scholarly journals Recurrence of Overdose Suicide Attempt Index: A Novel Scoring System for Predicting the Recurrence of Intentional Overdose

2020 ◽  
Author(s):  
Masayuki Hirose ◽  
Daisuke Kasugai ◽  
Kousuke Tajima ◽  
Hiroshi Takahashi ◽  
Shigeki Yamada ◽  
...  
Keyword(s):  
Risk Factors ◽  
Suicide Attempt ◽  
Predictive Value ◽  
Suicide Attempts ◽  
Multivariate Logistic Regression Analysis ◽  
Somatoform Disorder ◽  
High Risk Population ◽  
Operating Characteristics ◽  
Odds Ratios ◽  
Predictive Values

Abstract Aim: Repeated suicide attempts through intentional overdose are not infrequent, but little is known about the risk factors for intentional overdose. We aimed to investigate risk factors for the recurrence of intentional overdose within 1 year of discharge and to develop an index that predicts recurrence.Methods: This retrospective observational study included 419 patients admitted to our hospital between 2011 and 2018 because of an intentional overdose. Of them, 43 (10.0%) repeated an overdose within 1 year of discharge. The risk factors with the highest odds ratios in multivariate logistic regression analysis were used to develop an index Recurrence of Overdose Suicide Attempt. The predictive value of this index for recurrence was compared with that of the existing SAD PERSONS scale.Results: The following variables were significantly associated with recurrence and were included in the index: anxiety and/or insomnia at discharge; use of five or more psychotropic drugs; a neurotic, stress-related, or somatoform disorder; and female sex (odds ratios: 4.24; 5.52; 2.41; and 3.41, respectively). The newly developed index was a significantly better predictor of recurrence than the SAD PERSONS scale (area under the receiver operating characteristics curve, 0.797 vs. 0.668; p = 0.007). Sensitivity, specificity, and positive and negative predictive values for Recurrence of Overdose Suicide Attempt > 4 points (out of 6) were 72.1%, 75.8%, 25.4%, and 96.0%, respectively.Conclusion: The novel index can predict the recurrence of intentional overdose with a good negative predictive value and may therefore be a useful screening tool for this high-risk population.

Who are the suicide reattempters?

2016 ◽  
Vol 33 (S1) ◽  
pp. S600-S600
Author(s):  
E. Gattoni ◽  
C. Gramaglia ◽  
C. Delicato ◽  
S. Di Marco ◽  
I. Coppola ◽  
...  
Keyword(s):  
Risk Factors ◽  
Personality Disorder ◽  
Suicide Attempt ◽  
Emergency Room ◽  
Suicide Attempts ◽  
Somatoform Disorder ◽  
Psychiatric Disease ◽  
Psychiatric Evaluation ◽  
Axis I ◽  
Competing Interest

BackgroundHistory of previous suicide attempts is one of the most important risk factors for a subsequent completed suicide. Suicide reattempters (SR) has been long associated with demographic and clinical risk factors for suicide, such as unemployment and psychiatric disorders, however a recent review of the literature has not supported a specific age and gender profile of SR, but rather underscored that, as far as diagnosis is concerned, SR were more likely to have a personality disorder. According to literature, 16%–34% of the subjects repeat a suicide attempt within the first 2 years after the previous one.AimThe purpose of our study was evaluating clinical and socio-demographic characteristics and the outcome of psychiatric consultation among subjects referring to an emergency room for recommitting a suicide attempt.MethodsWe considered a sample of SR aged > 16 years. We extracted data from the database including all patients requiring psychiatric evaluation in the emergency room, and eventually compared the features of SR and patients with a single suicide attempt. For each patient, we gathered socio-demographic features, psychiatric history and current clinical issues, suicidal intent and suicidal behaviors.ResultsData collection and statistical analyses are still ongoing. Preliminary results show that, compared to patients with a single suicide attempt, SR were more frequent female, unmarried, employed, with a low level of instruction; they had a psychiatric disease (axis I – anxiety disorder, somatoform disorder; axis II – histrionic personality disorder); they are under the care of mental health services and under psychopharmacological treatment.Disclosure of interestThe authors have not supplied their declaration of competing interest.

Attachment Organization in Suicide Prevention Research

Crisis ◽  
2014 ◽  
Vol 35 (1) ◽  
pp. 60-66 ◽  
Author(s):  
Amanda Venta ◽  
Carla Sharp
Keyword(s):  
Risk Factors ◽  
Suicidal Ideation ◽  
Suicide Attempt ◽  
Interpersonal Relationships ◽  
Suicide Ideation ◽  
Suicide Attempts ◽  
Critical Role ◽  
Self Report ◽  
Future Research ◽  
Self Harm

Background: Identifying risk factors for suicide-related thoughts and behaviors (SRTB) is essential among adolescents in whom SRTB remain a leading cause of death. Although many risk factors have already been identified, influential theories now suggest that the domain of interpersonal relationships may play a critical role in the emergence of SRTB. Because attachment has long been seen as the foundation of interpersonal functioning, we suggest that attachment insecurity warrants attention as a risk factor for SRTB. Aims: This study sought to explore relations between attachment organization and suicidal ideation, suicide attempts, and self-harm in an inpatient adolescent sample, controlling for demographic and psychopathological covariates. Method: We recruited 194 adolescents from an inpatient unit and assigned them to one of four attachment groups (secure, preoccupied, dismissing, or disorganized attachment). Interview and self-report measures were used to create four variables reflecting the presence or absence of suicidal ideation in the last year, single lifetime suicide attempt, multiple lifetime suicide attempts, and lifetime self-harm. Results: Chi-square and regression analyses did not reveal significant relations between attachment organization and SRTB, although findings did confirm previously established relations between psychopathology and SRTB, such that internalizing disorder was associated with increased self-harm, suicide ideation, and suicide attempt and externalizing disorder was associated with increased self-harm. Conclusion: The severity of this sample and methodological differences from previous studies may explain the nonsignificant findings. Nonsignificant findings may indicate that the relation between attachment organization and SRTB is moderated by other factors that should be explored in future research.

Suicide Attempts Among Depressed Inpatients with Depressive Disorder in a Malaysian Sample

Crisis ◽  
2011 ◽  
Vol 32 (5) ◽  
pp. 283-287 ◽  
Author(s):  
L. F. Chan ◽  
T. Maniam ◽  
A. S. Shamsul
Keyword(s):  
Risk Factors ◽  
Suicidal Ideation ◽  
Suicide Attempt ◽  
Depressive Disorder ◽  
Suicide Attempts ◽  
Psychosocial Risk Factors ◽  
Psychosocial Risk ◽  
Life Event ◽  
Axis I ◽  
A Current

Background: Depressed inpatients constitute a high-risk population for suicide attempts. Aims: To describe the interactions of clinical and psychosocial risk factors influencing suicide attempts among a Malaysian sample of depressed inpatients. Methods: Seventy-five subjects were diagnosed with a depressive disorder according to the Structured Clinical Interview for DSM-IV Axis I Disorders-Clinical Version (SCID-CV). Data on suicide attempts, suicidal ideation (Scale for Suicidal Ideation, SSI), depression severity (Beck’s Depression Inventory, BDI), recent life-event changes (Social Readjustment Rating Scale, SRRS), sociodemographic and other relevant clinical factors were collected. Results: A third of the subjects presented after a current suicide attempt. Significant factors for a current suicide attempt were race, religion, recent life-event changes, suicidal ideation, and alcohol use disorder. Independent predictive risk factors for a current suicide attempt were Chinese race, recent marital separation, major mortgage or loans, and being newly diagnosed with depression. Any recent change in personal habits was shown to be a protective factor against current suicide attempt. Age and gender were nonsignificant factors. Conclusions: The findings are generally consistent with existing studies and highlight the role of psychosocial risk factors.

Risk Factors for Suicide Attempts Among African American Women Experiencing Recent Intimate Partner Violence

2002 ◽  
Vol 17 (3) ◽  
pp. 283-295 ◽  
Author(s):  
Martie P. Thompson ◽  
Nadine J. Kaslow ◽  
J. B. Kingree
Keyword(s):  
Risk Factors ◽  
African American ◽  
Suicide Attempt ◽  
African American Women ◽  
Suicide Attempts ◽  
Risk Model ◽  
Cumulative Risk ◽  
American Women ◽  
Cumulative Risk Model ◽  
Risk Factors For Suicide

The purposes of this study were to identify risk factors for suicide attempts among 200 African American abused women (100 attempters, 100 nonattempters) and to test a cumulative risk model to determine if a woman’s likelihood of making a suicide attempt increased as the number of risk factors increased. Results revealed that attempters were significantly more likely than nonattempters to report high levels of depressive symptoms, hopelessness, drug abuse, and childhood abuse and neglect. Results from the cumulative risk model revealed a linear association between the number of risk factors and the odds of making a suicide attempt. Compared to women with no risk factors, women with two risk factors, women with three risk factors, and women with four to five risk factors were 10, 25, and 107 times, respectively, more likely to attempt suicide. The identification of risk variables highlights the importance of designing interventions to address these factors in order to reduce the risk of suicidal behavior in abused, African American women.

scholarly journals COMPARATIVE ASSESSMENT OF PREDICTIVE VALUE OF TOTAL CARDIOVASCULAR RISK FACTORS FOR PROGNOSIS OF STROKE AND HEART ATTACK IN HYPERTENSION

2009 ◽  
Vol 15 (6) ◽  
pp. 665-670
Author(s):  
A. A. Dzizinskij ◽  
G. M. Sinkova ◽  
V. V. Sprach ◽  
A. V. Sinkov
Keyword(s):  
Risk Factors ◽  
Cardiovascular Risk ◽  
Cardiovascular Risk Factors ◽  
Predictive Value ◽  
Heart Attack ◽  
Comparative Assessment ◽  
Predictive Values ◽  
Hypertensive Patients ◽  
Design And Methods

Objective. To assess predictive value of total cardiovascular risk (CV) factors for prognosis of stroke and heart attack in hypertension. Design and methods. 841 hypertensive patients (197 men, 644 women) 19-95 years old were examined. Results. It was established that total CV risk factors have different predictive values. The majority of factors were more valuable for prognosis of heart attack, but not for stroke.

scholarly journals Positive Predictive Value of ICD-10-CM Definitions for Adolescent Intentional Self-Harm: An Emergency Department Medical Record Review

2020 ◽  
Author(s):  
Anna Hansen ◽  
Dessi Slavova ◽  
Gena Cooper ◽  
Jaryd Zummer ◽  
Julia F Costich
Keyword(s):  
Emergency Department ◽  
Suicide Attempt ◽  
Positive Predictive Value ◽  
Medical Record ◽  
Predictive Value ◽  
Suicide Attempts ◽  
Pediatric Population ◽  
Icd 10 ◽  
Self Harm ◽  
Coding Guidelines

Abstract Background Non-suicidal self-injury and suicide attempts are increasing problems among American adolescents. This study proposed a definition for identifying intentional self-harm injuries (ISHIs) in emergency department (ED) records coded with International Classification of Diseases, 10th Revision, Clinical Modification (ICD-10-CM) codes and sought to estimate: (1) the definition’s positive predictive value (PPV) in a pediatric population treated in one Kentucky ED, and (2) the proportion of Intentional self-harm injuries (ISHIs) with intent to die (i.e., suicide attempt) that cannot be captured by ICD-10-CM codes and can only be identified by a medical record abstraction. Methods The study definition captured initial encounters for ISHIs based on first valid external cause-of-injury self-harm codes in the ICD-10-CM range X71-X83, T14.91, T36-T65, or T71. Medical records for a random sample of 207 ED discharge records were reviewed following a specified protocol. The PPV for the study definition was reported with its 95% confidence interval (95%CI). Results The estimated PPV for the study definition’s ability to capture true ISHIs was 88.9%, 95%CI (83.8%, 92.8%). The estimated percentage of ISHIs with intent to die was 45.9%, 95%CI (47.1%, 61.0%). The ICD-10-CM code “suicide attempt” (T14.91) captured only 7 cases, but coding guidelines allow assignment of this code only when the mechanism of the suicide attempt is unknown. Conclusions This study demonstrated a critical shortcoming in U.S. morbidity surveillance. The ICD-10-CM coding system and coding guidelines do not allow accurate identification of ISHIs with intent to die; modifications are needed to address this issue.

scholarly journals Association of Biomarkers Related to Preoperative Inflammatory and Coagulation with Postoperative In-Hospital Deaths in Patients with Type A Acute Aortic Dissection

2021 ◽  
Author(s):  
Ming Li ◽  
Haifeng Sun ◽  
Suochun Xu ◽  
Yang Yan ◽  
Haichen Wang ◽  
...  
Keyword(s):  
Risk Factors ◽  
Logistic Regression ◽  
Regression Analysis ◽  
Logistic Regression Analysis ◽  
Predictive Value ◽  
Multivariate Logistic Regression Analysis ◽  
Type A ◽  
Hospital Deaths ◽  
Independent Risk Factors ◽  
D Dimer

Abstract Background: The aim of this study was to analyze the predictive value of biomarkers related to preoperative inflammatory and coagulation in the prognosis of patients with type A acute aortic dissection (AAD). Methods: A total of 206 patients with type A AAD who had received surgical treatment were enrolled. Patients were divided into two groups according to whether they died during hospitalization. Peripheral blood samples were collected before anesthesia induction. Preoperative levels of D-dimer, fibrinogen (FIB), platelet (PLT), white blood cells (WBC) and neutrophil (NEU) between the two groups were compared. Univariate and multivariate logistic regression analysis were utilized to identify the independent risk factors for postoperative in-hospital deaths of patients with type A AAD. Receiver operating characteristic (ROC) curve were used to analyze the predictive value of D-dimer, FIB, PLT, WBC, NEU and CRP in the prognosis of the patients. Results: Univariate logistic regression analysis showed that the P values of the five parameters including D-dimer, FIB, PLT, WBC and NEU were all less than 0.1, which may be risk factors for postoperative in-hospital deaths of patients with type A AAD. Further multivariate logistic regression analysis indicated that higher preoperative D-dimer and WBC levels were independent risk factors for in-hospital deaths of patients with type A AAD. ROC curve analysis indicated that FIB+PLT combination is provided with the highest predictive value for in-hospital deaths.Conclusion: Both preoperative D-dimer and WBC in patients with type A AAD may be used as independent risk factors for the prognosis of such patients. Combined use of FIB and PLT may improve the accuracy and accessibility of clinical prognostic assessment.

scholarly journals Risk Factors for Serious Suicide Attempts: Difference Between Older and Younger Attempters in the Emergency Department

2021 ◽  
Vol 11 ◽  
Author(s):  
Dong Wook Kim ◽  
Seo Eun Cho ◽  
Jae Myeong Kang ◽  
Soo Kyun Woo ◽  
Seung-Gul Kang ◽  
...  
Keyword(s):  
Risk Factors ◽  
Older Adults ◽  
Emergency Department ◽  
Suicide Attempt ◽  
Old Age ◽  
Rating Scale ◽  
Suicide Attempts ◽  
Interpersonal Stress ◽  
Suicide Attempters ◽  
Male Sex

Objective: Suicide attempts of the older adults are known to be more serious than that of the younger adults. Despite its major social impact in South Korea, the behavioral mechanism of serious suicide attempt (SSA) in old people remains to be elucidated. Thus, we investigated the risk factors for SSA in older and younger suicide attempters in the emergency department.Methods: Demographic data, clinical information, and the level of seriousness of suicide with Risk Rescue Rating Scale were compared between older (age ≥65) and younger (age <65) adults who visited the emergency department for a suicide attempt. Regression analyses were performed to identify the risk factors for SSA in these two groups.Results: Among 370 patients, 37 were older adults (10%; aged 74.41 ± 6.78), more likely to have another medical disease (p < 0.001), and a higher suicide completion rate (16.2 vs. 5.4%, p = 0.023). In the younger group, old age (B = 0.090, p < 0.001), male sex (B = −0.038, p = 0.019), and impression of schizophrenia (B = 0.074, p = 0.027) were associated with a higher risk-rescue ratio and interpersonal stress condition was associated with a lower risk-rescue ratio (B = −0.045, p = 0.006). In the older group, however, no variables were included significant in the regression model for the Risk Rescue Rating Scale.Conclusions: Demographic and clinical factors such as old age, male sex, interpersonal stress, and impression of schizophrenia were associated with lethality in the younger suicide attempters. However, no factors were associated with SSA in the older adult group. Different mechanisms may underly the lethality in old age suicide.

scholarly journals Early alterations of circulating immune cell counts in severe trauma patients are related to later occurrence of nosocomial infection, sepsis and mortality

2019 ◽  
Author(s):  
Xijie Dong ◽  
Chuntao Wang ◽  
Xinghua Liu ◽  
Xiangjun Bai ◽  
Zhanfei Li
Keyword(s):  
Risk Factors ◽  
Nosocomial Infection ◽  
Predictive Value ◽  
Injury Severity ◽  
Immune Cell ◽  
Multivariate Logistic Regression Analysis ◽  
Severe Trauma ◽  
Pronounced Increase ◽  
Cell Counts ◽  
Independent Risk Factors

Abstract Background: Severe trauma leads to extensive disturbances of the innate and adaptive arms of the immune system, which in turn may affect the prognosis. The main objective of this study was to investigate the relationship between the alterations of circulating immune cell counts in the early stage of severe trauma and the later occurrence of nosocomial infection, sepsis and mortality. Methods: This was a retrospective study of 876 patients with an Injury Severity Score (ISS) ≥ 16. Demographic data, the absolute counts of neutrophil, lymphocyte and monocyte (ANC, ALC and AMC) on days 1, 3, and 7 (D1, D3, and D7) after trauma, and whether nosocomial infection, sepsis or death occurred within 60 days were recorded. Ratios were calculated between immune cell counts of each two time points, namely day 3/day 1 (D3/D1) and day 7/day 3 (D7/D3). Patients were grouped based on ISS and the occurrence of nosocomial infection, sepsis or death. Comparative studies were conducted between each two groups. Univariate and multivariate logistic regression analysis were used to identify variables related to the risk of nosocomial infection, sepsis, and mortality. Receiver operating characteristic (ROC) curve was plotted to assess the predictive value of various risk factors. Results: More severe trauma leads to more pronounced increase in ANC and more slowly recovery of ALC. In patients with subsequent nosocomial infection and sepsis, ANC was higher and ALC recovery was slower than those without nosocomial infection and sepsis within 7 days. In non-survivors, ALC had not recovered and AMC (D3) and AMC (D7) was lower than survivors within 7 days. ALC (D3) and ALC (D3/D1) are independent risk factors for nosocomial infection and sepsis. ALC (D3), ALC (D3/D1), ALC (D7) and AMC (D7) are independent risk factors for death. The combination of ALC (D3/D1) and ALC (D3) had a good predictive value for the occurrence of nosocomial infection, sepsis, and mortality. Conclusions: More severe trauma causes more intense interference to circulating immunocyte counts. Worse alterations in circulating immunocyte counts within 7 days may increase the risk of subsequent nosocomial infection, sepsis and mortality.

Prevalence of and Risk Factors for Suicide Attempts Among Patients With Severe Psychiatric Disorders in Eastern Morocco

Crisis ◽  
2021 ◽  
Author(s):  
Mohammed Barrimi ◽  
Khalid Serraj ◽  
Ismail Rammouz ◽  
Rachid Alouane ◽  
Najoua Messaoudi ◽  
...  
Keyword(s):  
Risk Factors ◽  
Family History ◽  
Suicide Attempt ◽  
Psychiatric Disorders ◽  
Suicide Attempts ◽  
Personal History ◽  
University Hospital ◽  
Number Of Patients ◽  
History Of ◽  
Risk Factors For Suicide

Abstract. Background: Suicide attempts are common in patients with severe psychiatric disorders; however, they are rarely studied in this population. Aims: To investigate the prevalence and risk factors associated with suicide attempts among patients with severe psychiatric disorders. Method: This is a cross-sectional study of patients admitted to the Mohammed VI University Hospital of Psychiatry in Oujda, Morocco. Results: A total of 250 patients with a psychiatric disorder were recruited in this study. Among these, 78 cases (31.2%) had a personal history of suicide attempts. A personal history of suicide attempt was significantly higher among women compared to men (45.5% vs. 27.2%, p = .0099). The most common method of suicide attempts was jumping from heights (31%). Patients with a personal history of suicide attempts had a significantly higher prevalence of alcohol consumption ( p = .0063), family history of psychiatric disorders ( p = .002), family history of suicide attempt ( p = .00004), and family history of suicide ( p = .018) compared to those who had never made suicide attempts. Limitations: As suicidal behavior is highly stigmatized in Morocco, the number of patients who have made a suicide attempt may be underestimated. Conclusion: Our findings justify the need to provide specialized support to psychiatric patients with risk factors for suicide attempts.

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