Centre for Mental Health Research, The Australian National University, Canberra, ACT 0200, Australia.
J Affect Disord. 2012 Dec 15;142(1-3):306-14. doi: 10.1016/j.jad.2012.05.021. Epub 2012 Jul 26.
While associations between specific risk factors and subsequent suicidal thoughts or behaviours have been widely examined, there is limited understanding of the interplay between risk factors in the development of suicide risk. This study used a decision tree approach to develop individual models of suicide risk and identify the risk factors for suicidality that are important for different subpopulations.
In a population cohort of 6656 Australian adults, the study examined whether measures of mental health, physical health, personality, substance use, social support, social stressors and background characteristics were associated with suicidal ideation and suicidal behaviours after four-year follow-up.
Previous suicidality, anxiety symptoms, depression symptoms, neuroticism and rumination were the strongest predictors of suicidal ideation and behaviour after four years. However, divergent factors were predictive of suicidal thoughts and behaviours across the spectrum of mental health. In particular, substance use was only associated with suicidal thoughts and behaviours in those with moderate levels of anxiety or depression.
Most of the measurements were based on self-report. Further research is required to assess whether changes in risk factors lead to changes in suicidality.
Examining suicide risk factors using decision trees is a promising approach for developing individualised assessments of suicide risk and tailored intervention programs.
虽然特定风险因素与随后的自杀想法或行为之间的关联已被广泛研究，但对于风险因素在自杀风险发展中的相互作用仍知之甚少。本研究采用决策树方法来为个体的自杀风险建立模型，并确定对于不同亚人群而言重要的自杀风险因素。
在一项针对 6656 名澳大利亚成年人的人群队列研究中，研究人员调查了心理健康、身体健康、人格、物质使用、社会支持、社会压力源和背景特征等指标是否与四年随访后的自杀意念和自杀行为相关。
既往自杀、焦虑症状、抑郁症状、神经质和反刍是四年后自杀意念和行为的最强预测因素。然而，在心理健康的各个方面，不同的因素预测着自杀想法和行为。特别是，物质使用仅与中度焦虑或抑郁患者的自杀想法和行为相关。
大多数测量都是基于自我报告。需要进一步的研究来评估风险因素的变化是否会导致自杀意念的变化。
使用决策树来检查自杀风险因素是一种很有前途的方法，可以对自杀风险进行个体化评估，并制定个性化的干预计划。
