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Severity and Variability of Depression Symptoms Predicting Suicide Attempt in High-Risk Individuals.


ABSTRACT: Importance:Predicting suicidal behavior continues to be among the most challenging tasks in psychiatry. Objectives:To examine the trajectories of clinical predictors of suicide attempt (specifically, depression symptoms, hopelessness, impulsivity, aggression, impulsive aggression, and irritability) for their ability to predict suicide attempt and to compute a risk score for suicide attempts. Design, Setting, and Participants:This is a longitudinal study of the offspring of parents (or probands) with mood disorders who were recruited from inpatient units at Western Psychiatric Institute and Clinic (Pittsburgh) and New York State Psychiatric Institute. Participants were recruited from July 15, 1997, to September 6, 2005, and were followed up through January 21, 2014. Probands and offspring (n?=?663) were interviewed at baseline and at yearly follow-ups for 12 years. Lifetime and current psychiatric disorders were assessed, and self-reported questionnaires were administered. Model evaluation used 10-fold cross-validation, which split the entire data set into 10 equal parts, fit the model to 90% of the data (training set), and assessed it on the remaining 10% (test set) and repeated that process 10 times. Preliminary analyses were performed from July 20, 2015, to October 5, 2016. Additional analyses were conducted from July 26, 2017, to July 24, 2018. Main Outcomes and Measures:The broad definition of suicide attempt included actual, interrupted, and aborted attempts as well as suicidal ideation that prompted emergency referrals during the study. The narrow definition referred to actual attempt only. Results:The sample of offspring (n?=?663) was almost equally distributed by sex (316 female [47.7%]) and had a mean (SD) age of 23.8 (8.5) years at the time of censored observations. Among the 663 offspring, 71 (10.7%) had suicide attempts over the course of the study. The trajectory of depression symptoms with the highest mean scores and variability over time was the only trajectory to predict suicide attempt (odds ratio [OR], 4.72; 95% CI, 1.47-15.21; P?=?.01). In addition, we identified the following predictors: younger age (OR, 0.82; 95% CI, 0.74-0.90; P?

SUBMITTER: Melhem NM 

PROVIDER: S-EPMC6551844 | biostudies-literature | 2019 Jun

REPOSITORIES: biostudies-literature

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Severity and Variability of Depression Symptoms Predicting Suicide Attempt in High-Risk Individuals.

Melhem Nadine M NM   Porta Giovanna G   Oquendo Maria A MA   Zelazny Jamie J   Keilp John G JG   Iyengar Satish S   Burke Ainsley A   Birmaher Boris B   Stanley Barbara B   Mann J John JJ   Brent David A DA  

JAMA psychiatry 20190601 6


<h4>Importance</h4>Predicting suicidal behavior continues to be among the most challenging tasks in psychiatry.<h4>Objectives</h4>To examine the trajectories of clinical predictors of suicide attempt (specifically, depression symptoms, hopelessness, impulsivity, aggression, impulsive aggression, and irritability) for their ability to predict suicide attempt and to compute a risk score for suicide attempts.<h4>Design, setting, and participants</h4>This is a longitudinal study of the offspring of  ...[more]

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