Suicide Risk Among Hospitalized Versus Discharged Deliberate Self-Harm Patients: Generalized Random Forest Analysis Using a Large Claims Data Set

2021 ◽  
Author(s):  
Sidra J. Goldman-Mellor ◽  
Harish S. Bhat ◽  
Michael H. Allen ◽  
Michael Schoenbaum
Keyword(s):  
Random Forest ◽  
Suicide Risk ◽  
Claims Data ◽  
Data Set ◽  
Deliberate Self Harm ◽  
Random Forest Analysis ◽  
Self Harm

scholarly journals Repetition of deliberate self-harm and subsequent suicide risk: Long-term follow-up study of 11 583 patients

2004 ◽  
Vol 185 (1) ◽  
pp. 70-75 ◽  
Author(s):  
Daniel Louis Zahl ◽  
Keith Hawton
Keyword(s):  
Relative Risk ◽  
Suicide Risk ◽  
Single Episode ◽  
Deliberate Self Harm ◽  
Young Females ◽  
Follow Up Study ◽  
Increased Risk ◽  
Self Harm

BackgroundRepetition of deliberate self-harm (DSH) is a risk factor for suicide. Little information is available on the risk for specific groups of people who deliberately harm themselves repeatedly.AimsTo investigate the long-term risk of suicide associated with repetition of DSH by gender, age and frequency of repetition.MethodA mortality follow-up study to the year 2000 was conducted on 11583 people who presented to the general hospital in Oxford between 1978 and 1997. Repetition of DSH was determined from reported episodes prior to the index episode and episodes presenting to the same hospital during the follow-up period. Deaths were identified through national registers.ResultsThirty-nine percent of patients repeated the DSH. They were at greater relative risk of suicide than the single-episode DSH group (2.24; 95% CI 1.77–2.84). The relative risk of suicide in the repeated DSH group compared with the single-episode DSH group was greater in females (3.5; 95% C11.3–2.4) than males (1.8; 95% C1 2.3–5.3) and was inversely related to age (up to 54 years). Suicide risk increased further with multiple repeat episodes of DSH in females.ConclusionsRepetition of DSH is associated with an increased risk of suicide in males and females. Repetition may be a better indicator of risk in females, especially young females.

Psychiatry

2012 ◽  
pp. 601-629
Author(s):  
Jonathan P. Wyatt ◽  
Robin N. Illingworth ◽  
Colin A. Graham ◽  
Kerstin Hogg ◽  
Michael J. Clancy ◽  
...  
Keyword(s):  
Mental State ◽  
Suicide Risk ◽  
Psychiatric Interview ◽  
Deliberate Self Harm ◽  
Self Harm ◽  
State Examination ◽  
Psychiatric Problems

Approach to psychiatric problems 602 Glossary of psychiatric terms 603 The psychiatric interview 604 Mental state examination 606 The aggressive patient: background 608 Safe consultations with potentially violent patients 609 Managing aggression 610 Emergency sedation of a violent patient 611 Deliberate self-harm 612 Assessment of suicide risk ...

Factors that influence emergency department doctors?? assessment of suicide risk in deliberate self-harm patients

2003 ◽  
Vol 10 (4) ◽  
pp. 283-287 ◽  
Author(s):  
Jayne B. Cooper ◽  
Martin P. Lawlor ◽  
Urara Hiroeh ◽  
Navneet Kapur ◽  
Louis Appleby
Keyword(s):  
Emergency Department ◽  
Suicide Risk ◽  
Deliberate Self Harm ◽  
Self Harm

Summary Australian and New Zealand Clinical Practice Guideline for the Management of Adult Deliberate Self-Harm (2003)

2003 ◽  
Vol 11 (2) ◽  
pp. 150-155 ◽  
Author(s):  
Philip Boyce ◽  
Greg Carter ◽  
Jonine Penrose-Wall ◽  
Kay Wilhelm ◽  
Robert Goldney
Keyword(s):  
Clinical Practice ◽  
New Zealand ◽  
Mental Disorders ◽  
Clinical Practice Guideline ◽  
Practice Guideline ◽  
Suicide Risk ◽  
Deliberate Self Harm ◽  
Self Harm ◽  
Axis I ◽  
Drug Problems

Objective: To provide a summary of the Royal Australian and New Zealand College of Psychiatrists (RANZCP) Clinical Practice Guideline for the Management of Deliberate Self-Harm. Conclusions: This guideline covers self-harm regardless of intent. It is an evidence-based guideline developed from a systematic review of epidemiological, treatment and medico-legal literature. All patients presenting to hospital after deliberate self-harm should be comprehensively assessed to detect and treat the high rates of mental disorders, alcohol and other drug problems and personality disorders in this group. General hospital management aims to ensure safety from further self-harm, assess and treat injuries; prevent disablement and death as a result of injuries or poisoning and manage suicide risk by ensuring prompt psychiatric referral and mobilizing social supports. Psychological management aims to detect and treat underlying mental disorders, reduce distress and enhance coping skills and thereby, reduce repeat episodes and habituation of self-harm. Managing suicide risk is a continuous responsibility and suicide vulnerability may persist long-term in some patients. There is little firm guidance from the literature on treatment efficacy to guide ongoing psychiatric management. Studies are often compromised because between 41 and 70% of patients do not attend follow up. The mainstay of psychological care remains the treatment of underlying Axis I and Axis II disorders. Cognitive-behavioural therapy (CBT) and problem-orientated approaches appear promising for reducing repeated self-harm for most patient groups but no single treatment has confirmed superiority. Dialectical behaviour therapy (DBT) appears to confer most benefit. Self-harm may follow some forms of in-depth therapy in some vulnerable individuals. There is no one recommended pharmacological treatment specifically to reduce self-harming behaviours. Lithium may have antiself-harm properties for some groups with bipolar disorder. There is emerging evidence for selfharm reduction using clozapine for patients with schizophrenia and schizoaffective disorder.

Thirteen-year follow-up of deliberate self-harm, using linked data

1998 ◽  
Vol 172 (3) ◽  
pp. 239-242 ◽  
Author(s):  
David J. Hall ◽  
Fiona O'Brien ◽  
Cameron Stark ◽  
Antony Pelosi ◽  
Helen Smith
Keyword(s):  
Linked Data ◽  
Attempted Suicide ◽  
Alcohol Misuse ◽  
Median Number ◽  
Contributory Factor ◽  
Data Set ◽  
General Hospitals ◽  
Deliberate Self Harm ◽  
Self Harm

BackgroundWe describe a national cohort of individuals surviving an episode of deliberate self-harm (DSH). Subsequent admissions for DSH and mortality over the following 13 years were studied.MethodIn 1981, 8304 individuals were discharged from Scottish general hospitals with a diagnosis of attempted suicide (E950–959). They were followed-up to the end of 1994 using the Scottish Linked Data Set. Mortality was compared to the Scottish population using person-years analysis.Results2624 people (31.6%) were readmitted with further episodes of DSH. The median number of readmissions was I, range 1–137. The observed: expected ratio for all-cause mortality was 2.26 (95% CI 2.13–2.26). One hundred and sixty-eight people (2%) died from suicide, and 46 (0.6%) from undetermined causes. The observed: expected ratio for suicide plus undetermined deaths was 12.17 (95% CI 10.64-13.91). Accidental deaths in men and homicide deaths in men and women were elevated. The pattern of deaths from other causes suggested that alcohol misuse was a contributory factor.ConclusionsPeople admitted to general hospitals in Scotland after attempted suicide are at high risk of readmission for further episodes of DSH. Long-term follow-up of such large cohorts is impractical, but services should review the scope for intervention in alcohol misuse following DSH.

A systematic review of efficacy of Collaborative Assessment and Management of Suicidality (CAMS) in managing suicide risk and deliberate self-harm in adult populations

2019 ◽  
Vol 27 (6) ◽  
pp. 559-564 ◽  
Author(s):  
Donal Hanratty ◽  
Jan Kilicaslan ◽  
Helen Wilding ◽  
David Castle
Keyword(s):  
Systematic Review ◽  
Suicide Risk ◽  
Limited Evidence ◽  
Deliberate Self Harm ◽  
Collaborative Assessment ◽  
Self Harm ◽  
Suicidal Patients

Objective: Evaluate the efficacy of Collaborative Assessment and Management of Suicidality (CAMS) in managing suicide risk and deliberate self-harm in adults. Methods: Ten databases were searched for publications referring to CAMS or the Suicide Status Form. Results were evaluated by two reviewers. Results: Limited evidence that CAMS is effective in reducing suicide risk and deliberate self-harm in adult populations. Conclusions: Although CAMS appears to show promise in managing suicidal patients across a range of measures, further evidence is needed to clarify its efficacy in managing suicide risk and deliberate self-harm.

Prediction of Repeated Self-Harm in Six Months: Comparison of Traditional Psychometrics With Random Forest Algorithm

2021 ◽  
pp. 003022282110605
Author(s):  
Shu-Chin Chen ◽  
Hui-Chun Huang ◽  
Shen-Ing Liu ◽  
Sue-Huei Chen
Keyword(s):  
Random Forest ◽  
Suicide Risk ◽  
Predictive Ability ◽  
Random Forest Algorithm ◽  
The Past ◽  
Self Harm ◽  
Two Phases ◽  
Screening Scale ◽  
Potential Tool

Suicidal risk has been a significant mental health problem. However, the predictive ability for repeated self-harm (SH) has not improved over the past decades. This study thus aimed to explore a potential tool with theoretical accommodation and clinical application by employing traditional logistic regression (LR) and newly developed machine learning, random forest algorithm (RF). Starting with 89 items from six commonly used scales (i.e., proximal suicide risk factors) as preliminary predictors, both LR and RF resulted in a better solution with much fewer items in two phases of item selections and analyses, with prediction accuracy 88.6% and 79.8%, respectively. A combination with 12 selected items, named LR-12, well predicted repeated self-harm in 6-month follow-up with satisfactory performance (AUC = 0.84, 95% CI: 0.76–0.92; cut-off point by 1/2 with sensitivity 81.1% and specificity 74.0%). The psychometrically appealing LR-12 could be used as a screening scale for suicide risk assessment.

A machine learning approach to identification of self-harm and suicidal ideation among military and police Veterans

2021 ◽  
Author(s):  
Sinisa Colic ◽  
Jiang Chen He ◽  
J. Don Richardson ◽  
Kate St. Cyr ◽  
James P. Reilly ◽  
...  
Keyword(s):  
Machine Learning ◽  
Suicidal Ideation ◽  
Suicide Risk ◽  
Predictive Accuracy ◽  
Large Data ◽  
Suicide Risk Assessment ◽  
Data Set ◽  
Psychological Phenomena ◽  
Machine Learning Approach ◽  
Self Harm

LAY SUMMARY Combat Veterans are vulnerable to suicidal thoughts and behaviour. Many who die by suicide deny having suicidal ideation (SI). Typically, researchers try to find variables indicating the presence of SI using traditional statistical approaches. These approaches do not possess the capacity to detect highly complex multivariable interactions. In contrast, machine learning (ML) is designed to detect such patterns and can consequently yield much higher predictive accuracy. In this study, the authors trained ML algorithms using 192 variables extracted from questionnaires administered to 738 Veterans and serving personnel to detect the presence of self-harm and SI (SHSI). Using the 10 most predictive non-suicide-related items, the ML algorithms could detect SHSI with 75.3% accuracy. Most of these items reflect psychological phenomena that can change quickly over time, allowing repeated risk re-assessment from day to day. The study’s findings suggest that ML methods may play an important role in the discovery, within a large data set, of predictive patterns that might be useful in suicide risk assessment.

Coping Style as a Mediator of the Relationship Between Depressive Symptoms and Deliberate Self-Harm

Crisis ◽  
2011 ◽  
Vol 32 (5) ◽  
pp. 272-279 ◽  
Author(s):  
Allison S. Christian ◽  
Kristen M. McCabe
Keyword(s):  
Depressive Symptoms ◽  
Undergraduate Students ◽  
Cross Sectional Study ◽  
Self Report ◽  
Hierarchical Regression ◽  
Cross Sectional ◽  
Deliberate Self Harm ◽  
Self Blame ◽  
Self Harm ◽  
The Relationship

Background: Deliberate self-harm (DSH) occurs with high frequency among clinical and nonclinical youth populations. Although depression has been consistently linked with the behavior, not all depressed individuals engage in DSH. Aims: The current study examined maladaptive coping strategies (i.e., self-blame, distancing, and self-isolation) as mediators between depression and DSH among undergraduate students. Methods: 202 students from undergraduate psychology courses at a private university in Southern California (77.7% women) completed anonymous self-report measures. Results: A hierarchical regression model found no differences in DSH history across demographic variables. Among coping variables, self-isolation alone was significantly related to DSH. A full meditational model was supported: Depressive symptoms were significantly related to DSH, but adding self-isolation to the model rendered the relationship nonsignificant. Limitations: The cross-sectional study design prevents determination of whether a casual relation exists between self-isolation and DSH, and obscures the direction of that relationship. Conclusions: Results suggest targeting self-isolation as a means of DSH prevention and intervention among nonclinical, youth populations.

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