novel statistical methods found several clinical features that were associated with a history of frequent suicide attempts. The identified pathways may promote new hypothesis-driven studies of suicide attempts and preventive strategies.

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Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Distinguishing the relevant features of frequent suicide attempters

López-Castromán

Perez‐Rodriguez

Jaussent

et al. 2011

Journal of Psychiatric Research

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“…2 These assessments are difficult owing to the lack of valid and reliable suicidal or future self-harm scales, the low rate of suicide even in high-risk groups, and because many of these patients provide inaccurate information to physicians. [3][4][5][6] There has been research on risk factors [7][8][9][10] and the use of psychometric tools 5,[11][12][13][14] in the prediction of suicide and self-harm. Research on this subject has been undertaken, evaluating psychometric evaluation of depression, 15 hopelessness, 15,16 and various suicide-specific questionnaires.…”

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confidence: 99%

Emergency Department Assessment of Self-Harm Risk Using Psychometric Questionnaires

2012

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Objective: To examine several potential predictive screening tools for emergency department assessment of risk of self-harm. Methods:Adult patients presenting with self-harm or suicidal ideation were enrolled at 2 emergency departments at large teaching hospitals in Edmonton, Alberta. Patients completed a brief interview assessing demographics and psychiatric history and several questionnaires (the Beck Hopelessness Scale, the Barrett Impulsiveness Scale [BIS], and the Brief Symptom Inventory [BSI]) and drug and alcohol abuse screens (Drug Abuse Screening Test and the Cut down, Annoyed, Guilt, Eye-opener [commonly referred to as CAGE] Questionnaire). At 3 months, patients were followed up via telephone and electronic health records to ascertain self-harm outcome. Questionnaires and their subscales were assessed using logistic regression. Receiver operating characteristic (ROC) analysis was performed on the results. Results:Among the 157 patients enrolled, 49% were women and 36% (of the total) were aged 18 to 29 years. Several of the subscales of the BSI and BIS as well as the DAST-10 were significant predictors of self-harm (P < 0.05). ROC analysis showed that none of the scales in isolation were very strong predictors. Hierarchical regression analysis that combined the significant scales with clinical risk factors that were significantly related to self-harm (that is, age, education level, history of self-harm, and whether they presented with self-harm or only suicidal ideation) indicated that the BIS and DAST-10 questionnaires each added significantly to the predictive ability of a model with these risk factors.Conclusions: While many of the questionnaires and their related constructs are related to future self-harm, none of them are particularly strong and their diagnostic usefulness is limited. W W WObjectif : Examiner plusieurs instruments de dépistage prédictifs potentiels pour l'évaluation au service d'urgence du risque d'automutilation. Résultats :Parmi les 157 patients inscrits, 49 % étaient des femmes et 36 % (du total) étaient âgés de 18 à 29 ans. Plusieurs des sous-échelles du BSI et de la BIS ainsi que du DAST-10 étaient des prédicteurs significatifs de l'automutilation (P < 0,05). L'analyse ROC a indiqué qu'aucune des échelles en isolation n'était un prédicteur très fort. L'analyse de régression hiérarchique qui combinait les échelles significatives avec les facteurs de risque cliniques significativement liés à l'automutilation (c'est-à-dire, l'âge, le niveau d'instruction, les antécédents d'automutilation, et s'ils présentaient de l'automutilation ou seulement une idéation suicidaire) indiquait que les questionnaires BIS et DAST-10 ajoutaient chacun significativement à la capacité prédictive d'un modèle avec ces facteurs de risque.

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“…Individuals who intentionally injure themselves often suffer from a variety of problems such as depression, personality disorder, situational crises, abuse, and financial difficulties (Dyck et al 1988; Thompson and Bland 1995;Suominen et al 1996;Goldney 2002;Morgan et al 1975;Colman et al 2004a), are intensive consumers of healthcare resources (Colman et al 2004b), and are at high risk of further self-inflicted injuries and completed suicide (Harris and Barraclough 1998;Owens et al 2002). The detection of clusters of self-inflicted injuries is important from a public health perspective to better focus suicide prevention strategies.…”

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confidence: 99%

Comparison of cluster detection using patients and events of medically treated self-inflicted injuries in Alberta, Canada

Rosychuk

Colman

Rowe

2009

Health Serv Outcomes Res Method

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Geographic regions may be routinely evaluated for high rates of disease through statistical cluster detection tests. Areas with statistically higher rates can be targeted for further epidemiological study and possible interventions. Generally these tests are performed on incident or prevalent cases of a disease, and are not necessarily applicable to the health services context. We examine a new method appropriate for health services data and introduce this new method to health services researchers through a case study of selfinflicted injury presentations to emergency departments (EDs). We consider spatial clustering with two approaches. A case-based method uses only the number of patients whereas an event-based method uses the number of patients and the number of ED presentations. Analyses are adjusted by the age and gender distribution and restricted to a sub-group of the population. Several potential clusters are identified within each method. The case-based method identifies 10 geographic areas with statistically higher numbers of individuals seeking ED care and the event-based method identifies nine geographic areas with statistically higher numbers of ED presentations. These potential clusters are not likely to have occurred by chance alone, given the age and gender distribution. The two testing procedures illustrate different aspects of the data: individuals and presentations. The potential clusters based on individual cases suggest areas that may need special intervention programs and services. The clustering of presentations may represent areas that require increased provision of health services.

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A multivariate study of predictors of repeat parasuicide

Abstract: This study identifies four key predictors of repeat parasuicide, and provides evidence that the risk of repeat parasuicide increases when multiple risk factors are present.

Cited by 47 publications

References 34 publications

Distinguishing the relevant features of frequent suicide attempters

Distinguishing the relevant features of frequent suicide attempters

Emergency Department Assessment of Self-Harm Risk Using Psychometric Questionnaires

Comparison of cluster detection using patients and events of medically treated self-inflicted injuries in Alberta, Canada

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