School of Nursing, Southern Medical University, No. 1023 Sha Tai South road, Baiyun district, Guangzhou, 510515, China.
Department of Medical Oncology, Nanfang Hospital, Southern Medical University, No. 1838, North Guangzhou Avenue, Baiyun District, Guangzhou, 510515, China.
BMC Psychiatry. 2022 May 24;22(1):353. doi: 10.1186/s12888-022-03987-z.
Suicidal ideation in cancer patients is a critical challenge. At present, few studies focus on factors associated with suicidal ideation, and predictive models are still lacking. This study aimed at investigating the risk factors for suicidal ideation among cancer patients, and developed a predictive nomogram to screen high risk cancer patients for early prevention and intervention.
A questionnaire survey was conducted among cancer patients between May 2021 and January 2022. The factors associated with suicidal ideation were used to construct a multivariate logistic regression model, which was visualized as a predictive nomogram to evaluate the risk of suicidal ideation. Areas under the curve, calibration plot, decision curve analysis, and internal and external validation were used to validate the discrimination, calibration and clinical usefulness of the model.
A total of 820 patients with cancer were recruited for this study and 213 (25.98%) developed suicidal ideation. Levels of demoralization, depression and cancer staging, marital status, residence, medical financial burden, and living condition were influence factors for suicidal ideation. Comparing nomogram with Self-rating Idea of Suicide Scale (SIOSS), the nomogram had a satisfactory discrimination ability with an AUC of 0.859 (95% CI: 0.827-0.890) and 0.818 (95% CI: 0.764-0.873) in the training and validation sets, respectively. The calibration plot and decision curve analysis revealed that this nomogram was in good fitness and could be beneficial in clinical applications.
Suicidal ideation is common in cancer patients. Levels of demoralization, depression and cancer staging were independent predictors of suicidal ideation. The nomogram is an effective and simple tool for predictive suicidal ideation in cancer patients.
癌症患者的自杀意念是一个严重的挑战。目前，很少有研究关注与自杀意念相关的因素，也缺乏预测模型。本研究旨在探讨癌症患者自杀意念的危险因素，并构建预测列线图以筛查高危癌症患者，进行早期预防和干预。
2021 年 5 月至 2022 年 1 月期间对癌症患者进行问卷调查。使用与自杀意念相关的因素构建多因素逻辑回归模型，并将其可视化作为预测列线图，以评估自杀意念的风险。使用曲线下面积、校准图、决策曲线分析以及内部和外部验证来验证模型的区分度、校准度和临床实用性。
共纳入 820 例癌症患者，其中 213 例（25.98%）出现自杀意念。抑郁和绝望水平、癌症分期、婚姻状况、居住地点、医疗经济负担和生活状况是自杀意念的影响因素。与自杀意念自评量表（SIOSS）相比，列线图具有较好的区分能力，在训练集和验证集中 AUC 分别为 0.859（95%CI：0.827-0.890）和 0.818（95%CI：0.764-0.873）。校准图和决策曲线分析表明，该列线图拟合良好，可在临床应用中获益。
癌症患者自杀意念较为常见。抑郁和绝望水平以及癌症分期是自杀意念的独立预测因素。列线图是一种预测癌症患者自杀意念的有效且简单的工具。
