Construction of risk factors and prediction models for suicidal ideation in inpatients with schizophrenia
10.3760/cma.j.cn113661-20230912-00057
- VernacularTitle:住院精神分裂症患者自杀意念影响因素及预测模型的构建
- Author:
Ting WANG
1
;
Lin WANG
;
Fei YE
;
Yunliang YAO
;
Min LING
;
Aiqin PENG
Author Information
1. 江苏省扬州五台山医院，扬州 225000
- Publication Type:Journal Article
- Keywords:
Schizophrenia;
Suicidal ideation;
Risk factors;
Logistic models
- From:
Chinese Journal of Psychiatry
2024;57(5):305-312
- CountryChina
- Language:Chinese
-
Abstract:
Objective:This study aims to analyze the current status and risk factors of suicidal ideation in inpatients with schizophrenia and develop prediction models to improve the identification of individuals at high risk of suicide attempts.Methods:A total of 252 inpatients with schizophrenia were grouped with a 7∶3 ratio into modeling group ( n=176) and validation group ( n=76). The Beck Scale for Suicide Ideation (BSI), the Hamilton Anxiety Scale (HAMA), the Hamilton Depression Scale (HAMD), the Social Support-Rating Scale (SSRS), the Brief Psychiatric Rating Scale (BPRS), the Pittsburgh Sleep Quality Index (PSQI) were used to assess suicidal ideation, anxiety symptoms, depressive symptoms, social support, psychotic symptoms, and sleep quality, respectively. According to the presence of suicidal ideation, all patients were classified into those with and without suicidal ideation. The difference in each potential risk factor between the two groups was tested using the independent sample t-test and χ 2 test as appropriate. Multivariate Logistic stepwise regression analysis was used to identify independent risk factors of suicidal ideation. The R 4.1.2 software was used to construct the risk prediction model and draw a nomogram to visualize the Logistic regression model. The receiver operating characteristic (ROC) and the area under curve (AUC) were calculated to evaluate the predictability of this model. Internal validation of the model was examined using the Boostrap validation method. Results:Of the 252 inpatients with schizophrenia, 92 patients experienced suicidal ideation, with an incidence of 36.51%. The Logistic regression model revealed that gender (β=0.70, OR=3.66, 95% CI=1.02-3.85), education (β=-0.54, OR=0.85, 95% CI=0.19-0.89), chaperonage (β=1.32, OR=6.72, 95% CI=1.38-10.16), anxiety symptoms (β=0.08, OR=3.98, 95% CI=1.01-1.18), depressive symptoms (β=0.11, OR=28.30, 95% CI=1.07-1.16) were independent risk factors of suicidal ideation in inpatients with schizophrenia (all P?0.05). The AUC of the modeling group and validation group were 0.83 and 0.82, respectively. Conclusion:The incidence of suicidal ideation was high in inpatients with schizophrenia. The Logistic risk prediction model constructed in this study has good predictive efficacy, which can provide a theoretical basis for early identification of individuals at high risk of suicide attempts.
