scholarly journals An approach for Risk Assessment Score of Suicide Attempt (RASSA)

2021 ◽  
Author(s):  
Ana Fructuoso ◽  
Inmaculada Fierro ◽  
María-Isabel Jiménez-Serranía ◽  
Alfonso Carvajal Garcia-Pando
Keyword(s):  
Risk Factors ◽  
Risk Assessment ◽  
Suicide Attempt ◽  
Suicide Risk ◽  
Psychiatric Patients ◽  
Opioid Analgesics ◽  
Health Records ◽  
Assessment Score ◽  
Somatic Comorbidity ◽  
Clinical Records

Abstract Background: Suicide remains a leading cause of death and psychiatric population is often at increased risk for suicide. Therefore, there is a persistent need for well-designed clinical instruments that allows us to identify relevant risk factors. Our study aims to improve patient follow-up and identify possible suicide risk markers from a passage to self-harm among hospitalized psychiatric patients. Methods: This case-control study included the review of psychiatric, sociodemographic, drug use, and other health-related data, retrieved from 1,680 psychiatric patients’ health records. Differences between comparative groups were examined, and stepwise logistic regression analyses were performed to identify suicide risk factors within this population.Results: From the analysis of 560 suicide attempters’ clinical records, thirteen risk items were included in our final model, named as Risk Assessment Score of Suicide Attempt (RASSA). The factors that scored the highest in this model were ‘not taking antipsychotic medication’, ‘somatic comorbidity’, and ‘a family history of suicide’. Suffering from depression has a high score, and treatment with selective serotonin reuptake inhibitors (SSRIs) is also involved in the risk of a suicide attempt. Regarding medication use, opioid analgesics decreased the risk score, while taking non-opioid analgesics increased it. In terms of commonly abused substances, alcohol, cocaine, and amphetamine dependence increased the score. A higher risk was also associated with cannabis dependence, while tobacco use reduced it. As for demographics, the risk was significantly greater for women and subjects who were unmarried. Conclusions: The proposed model of risk assessment score of suicide attempt (RASSA) offers the possibility of establishing a suicide attempt risk based on data directly gathered from the health records of psychiatric patients. Therefore, it might be used as an initial screening test before patient evaluation and psychometric tests.

scholarly journals An approach for Risk Assessment Score of Suicide Attempt (RASSA)

2021 ◽  
Author(s):  
Ana Fructuoso ◽  
Inmaculada Fierro ◽  
María-Isabel Jiménez-Serranía ◽  
Alfonso Carvajal Garcia-Pando
Keyword(s):  
Risk Factors ◽  
Risk Assessment ◽  
Suicide Attempt ◽  
Suicide Risk ◽  
Psychiatric Patients ◽  
Opioid Analgesics ◽  
Health Records ◽  
Assessment Score ◽  
Somatic Comorbidity ◽  
Clinical Records

Abstract Background: Suicide remains a leading cause of death and psychiatric population is often at increased risk for suicide. Therefore, there is a persistent need for well-designed clinical instruments that allows us to identify relevant risk factors. Our study aims to improve patient follow-up and identify possible suicide risk markers from a passage to self-harm among hospitalized psychiatric patients. Methods: This case-control study included the review of psychiatric, sociodemographic, drug use, and other health-related data, retrieved from 1,680 psychiatric patients’ health records. Differences between comparative groups were examined, and stepwise logistic regression analyses were performed to identify suicide risk factors within this population.Results: From the analysis of 560 suicide attempters’ clinical records, thirteen risk items were included in our final model, named as Risk Assessment Score of Suicide Attempt (RASSA). The factors that scored the highest in this model were ‘not taking antipsychotic medication’, ‘somatic comorbidity’, and ‘a family history of suicide’. Suffering from depression has a high score, and treatment with selective serotonin reuptake inhibitors (SSRIs) is also involved in the risk of a suicide attempt. Regarding medication use, opioid analgesics decreased the risk score, while taking non-opioid analgesics increased it. In terms of commonly abused substances, alcohol, cocaine, and amphetamine dependence increased the score. A higher risk was also associated with cannabis dependence, while tobacco use reduced it. As for demographics, the risk was significantly greater for women and subjects who were unmarried. Conclusions: The proposed model of risk assessment score of suicide attempt (RASSA) offers the possibility of establishing a suicide attempt risk based on data directly gathered from the health records of psychiatric patients. Therefore, it might be used as an initial screening test before patient evaluation and psychometric tests.

Suicide risk assessment in the elderly

2017 ◽  
Vol 41 (S1) ◽  
pp. S402-S402
Author(s):  
N. Smaoui ◽  
I. Baati ◽  
T. Dorsaf ◽  
S. Mkaouar ◽  
I. Abida ◽  
...  
Keyword(s):  
Risk Factors ◽  
Risk Assessment ◽  
Family History ◽  
Suicide Attempt ◽  
Suicide Risk ◽  
Depression Scale ◽  
University Hospital ◽  
Psychiatric Outpatients ◽  
Suicidal Thoughts ◽  
History Of

ObjectivesTo assess suicide risk in elderly psychiatric outpatients and to identify potential suicide risk factors in this population.MethodsThis was a cross-sectional, descriptive and analytical study, including 50 psychiatric outpatients, aged 65 years or more and attending the Hédi Chaker University Hospital, in Sfax (Tunisia), between November and December 2015. We used a hetero questionnaire including epidemiological and clinical data and three scales: the Suicidal Risk Assessment Scale of Ducher (RSD), the Hospital Anxiety and Depression Scale (HADS) and the Mini Mental State Examination (MMSE).ResultsThe sex ratio (M/F) was 1. The average age of patients was 68.62 years. The majority of them were married (68%), unemployed (98%), living in urban area (58%) and within their family (88%); they had at most a primary degree (80%) and a low socioeconomic level (74%).The prevalence of patients at risk of suicide (RSD ≥ 3) was 26%. This risk was high (RSD ≥ 7) in 18% of cases.The presence of suicidal ideation (RSD ≥ 3) was correlated with: a family history of suicide attempt (58.3% vs. 15.8%; P = 0.003), a personal history of suicide attempt (80% vs. 12.5%; P < 0.001), depressive symptoms (HAD-D ≥ 11) (36.7% vs. 10%; P = 0.05) and anxiety (HAD-A ≥ 11) (52.4% vs. 6.9%; P = 0.001).ConclusionOur study showed that among older psychiatric outpatients, one in four had suicidal thoughts. This high rate encourages us to search systematically these suicidal thoughts in this population, especially in patients with risk factors such as a family history of suicide attempt, depressive or anxious symptoms.Disclosure of interestThe authors have not supplied their declaration of competing interest.

scholarly journals Machine learning for suicide risk prediction in children and adolescents with electronic health records

2020 ◽  
Vol 10 (1) ◽  
Author(s):  
Chang Su ◽  
Robert Aseltine ◽  
Riddhi Doshi ◽  
Kun Chen ◽  
Steven C. Rogers ◽  
...  
Keyword(s):  
Machine Learning ◽  
Risk Factors ◽  
Children And Adolescents ◽  
Suicidal Behavior ◽  
Predictive Models ◽  
Suicide Risk ◽  
Health Records ◽  
Short And Long Term ◽  
Clinical Records

AbstractAccurate prediction of suicide risk among children and adolescents within an actionable time frame is an important but challenging task. Very few studies have comprehensively considered the clinical risk factors available to produce quantifiable risk scores for estimation of short- and long-term suicide risk for pediatric population. In this paper, we built machine learning models for predicting suicidal behavior among children and adolescents based on their longitudinal clinical records, and determining short- and long-term risk factors. This retrospective study used deidentified structured electronic health records (EHR) from the Connecticut Children’s Medical Center covering the period from 1 October 2011 to 30 September 2016. Clinical records of 41,721 young patients (10–18 years old) were included for analysis. Candidate predictors included demographics, diagnosis, laboratory tests, and medications. Different prediction windows ranging from 0 to 365 days were adopted. For each prediction window, candidate predictors were first screened by univariate statistical tests, and then a predictive model was built via a sequential forward feature selection procedure. We grouped the selected predictors and estimated their contributions to risk prediction at different prediction window lengths. The developed predictive models predicted suicidal behavior across all prediction windows with AUCs varying from 0.81 to 0.86. For all prediction windows, the models detected 53–62% of suicide-positive subjects with 90% specificity. The models performed better with shorter prediction windows and predictor importance varied across prediction windows, illustrating short- and long-term risks. Our findings demonstrated that routinely collected EHRs can be used to create accurate predictive models for suicide risk among children and adolescents.

Diagnostic scales for suicide risk assessment

2020 ◽  
pp. 67-79
Author(s):  
L. Gelda ◽  
L. Nesterovich
Keyword(s):  
Risk Factors ◽  
Risk Assessment ◽  
Medical Research ◽  
Suicide Risk ◽  
General Medicine ◽  
Diagnostic Tools ◽  
Suicide Risk Assessment ◽  
Research And Practice ◽  
Psychometric Instruments ◽  
High Incidence

The problem of adequate diagnostic tools use for suicide risk assessment т medical research and practice is of extreme importance because of the high incidence of suicide in the population of psychotic patients and the high vulnerability of the latter to the known risk factors. The article provides ап overview of the existing psychometric instruments (scales) used to assess the risk of suicide in psychiatry as well as in general medicine.

Suicide risk assessment in a large public mental health service: do suicide risk classifications identify those at risk?

2021 ◽  
pp. 103985622098403
Author(s):  
Marianne Wyder ◽  
Manaan Kar Ray ◽  
Samara Russell ◽  
Kieran Kinsella ◽  
David Crompton ◽  
...  
Keyword(s):  
Mental Health ◽  
Risk Factors ◽  
Risk Assessment ◽  
High Risk ◽  
Suicide Risk ◽  
Public Mental Health ◽  
Assessment Tools ◽  
Suicide Risk Assessment ◽  
Public Mental Health Service ◽  
Risk Assessment Tools

Introduction: Risk assessment tools are routinely used to identify patients at high risk. There is increasing evidence that these tools may not be sufficiently accurate to determine the risk of suicide of people, particularly those being treated in community mental health settings. Methods: An outcome analysis for case serials of people who died by suicide between January 2014 and December 2016 and had contact with a public mental health service within 31 days prior to their death. Results: Of the 68 people who had contact, 70.5% had a formal risk assessment. Seventy-five per cent were classified as low risk of suicide. None were identified as being at high risk. While individual risk factors were identified, these did not allow to differentiate between patients classified as low or medium. Discussion: Risk categorisation contributes little to patient safety. Given the dynamic nature of suicide risk, a risk assessment should focus on modifiable risk factors and safety planning rather than risk prediction. Conclusion: The prediction value of suicide risk assessment tools is limited. The risk classifications of high, medium or low could become the basis of denying necessary treatment to many and delivering unnecessary treatment to some and should not be used for care allocation.

scholarly journals A brief reflection on the role of cholesterol in psychopathology among female psychiatric patients

2021 ◽  
Vol 67 (2) ◽  
pp. 102-107
Author(s):  
Edina Dimeny ◽  
Erika Bán ◽  
Attila Brassai
Keyword(s):  
Risk Factors ◽  
Cholesterol Level ◽  
Suicide Risk ◽  
Psychiatric Patients ◽  
Blood Cholesterol ◽  
Total Serum ◽  
Risk Category ◽  
Moderate Risk ◽  
Cholesterol Levels ◽  
Suicide Behavior

Abstract Objective: Cholesterol is one of the cardiovascular risk factors, but also a core component of the central nervous system. Moreover, hyper-cholesterolemia and hypocholesterolemia are directly related to numerous mental illnesses too. This study intents to examine the association between cholesterol level and autolytic behavior among female psychiatric patients. Methods: The present study involves 123 female subjects, who suffered from suicidal thoughts at the moment of hospitalization. The risk of suicidal intentions was assessed by the Modified Scale for Suicide Ideation (Miller et al) and their total serum cholesterol levels were measured. We performed a case-control, analytical, randomized, observational study at the Clinical Hospital of Neurology and Psychiatry Brasov among adult female psychiatric patients admitted during 2014. Results: By our results we distinguished 3 categories: 38 patients with low suicide risk, 32 with moderate risk and 53 with high suicide risk. Significant difference can be noticed in the higher suicide risk patients’ blood cholesterol levels: 44 patients having under 4,5mmol/L total cholesterol level (83%). Although, in other two categories, this proportion is minimal: in the moderate-risk category were 8 patients, representing just 25 %, and in the low-risk category only 1 patient had her cholesterol level under 4,5mmol/L (2,6%). Conclusions: According to our results, proposing cholesterol-level as a biomarker for the determination of high-risk suicide behavior can be important. The presence of other important risk factors (sociodemographic and psychiatric variables) can increase exponentially the suicide behavior. The limitations of this study are the relatively small number of cases and the lack of longitudinal subsequent follow-up. Further investigations are needed on a larger and more heterogenous sample of patients in order to clarify this suggestive correlation.

Suicide in recently discharged psychiatric patients: a case-control study

2008 ◽  
Vol 39 (3) ◽  
pp. 443-449 ◽  
Author(s):  
I. M. Hunt ◽  
N. Kapur ◽  
R. Webb ◽  
J. Robinson ◽  
J. Burns ◽  
...  
Keyword(s):  
Mental Health ◽  
Risk Factors ◽  
Suicide Risk ◽  
Case Control Study ◽  
Clinical Symptoms ◽  
Risk Measures ◽  
Psychiatric Patients ◽  
Case Control ◽  
Control Study

BackgroundFew controlled studies have specifically investigated aspects of mental health care in relation to suicide risk among recently discharged psychiatric patients. We aimed to identify risk factors, including variation in healthcare received, for suicide within 3 months of discharge.MethodWe conducted a national population-based case-control study of 238 psychiatric patients dying by suicide within 3 months of hospital discharge, matched on date of discharge to 238 living controls.ResultsForty-three per cent of suicides occurred within a month of discharge, 47% of whom died before their first follow-up appointment. The first week and the first day after discharge were particular high-risk periods. Risk factors for suicide included a history of self-harm, a primary diagnosis of affective disorder, recent last contact with services and expressing clinical symptoms at last contact with staff. Suicide cases were more likely to have initiated their own discharge and to have missed their last appointment with services. Patients who were detained for compulsory treatment at last admission, or who were subject to enhanced levels of aftercare, were less likely to die by suicide.ConclusionsThe weeks after discharge from psychiatric care represent a critical period for suicide risk. Measures that could reduce risk include intensive and early community follow-up. Assessment of risk should include established risk factors as well as current mental state and there should be clear follow-up procedures for those who have self-discharged. Recent detention under the Mental Health Act and current use of enhanced levels of aftercare may be protective.

scholarly journals Assessment of violence risk in 440 psychiatric patients in China: examining the feasibility and acceptability of a novel and scalable approach (FoVOx)

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Shaoling Zhong ◽  
◽  
Rongqin Yu ◽  
Robert Cornish ◽  
Xiaoping Wang ◽  
...  
Keyword(s):  
Mental Health ◽  
Risk Factors ◽  
Risk Assessment ◽  
Decision Making ◽  
Clinical Decision Making ◽  
Psychiatric Patients ◽  
Clinical Decision ◽  
Violence Risk ◽  
Violence Risk Assessment ◽  
Risk Categories

Abstract Background Violence risk assessment is a routine part of clinical services in mental health, and in particular secure psychiatric hospitals. The use of prediction models and risk tools can assist clinical decision-making on risk management, including decisions about further assessments, referral, hospitalization and treatment. In recent years, scalable evidence-based tools, such as Forensic Psychiatry and Violent Oxford (FoVOx), have been developed and validated for patients with mental illness. However, their acceptability and utility in clinical settings is not known. Therefore, we conducted a clinical impact study in multiple institutions that provided specialist mental health service. Methods We followed a two-step mixed-methods design. In phase one, we examined baseline risk factors on 330 psychiatric patients from seven forensic psychiatric institutes in China. In phase two, we conducted semi-structured interviews with 11 clinicians regarding violence risk assessment from ten mental health centres. We compared the FoVOx score on each admission (n = 110) to unstructured clinical risk assessment and used a thematic analysis to assess clinician views on the accuracy and utility of this tool. Results The median estimated probability of violent reoffending (FoVOx score) within 1 year was 7% (range 1–40%). There was fair agreement (72/99, 73% agreement) on the risk categories between FoVOx and clinicians’ assessment on risk categories, and moderate agreement (10/12, 83% agreement) when examining low and high risk categories. In a majority of cases (56/101, 55%), clinicians thought the FoVOx score was an accurate representation of the violent risk of an individual patient. Clinicians suggested some additional clinical, social and criminal risk factors should be considered during any comprehensive assessment. In addition, FoVOx was considered to be helpful in assisting clinical decision-making and individual risk assessment. Ten out of 11 clinicians reported that FoVOx was easy to use, eight out of 11 was practical, and all clinicians would consider using it in the future. Conclusions Clinicians found that violence risk assessment could be improved by using a simple, scalable tool, and that FoVOx was feasible and practical to use.

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