Zhao Juan, Li Ying, Chen Yangjie, Shuid Ahmad Naqib
Department of Psychiatry, First Hospital / First Clinical Medical College of Shanxi Medical University, Taiyuan, China.
2Advanced Medical and Dental Institute, Universiti Sains Malaysia, Kepala Batas, Pulau Pinang, Malaysia.
Front Psychiatry. 2025 May 2;16:1532828. doi: 10.3389/fpsyt.2025.1532828. eCollection 2025.
Adolescent suicide risk, particularly among individuals with depression, is a growing public health concern in China, driven by increasing social pressures and evolving family dynamics. However, limited research has focused on suicide prediction models tailored for hospitalized Chinese adolescents with depression. This study aims to develop a suicide risk prediction model for early identification of high-risk individuals using internal validation, providing insights for future clinical applications.
The study involved 229 adolescents aged 13-18 diagnosed with depression, admitted to a hospital in Shanxi, China. Feature selection was performed using Least Absolute Shrinkage and Selection Operator (Lasso) regression, and key predictors were incorporated into a multivariate logistic regression model. Model performance was assessed using the area under the receiver operating characteristic curve (AUC), Hosmer-Lemeshow test, calibration curves, decision curve analysis (DCA), and clinical impact curves (CIC).
The model demonstrated AUC values of 0.839 (95% CI: 0.777, 0.899) for the training set and 0.723 (95% CI: 0.601, 0.845) for the testing set, indicating strong discrimination capability. Significant predictors included gender, social frequency, parental relationships, self-harm behavior, experiences of loss, and sleep duration. DCA and CIC supported the model's predictive potential.
The model demonstrated strong predictive performance in internal validation, suggesting potential value for suicide risk assessment in hospitalized adolescents with depression. However, its generalizability remains to be confirmed. Further external validation in larger, multi-center cohorts is required to assess its robustness and clinical applicability.
在中国,青少年自杀风险,尤其是抑郁症患者的自杀风险,已成为日益严重的公共卫生问题,这是由社会压力增加和家庭动态变化所驱动的。然而,针对住院的中国抑郁症青少年的自杀预测模型的研究却十分有限。本研究旨在开发一种自杀风险预测模型,通过内部验证来早期识别高危个体,为未来的临床应用提供见解。
该研究纳入了229名年龄在13至18岁之间、被诊断为抑郁症且在中国山西某医院住院的青少年。使用最小绝对收缩和选择算子(Lasso)回归进行特征选择,并将关键预测因子纳入多变量逻辑回归模型。使用受试者工作特征曲线下面积(AUC)、Hosmer-Lemeshow检验、校准曲线、决策曲线分析(DCA)和临床影响曲线(CIC)来评估模型性能。
该模型在训练集上的AUC值为0.839(95%CI:0.777,0.899),在测试集上的AUC值为0.723(95%CI:0.601,0.845),表明具有很强的区分能力。显著的预测因子包括性别、社交频率、亲子关系、自伤行为、丧失经历和睡眠时间。DCA和CIC支持了该模型的预测潜力。
该模型在内部验证中表现出很强的预测性能,表明其在评估住院抑郁症青少年自杀风险方面具有潜在价值。然而,其普遍性仍有待证实。需要在更大规模的多中心队列中进行进一步的外部验证,以评估其稳健性和临床适用性。