Mortier Philippe, Kiekens Glenn, Auerbach Randy P, Cuijpers Pim, Demyttenaere Koen, Green Jennifer G, Kessler Ronald C, Nock Matthew K, Zaslavsky Alan M, Bruffaerts Ronny
Research Group Psychiatry, Department of Neurosciences, KU Leuven University, Herestraat 49, Leuven, Belgium.
Research Group Psychiatry, Department of Neurosciences, KU Leuven University, Leuven, Belgium.
J Clin Psychiatry. 2017 Jul;78(7):e828-e836. doi: 10.4088/JCP.17m11485.
The primary aims of this study are to (a) identify patterns of suicidal thoughts and behaviors (STB) during college among students with lifetime pre-matriculation STB and (b) develop a risk-screening algorithm for persistence of pre-matriculation STB during college.
Data come from the Leuven College Surveys, a series of prospective cohort studies of all incoming KU Leuven University freshmen. In the academic year 2012-2013, 4,889 incoming freshmen (73.2% response rate) provided baseline data on sociodemographic variables, childhood-adolescent traumatic experiences, 12-month stressful experiences, 12-month mental disorders, 12-month STB, and severity markers of pre-matriculation STB. A total of 2,566 students (69.3% conditional response rate) participated in 12- and 24-month follow-up surveys during the first 2 college years.
Thirteen percent (weighted n = 535) of incoming freshmen reported lifetime pre-matriculation STB. Of those, 28.0% reported 12-month STB in 1 follow-up assessment, and another 27.7%, in both follow-up assessments. High persistence of STB (ie, 12-month STB in 2 follow-up assessments) was most strongly associated with severity markers of pre-matriculation STB, with odds ratios in the 2.4-10.3 range and population attributable risk proportions between 9.2% and 50.8%. When the aim was for less than 50% of false-positive cases (positive predictive value = 54.4%), a multivariate predictive risk algorithm (cross-validated area under the curve = 0.79) situated 59.9% of highly persistent cases among the 30% respondents with highest baseline predicted risk.
An individualized web-based screening approach is a promising strategy to identify students at the time of university entrance who may be at high risk for STB persistence during their academic career.
本研究的主要目的是：（a）确定大学期间有入学前终生自杀想法和行为（STB）的学生的自杀想法和行为模式；（b）开发一种风险筛查算法，以预测大学期间入学前STB持续存在的情况。
数据来自鲁汶大学调查，这是对所有鲁汶大学新生进行的一系列前瞻性队列研究。在2012 - 2013学年，4889名新生（回复率73.2%）提供了关于社会人口统计学变量、儿童期 - 青少年期创伤经历、12个月应激经历、12个月精神障碍、12个月STB以及入学前STB严重程度指标的基线数据。在大学的前两年，共有2566名学生（条件回复率69.3%）参与了12个月和24个月的随访调查。
13%（加权n = 535）的新生报告有入学前终生STB。其中，28.0%在一次随访评估中报告有12个月STB，另有27.7%在两次随访评估中均报告有12个月STB。STB的高持续性（即两次随访评估中均有12个月STB）与入学前STB的严重程度指标最密切相关，优势比在2.4 - 10.3范围内，人群归因风险比例在9.2%至50.8%之间。当目标是假阳性病例少于50%（阳性预测值 = 54.4%）时，一种多变量预测风险算法（曲线下交叉验证面积 = 0.79）在基线预测风险最高的30%受访者中识别出了59.9%的高持续性病例。
一种基于网络的个性化筛查方法是一种有前景的策略，可在大学入学时识别出在其学业生涯中可能有STB持续高风险的学生。
