Chiang Yung-Chih, Couper Jeremy, Chen Jing-Wen, Lin Ke-Jui, Wu Han-Ping
Department of Psychiatry, Kaohsiung Veterans General Hospital, Kaohsiung, Taiwan.
Eastern Health, Melbourne, Victoria, Australia.
Support Care Cancer. 2022 Jun;30(6):5047-5053. doi: 10.1007/s00520-022-06801-4. Epub 2022 Feb 24.
This study aimed to assess the association between the Distress Thermometer (DT) score and risk of suicide in patients with cancer. In addition, we aimed to determine the best cutoff score to predict patients at risk of suicide.
From 2015 to 2016, we retrospectively collected data on patients with cancer. DT scores were collected, and the association between DT score and risk of suicide (suicide ideation or death ideation) was analyzed. Furthermore, receiver operating characteristic (ROC) analysis was performed to identify the appropriate cutoff score for predicting risk of suicide.
A total of 260 patients with cancer were included, and suicidal ideation was identified in 33 cases referred for psychological intervention. The DT scores of the patients with suicidal ideation were significantly higher than those of patients without suicidal ideation (6.30±2.11 vs. 4.29±1.72, p<0.05). In addition, the area under the ROC curve for predicting risk for suicide was 0.758. The cutoff DT score of 3 had the highest sensitivity of 1.00 to rule out suicidal ideation, while 9 had the highest specificity of 1.00 to rule in suicidal ideation. Moreover, the appropriate cutoff DT score to predict patients with suicidal ideation was 5, with a sensitivity of 0.52, specificity of .84, positive likelihood ratio of 3.24, and negative likelihood ratio of 0.58.
The DT score may be a helpful clinical tool to evaluate emotional distress and risk of suicide in patients with cancer. Clinically, for DT scores greater than 5 in patients with cancer, the risk of suicide greatly increases. In view of the DT's widespread use internationally by non-mental health clinicians in cancer to guide the need for specialist mental health interventions, its potential utility in also predicting suicide risk is of great interest.
本研究旨在评估癌症患者的苦恼温度计（DT）得分与自杀风险之间的关联。此外，我们旨在确定预测自杀风险患者的最佳临界值。
2015年至2016年，我们回顾性收集了癌症患者的数据。收集DT得分，并分析DT得分与自杀风险（自杀意念或死亡意念）之间的关联。此外，进行了受试者工作特征（ROC）分析，以确定预测自杀风险的合适临界值。
共纳入260例癌症患者，其中33例因心理干预而被转诊，被确定有自杀意念。有自杀意念患者的DT得分显著高于无自杀意念患者（6.30±2.11 vs. 4.29±1.72，p<0.05）。此外，预测自杀风险的ROC曲线下面积为0.758。DT临界值为3时，排除自杀意念的灵敏度最高，为1.00；而临界值为9时，纳入自杀意念的特异性最高，为1.00。此外，预测有自杀意念患者的合适DT临界值为5，灵敏度为0.52，特异性为0.84，阳性似然比为3.24，阴性似然比为0.58。
DT得分可能是评估癌症患者情绪困扰和自杀风险的有用临床工具。临床上，癌症患者DT得分大于5时，自杀风险会大幅增加。鉴于DT在国际上被癌症领域的非心理健康临床医生广泛用于指导专业心理健康干预的需求，其在预测自杀风险方面的潜在效用备受关注。
