Prediction of suicidal ideation risk in a prospective cohort study of medical interns.
Prediction of suicidal ideation risk in a prospective cohort study of medical interns.
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DOI：
10.1371/journal.pone.0260620
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发表时间：
2021
期刊：
影响因子：
3.7
通讯作者：
Scott LJ
中科院分区：
文献类型：
--
作者：
Malone TL;Zhao Z;Liu TY;Song PXK;Sen S;Scott LJ
本研究的目的是确定与自杀风险增加相关的个人和住院医师项目因素，以自杀意念为衡量标准。我们采用前瞻性、纵向队列研究设计，评估了美国医院系统中6，691名（2012-2014年队列，培训数据集）和4，904名（2015年队列，测试数据集）第一年培训医生（实习生）的自杀意念的患病率和预测因素。我们在实习前两个月评估了自杀意念，然后每季度评估一次。研究人群中报告的自杀意念的患病率从基线时的3.0%增加到实习期间的平均6.9%。16.4%的实习生在实习期间至少有一次自杀意念。在训练数据集中，一系列基线人口统计学（男性）和心理因素（高神经质，抑郁症状和自杀意念）与实习期间自杀意念的风险增加相关。此外，前一季度的精神症状（抑郁症状和自杀意念）和并发的工作相关因素（增加自我报告的工作时间和医疗错误）与自杀意念的风险增加。从训练数据集导出的模型在测试数据集中具有0.83的受试者操作特征曲线（AUC）下的预测面积。在这项研究中分析的自杀意念风险预测因子可以帮助项目和实习生在培训开始前识别那些有自杀意念风险的人。此外，自我报告的工作时间和与医疗差错增加相关的环境的增加是住院医师项目以降低自杀风险为目标的潜在可修改因素。
The purpose of this study was to identify individual and residency program factors associated with increased suicide risk, as measured by suicidal ideation. We utilized a prospective, longitudinal cohort study design to assess the prevalence and predictors of suicidal ideation in 6,691 (2012–2014 cohorts, training data set) and 4,904 (2015 cohort, test data set) first-year training physicians (interns) at hospital systems across the United States. We assessed suicidal ideation two months before internship and then quarterly through intern year. The prevalence of reported suicidal ideation in the study population increased from 3.0% at baseline to a mean of 6.9% during internship. 16.4% of interns reported suicidal ideation at least once during their internship. In the training dataset, a series of baseline demographic (male gender) and psychological factors (high neuroticism, depressive symptoms and suicidal ideation) were associated with increased risk of suicidal ideation during internship. Further, prior quarter psychiatric symptoms (depressive symptoms and suicidal ideation) and concurrent work-related factors (increase in self-reported work hours and medical errors) were associated with increased risk of suicidal ideation. A model derived from the training dataset had a predicted area under the Receiver Operating Characteristic curve (AUC) of 0.83 in the test dataset. The suicidal ideation risk predictors analyzed in this study can help programs and interns identify those at risk for suicidal ideation before the onset of training. Further, increases in self-reported work hours and environments associated with increased medical errors are potentially modifiable factors for residency programs to target to reduce suicide risk.
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影响因子：
25.8
作者：
Guille C;Zhao Z;Krystal J;Nichols B;Brady K;Sen S
通讯作者：
Sen S
影响因子：
6.9
作者：
Fried, E. I.;Nesse, R. M.;Sen, S.
通讯作者：
Sen, S.
影响因子：
4.6
作者：
Joiner, Thomas E., Jr.;Van Orden, Kimberly A.;Witte, Tracy K.;Selby, Edward A.;Ribeiro, Jessica D.;Lewis, Robyn;Rudd, M. David
通讯作者：
Rudd, M. David
影响因子：
11.3
作者：
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通讯作者：
Fink-Miller, Erin L.
影响因子：
4.4
作者：
Conner, Kenneth R.;Britton, Peter C.;Joiner, Thomas E., Jr.
通讯作者：
Joiner, Thomas E., Jr.