Center for Suicide Prevention Research, School of Public Health, Shandong University, 44 Wenhuaxi Road, Jinan 250012, China.
Key Laboratory for Health Economics and Policy Research (Shandong University), National Health Commission of China, 44 Wenhuaxi Road, Jinan 250012, China.
Int J Environ Res Public Health. 2021 Dec 18;18(24):13362. doi: 10.3390/ijerph182413362.
Although many suicide risk assessment tools are available in the world, their validity is not adequately assessed. In this study, we aimed to develop and evaluate a suicide risk assessment model among Chinese rural youths aged 15-34 years. Subjects were 373 suicide deaths and 507 suicide attempters aged 15-34 years in three Chinese provinces (Shandong, Liaoning, and Hunan). Information about the community residents was also collected as the control groups. Social-demographic, social and psychological variables were examined for the suicides, suicide attempters, and community residents. Logistic regressions based on subjects from Shandong and Liaoning provinces were conducted to establish the suicide risk assessment models. Receiver operating characteristic (ROC) curves were drawn, and area under the ROC curves (AUC) were calculated to show how well the models separated the group being tested into those with and without suicide attempt or suicide. The assessment model for suicide death included education years (OR = 0.773, < 0.001), agricultural worker (OR = 2.091, < 0.05), physical health (OR = 0.445, < 0.05), family suicide history (OR = 6.858, < 0.001), negative life events (OR = 1.340, < 0.001), hopelessness (OR = 1.171, < 0.001), impulsivity (OR = 1.151, < 0.001), and mental disorder (OR = 8.384, < 0.001). All these factors were also supported in the assessment model for suicide attempt, with an extension of very poor economic status (OR = 1.941, < 0.01) and social interaction (OR = 0.855, < 0.001). The AUC was 0.950 and 0.857 for the sample used to establish the assessment models of suicide death and attempt, respectively. The AUC was 0.967 and 0.942 for the sample used to verify the established assessment models of suicide death and attempt, respectively. Compared with some other assessment tools, the models for suicide death and attempt in the current study performed well among Chinese rural youths aged 15-34 years. A reliable suicide risk assessment approach, which includes multiple risk factors, should be evaluated in various cultures and populations.
尽管世界上有许多自杀风险评估工具，但它们的有效性并未得到充分评估。在这项研究中，我们旨在为中国农村 15-34 岁的年轻人开发和评估一种自杀风险评估模型。研究对象为三个中国省份（山东、辽宁和湖南）的 373 例自杀死亡和 507 例自杀未遂者，以及社区居民作为对照组。还收集了有关社区居民的信息。对自杀者、自杀未遂者和社区居民进行了社会人口学、社会和心理变量的检查。根据来自山东和辽宁的研究对象进行了逻辑回归，以建立自杀风险评估模型。绘制了接收者操作特征（ROC）曲线，并计算了 ROC 曲线下的面积（AUC），以显示模型如何将被测试组分为有自杀未遂或自杀倾向的组和没有自杀未遂或自杀倾向的组。自杀死亡评估模型包括受教育年限（OR=0.773，<0.001）、农业工人（OR=2.091，<0.05）、身体健康（OR=0.445，<0.05）、家族自杀史（OR=6.858，<0.001）、负性生活事件（OR=1.340，<0.001）、绝望（OR=1.171，<0.001）、冲动（OR=1.151，<0.001）和精神障碍（OR=8.384，<0.001）。这些因素在自杀未遂评估模型中也得到了支持，扩展了非常贫困的经济状况（OR=1.941，<0.01）和社会互动（OR=0.855，<0.001）。用于建立自杀死亡和尝试评估模型的样本的 AUC 分别为 0.950 和 0.857。用于验证建立的自杀死亡和尝试评估模型的样本的 AUC 分别为 0.967 和 0.942。与其他一些评估工具相比，该研究中针对 15-34 岁中国农村青年的自杀死亡和尝试评估模型表现良好。应在各种文化和人群中评估一种包含多种危险因素的可靠自杀风险评估方法。
