Prediction of Suicidal Behavior in Clinical Research by Lifetime Suicidal Ideation and Behavior Ascertained by the Electronic Columbia-Suicide Severity Rating Scale
Prediction of Suicidal Behavior in Clinical Research by Lifetime Suicidal Ideation and Behavior Ascertained by the Electronic Columbia-Suicide Severity Rating Scale
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DOI：
10.4088/jcp.13m08398
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发表时间：
2013-01-01
影响因子：
5.3
通讯作者：
Posner, Kelly
中科院分区：
文献类型：
--
作者：
Mundt, James C.;Greist, John H.;Posner, Kelly
目的：为了评估是否终身自杀意念与意图采取行动和/或自杀行为报告在基线预测风险的前瞻性报告自杀行为在随后的studyparticipation.Method：数据从研究中使用电子哥伦比亚自杀严重程度评定量表（eC-SSRS），以前瞻性监测自杀意念和行为之间的2009年9月和2011年5月进行了分析。研究包括重度抑郁症、失眠症、创伤后应激障碍、癫痫和纤维肌痛患者。提取了35，224项eC-SSRS评估的记录。缺失基线评估或无前瞻性随访评估的患者的不完整评估和eC-SSRS记录被排除。基线终身eC-SSRS报告分为阴性（无终身意图行为或既往自杀行为的想法）或阳性（终身意图行为但无既往行为的想法，无意图行为但有既往行为的想法，或终身意图行为和既往行为的想法）。平均随访时间为64天。在终生报告阴性的患者中，2.4%的患者随后在参与研究期间报告了自杀行为，相比之下，12.0%的终生意念仅为意图的患者（OR = 5.55; 95%CI，2.65-11.59），9.6%的患者仅具有终生行为（OR = 4.33; 95%CI，2.94-6.39），18.3%的患者同时患有两种疾病（OR = 9.13; 95%CI，6.47-12.88）。敏感性和特异性的积极报告，以确定自杀behaviors. Conclusions的敏感性和特异性分别为0.67和0.76，分别：患者报告一生自杀意念与意图采取行动和/或先前的自杀行为在基线是4至9倍更有可能前瞻性地报告自杀行为在研究参与。
Objective: To evaluate whether lifetime suicidal ideation with intention to act and/or suicidal behaviors reported at baseline predict risk of prospectively reporting suicidal behavior during subsequent study participation.Method: Data from studies using the electronic Columbia-Suicide Severity Rating Scale (eC-SSRS) to prospectively monitor suicidal ideation and behaviors between September 2009 and May 2011 were analyzed. Studies included patients with major depressive disorder, insomnia, posttraumatic stress disorder, epilepsy, and fibromyalgia. Records for 35,224 eC-SSRS assessments were extracted. Incomplete assessments and eC-SSRS records from patients missing a baseline assessment or with no prospective follow-up assessments were excluded. Baseline lifetime eC-SSRS reports were categorized as negative (no lifetime ideation with intent to act or prior suicidal behavior) or positive (lifetime ideation with intent to act but no prior behavior, no ideation with intent to act but prior behavior, or both lifetime ideation with intent and prior behavior).Results: 3,776 patients completed a baseline and 1 or more follow-up assessments. The mean follow-up period was 64 days. Of patients with negative lifetime reports, 2.4% subsequently reported suicidal behavior during study participation, compared to 12.0% of patients with lifetime ideation with intent only (OR = 5.55; 95% CI, 2.65-11.59), 9.6% of patients with lifetime behavior only (OR = 4.33; 95% CI, 2.94-6.39), and 18.3% of patients with both (OR = 9.13; 95% CI, 6.47-12.88). Sensitivity and specificity of positive reports for identifying suicidal behaviors were 0.67 and 0.76, respectively.Conclusions: Patients reporting lifetime suicidal ideation with intent to act and/or prior suicidal behavior at baseline are 4 to 9 times more likely to prospectively report suicidal behavior during study participation.