Combining scales to assess suicide risk

Abstract

Esta es la versión de autor del artículo publicado en: This is an author produced version of a paper published in: El acceso a la versión del editor puede requerir la suscripción del recurso Access to the published version may require subscription Dear Author, Please check your proof carefully and mark all corrections at the appropriate place in the proof (e.g., by using on-screen annotation in the PDF file) or compile them in a separate list. Note: if you opt to annotate the file with software other than Adobe Reader then please also highlight the appropriate place in the PDF file. To ensure fast publication of your paper please return your corrections within 48 hours.For correction or revision of any artwork, please consult http://www.elsevier.com/artworkinstructions.Any queries or remarks that have arisen during the processing of your manuscript are listed below and highlighted by flags in the proof. Location in articleQuery / Remark: Click on the Q link to find the query's location in text Please insert your reply or correction at the corresponding line in the proof Q1The citations 'Patton JH, 1995; Efron B., 2004' have been changed to match the author name in the reference list. Please check and correct if necessary. Q2Please note that the funding details provided under the 'Role of funding source' and 'Acknowledgments' were similar. Hence the section 'Role of funding source' is not retained. Kindly check and amend if necessary. Q3Please check the expanded journal titles in references. Q4Please provide an update for reference "Delgado-Gomez et al., in press". Q5Please check the layout of Table 3, and correct if necessary. Q6Please confirm that given names and surnames have been identified correctly. a b s t r a c tObjectives: A major interest in the assessment of suicide risk is to develop an accurate instrument, which could be easily adopted by clinicians. This article aims at identifying the most discriminative items from a collection of scales usually employed in the assessment of suicidal behavior. Methods: The answers to the Barrat Impulsiveness Scale, International Personality Disorder Evaluation Screening Questionnaire, BrowneGoodwin Lifetime History of Aggression, and Holmes & Rahe Social Readjustment Rating Scale provided by a group of 687 subjects (249 suicide attempters, 81 non-suicidal psychiatric inpatients, and 357 healthy controls) were used by the Lars-en algorithm to select the most discriminative items. Results: We achieved an average accuracy of 86.4%, a specificity of 89.6%, and a sensitivity of 80.8% in classifying suicide attempters using 27 out of the 154 items from the original scales. Conclusions:The 27 items reported here should be considered a preliminary step in the development of a new scale evaluating suicidal risk in settings where time is scarce.

Horror Vacui: Emptiness Might Distinguish between Major Suicide Repeaters and Nonmajor Suicide Repeaters: A Pilot Study

“…SBs may also function as a means of generating feelings. Emptiness, which is one of the factors of the Orbach and Mikulincer Mental Pain questionnaire [6], is considered a relevant factor influencing the occurrence of SBs [9,10]. This study extends our previous findings by suggesting that emptiness appears to be particularly relevant as a reason for SB for major repeaters.…”

Triglycerides as a biological marker of repeated re-hospitalization resulting from deliberate self-harm in acute psychiatry patients: a prospective observational study

“…However, acute settings are characterized by time pressure and high patient turnover. Screening instruments, such as the MINI Suicidal Scale, have been shown to help identify patients at risk for self-harm [3], and a 27-item scale based on 154 items from a collection of suicidal assessment instruments showed promise for the development of a new scale evaluating suicidal risk in settings in which time is limited [4]. …”

Predicting Suicidal Behavior: Are We Really that Far Along? Comment on “Discovery and Validation of Blood Biomarkers for Suicidality”

“…The low base rate of attempted and completed suicide [4], and the relatively poor performance of models based on a restricted number of variables [5] are major difficulties in the prediction of suicidal behavior. To date, clinical factors (notably depression and alcoholism), previous suicide attempts, and life events are among the best predictive factors for suicidal behavior [6–8].…”

“…Previous models have achieved better results in classifying suicide attempters just using the most discriminant items from four assessment scales and socio-demographic factors (AUC=0.92) [5]. For a biomarker to be clinically useful, it must have high sensitivity (>90%) and specificity (>90%) [13].…”

“…Among other pending tasks in suicidal research, clinicians can refine known endophenotypes for suicidal behavior, such as impulsive aggression traits or psychological pain, to facilitate the identification of expressed genes that are associated with them. Predicting suicidal behavior can also be enhanced by selecting the most discriminant variables [5], using predictors from different domains (clinical, neurobiological and cognitive) [18], and by applying novel methodological instruments such as data mining [19]. For the time being, we should remember that several strategies, such as assuring aggressive treatment for depression [20] and continuity of care to prevent relapses [21] may successfully reduce suicide rates, until such time as we reach the goal of predicting future suicide events.…”