Aguglia Andrea, Natale Antimo, Fusar-Poli Laura, Gnecco Giovanni Battista, Lechiara Alessio, Marino Margherita, Meinero Matteo, Pastorino Fabrizio, Costanza Alessandra, Spedicato Giorgio Alfredo, Amerio Andrea, Serafini Gianluca, Aguglia Eugenio, Amore Mario
Department of Neuroscience, Rehabilitation, Ophthalmology, Genetics, Maternal and Child Health, Section of Psychiatry, University of Genoa, 16132 Genoa, Italy.
Istituto di Ricovero e Cura a Carattere Scientifico Ospedale Policlinico San Martino, 16132 Genoa, Italy.
Life (Basel). 2022 Oct 7;12(10):1557. doi: 10.3390/life12101557.
The aim of the present study was to identify a cut-off of c-reactive protein (c-RP) potentially predictive of high-lethality suicide attempts (SA) in an inpatient psychiatric sample. After attempting suicide, subjects were admitted to the emergency ward of the IRCCS Ospedale Policlinico San Martino and later to the section of Psychiatry from 1 August 2013 to 31 July 2018. C-reactive protein was measured. The Area Under the Receiver Operating Characteristic (ROC_AUC) was used to assess the discriminative capacity of c-RP for high- vs. low-lethality SA, and a logistic regression was performed to detect the odds ratio, adjusted for age and sex. High-lethality suicide attempters were 133 (30.8%), while low-lethality suicide attempters were 299 (69.2%). The optimal cut-off threshold (and corresponding sensitivity and specificity values) for c-RP was 4.65 mg/L (68/71%). This cut-off corresponds to an AUC of 73.5%. An odds ratio of 4.70 was generated for current high-lethality SA after a logistic regression, adjusted for age and sex. Research on social and biological factors underlying the lethality of SA is crucial for a better understanding of this complex phenomenon. Identifying potential predictors of SA, especially those at high lethality, is essential to implement personalized preventive strategies.
本研究的目的是在住院精神科样本中确定一个C反应蛋白（c-RP）的临界值，该临界值可能预测高致死性自杀未遂（SA）。自杀未遂后，研究对象于2013年8月1日至2018年7月31日被收治入IRCCS圣马尔蒂诺综合医院急诊科，随后进入精神科。检测C反应蛋白。受试者工作特征曲线下面积（ROC_AUC）用于评估c-RP对高致死性与低致死性SA的判别能力，并进行逻辑回归以检测经年龄和性别调整后的优势比。高致死性自杀未遂者有133例（30.8%），而低致死性自杀未遂者有299例（69.2%）。c-RP的最佳临界阈值（以及相应的敏感性和特异性值）为4.65mg/L（68/71%）。该临界值对应的AUC为73.5%。经年龄和性别调整后的逻辑回归显示，当前高致死性SA的优势比为4.70。研究SA致死性背后的社会和生物学因素对于更好地理解这一复杂现象至关重要。确定SA的潜在预测因素，尤其是高致死性SA的预测因素，对于实施个性化预防策略至关重要。
