University of Lille, Inserm, CHU Lille, U1172 - LilNCog-Lille Neuroscience & Cognition, Lille, France.
Corresponding author: Alice Demesmaeker, MD, MSc, Hôpital Fontan, CHU de Lille, F-59037, Lille Cedex, France (
J Clin Psychiatry. 2021 Feb 18;82(1):20m13589. doi: 10.4088/JCP.20m13589.
Understanding the cumulative effect of several risk factors involved in suicidal behavior is crucial for the development of effective prevention plans. The objective of this study is to provide clinicians with a simple predictive model of the risk of suicide attempts and suicide within 6 months after suicide attempt.
A prospective observational cohort of 972 subjects, included from January 26, 2010, to February 28, 2013, was used to perform a survival tree analysis with all sociodemographic and clinical variables available at inclusion. The results of the decision tree were then used to define a simple predictive algorithm for clinicians.
The results of survival tree analysis highlighted 3 subgroups of patients with an increased risk of suicide attempt or death by suicide within 6 months after suicide attempt: patients with alcohol use disorder and a previous suicide attempt with acute alcohol use (risk ratio [RR] = 2.92; 95% CI, 2.08 to 4.10), patients with anxiety disorders (RR = 0.98; 95% CI, 0.69 to 1.39), and patients with a history of more than 2 suicide attempts in the past 3 years (RR = 2.11; 95% CI, 1.25 to 3.54). The good prognosis group comprised all other patients.
By using a data-driven method, this study identified 4 clinical factors interacting together to reduce or increase the risk of recidivism. These combinations of risk factors allow for a better evaluation of a subject's suicide risk in clinical practice.
ClinicalTrials.gov identifier: NCT01123174.
了解自杀行为相关的多种风险因素的累积效应对于制定有效的预防计划至关重要。本研究旨在为临床医生提供一种简单的预测模型，用于预测自杀未遂后 6 个月内自杀企图和自杀的风险。
采用前瞻性观察队列研究，纳入 2010 年 1 月 26 日至 2013 年 2 月 28 日期间的 972 例患者，对所有纳入时的社会人口学和临床变量进行生存树分析。然后，使用决策树的结果为临床医生定义一个简单的预测算法。
生存树分析结果突出了自杀未遂后 6 个月内自杀企图或自杀死亡风险增加的 3 个亚组患者：有酒精使用障碍且之前有自杀未遂伴急性酒精使用的患者（风险比 [RR] = 2.92；95%CI，2.08 至 4.10）、有焦虑障碍的患者（RR = 0.98；95%CI，0.69 至 1.39）和过去 3 年内有 2 次以上自杀企图史的患者（RR = 2.11；95%CI，1.25 至 3.54）。预后良好组包括所有其他患者。
本研究通过使用数据驱动的方法，确定了 4 种相互作用的临床因素，共同降低或增加复发风险。这些风险因素的组合可以更好地评估患者在临床实践中的自杀风险。
ClinicalTrials.gov 标识符：NCT01123174。
