College of Management, Shenzhen University, Shenzhen, China.
School of Business Informatics and Mathematics, University of Mannheim, Mannheim, Germany.
J Affect Disord. 2024 May 1;352:87-100. doi: 10.1016/j.jad.2024.02.035. Epub 2024 Feb 13.
Suicide has been recognized as a major global public health issue. Depressed adolescents are more prone to experiencing it. We explore risk factors and their differences on suicidal ideation and suicide attempts to further enhance our understanding of suicidal behavior.
2343 depressed adolescents aged 12-18 from 9 provinces/cities in China participated in this cross-sectional study. We utilized decision tree model, incorporating 32 factors encompassing participants' suicidal behavior. The feature importance of each factor was measured using Gini coefficients.
The decision tree model demonstrated a good fit with high accuracy (SI = 0.86, SA = 0.85 and F-Score (SI = 0.85, SA = 0.83). The predictive importance of each factor varied between groups with suicidal ideation and with suicide attempts. The most significant risk factor in both groups was depression (SI = 16.7 %, SA = 19.8 %). However, factors such as academic stress (SI = 7.2 %, SA = 1.6 %), hopelessness (SI = 9.1 %, SA = 5.0 %), and age (SI = 7.1 %, SA = 3.2 %) were more closely associated with suicidal ideation than suicide attempts. Factors related to the schooling status (SI = 3.5 %, SA = 10.1 %), total years of education (SI = 2.6 %, SA = 8.6 %), and loneliness (SI = 2.3 %, SA = 7.4 %) were relatively more important in the suicide attempt stage compared to suicidal ideation.
The cross-sectional design limited the ability to capture changes in suicidal behavior among depressed adolescents over time. Possible bias may exist in the measurement of suicidal ideation.
The relative importance of each risk factor for suicidal ideation and attempted suicide varies. These findings provide further empirical evidence for understanding suicide behavior. Targeted treatment measures should be taken for different stages of suicide in clinical interventions.
自杀已被公认为一个重大的全球公共卫生问题。抑郁青少年更容易经历自杀。我们探索自杀意念和自杀未遂的风险因素及其差异，以进一步增强我们对自杀行为的理解。
本横断面研究纳入了来自中国 9 个省/市的 2343 名 12-18 岁的抑郁青少年。我们利用决策树模型，纳入了 32 个包含参与者自杀行为的因素。使用基尼系数衡量每个因素的特征重要性。
决策树模型具有良好的拟合度和较高的准确性（SI=0.86，SA=0.85 和 F-分数（SI=0.85，SA=0.83）。有自杀意念和自杀未遂的两组之间，每个因素的预测重要性不同。两组中最显著的风险因素均为抑郁（SI=16.7%，SA=19.8%）。然而，与自杀未遂相比，学业压力（SI=7.2%，SA=1.6%）、绝望感（SI=9.1%，SA=5.0%）和年龄（SI=7.1%，SA=3.2%）等因素与自杀意念的关系更为密切。与学校教育状况（SI=3.5%，SA=10.1%）、受教育年限（SI=2.6%，SA=8.6%）和孤独感（SI=2.3%，SA=7.4%）相关的因素在自杀未遂阶段相对比自杀意念阶段更为重要。
横断面设计限制了捕捉抑郁青少年随时间推移自杀行为变化的能力。自杀意念的测量可能存在偏差。
自杀意念和自杀未遂的每个风险因素的相对重要性不同。这些发现为理解自杀行为提供了进一步的实证证据。在临床干预中，应针对自杀的不同阶段采取有针对性的治疗措施。
