A risk-scoring scheme for suicide attempts among patients with bipolar disorder in a Thai patient cohort

Background: In Thailand, risk factors associated with suicide attempts in bipolar disorder (BD) are rarely investigated, nor has a specific risk-scoring scheme to assist in the identification of BD patients at risk for attempting suicide been proposed. Objective: To develop a simple risk-scoring sch...

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Main Authors: Ruengorn C., Sanichwankul K., Niwatananun W., Suwat M., Wanida P., Patumanond J.
Format: Journal
Published: 2017
Online Access:https://www.scopus.com/inward/record.uri?partnerID=HzOxMe3b&scp=84875390396&origin=inward
http://cmuir.cmu.ac.th/jspui/handle/6653943832/42710
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Institution: Chiang Mai University
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spelling th-cmuir.6653943832-427102017-09-28T06:36:12Z A risk-scoring scheme for suicide attempts among patients with bipolar disorder in a Thai patient cohort Ruengorn C. Sanichwankul K. Niwatananun W. Suwat M. Wanida P. Patumanond J. Background: In Thailand, risk factors associated with suicide attempts in bipolar disorder (BD) are rarely investigated, nor has a specific risk-scoring scheme to assist in the identification of BD patients at risk for attempting suicide been proposed. Objective: To develop a simple risk-scoring scheme to identify patients with BD who may be at risk for attempting suicide. Methods: Medical files of 489 patients diagnosed with BD at Suanprung Psychiatric Hospital between October 2006 and May 2009 were reviewed. Cases included BD patients hospitalized due to attempted suicide (n = 58), and seven controls were selected (per suicide case) among BD in- and out-patients who did not attempt suicide, with patients being visited the same day or within 1 week of case study (n = 431). Broad sociodemographic and clinical factors were gathered and analyzed using multivariate logistic regression, to obtain a set of risk factors. Scores for each indicator were weighted, assigned, and summed to create a total risk score, which was divided into low, moderate, and high-risk suicide attempt groups. Results: Six statistically significant indicators associated with suicide attempts were included in the risk-scoring scheme: depression, psychotic symptom(s), number of previous suicide attempts, stressful life event(s), medication adherence, and BD treatment years. A total risk score (possible range -1.5 to 11.5) explained an 88.6% probability of suicide attempts based on the receiver operating characteristic (ROC) analysis. Likelihood ratios of suicide attempts with low risk scores (below 2.5), moderate risk scores (2.5-8.0), and high risk scores (above 8.0) were 0.11 (95% CI 0.04-0.32), 1.72 (95% CI 1.41-2.10), and 19.0 (95% CI 6.17-58.16), respectively. Conclusion: The proposed risk-scoring scheme is BD-specific, comprising six key indicators for simple, routine assessment and classification of patients to three risk groups. Further validation is required before adopting this scheme in other clinical settings. © 2012 Ruengorn et al, publisher and licensee Dove Medical Press Ltd. 2017-09-28T06:36:12Z 2017-09-28T06:36:12Z 2012-12-01 Journal 2-s2.0-84875390396 10.2147/PRBM.S30878 https://www.scopus.com/inward/record.uri?partnerID=HzOxMe3b&scp=84875390396&origin=inward http://cmuir.cmu.ac.th/jspui/handle/6653943832/42710
institution Chiang Mai University
building Chiang Mai University Library
country Thailand
collection CMU Intellectual Repository
description Background: In Thailand, risk factors associated with suicide attempts in bipolar disorder (BD) are rarely investigated, nor has a specific risk-scoring scheme to assist in the identification of BD patients at risk for attempting suicide been proposed. Objective: To develop a simple risk-scoring scheme to identify patients with BD who may be at risk for attempting suicide. Methods: Medical files of 489 patients diagnosed with BD at Suanprung Psychiatric Hospital between October 2006 and May 2009 were reviewed. Cases included BD patients hospitalized due to attempted suicide (n = 58), and seven controls were selected (per suicide case) among BD in- and out-patients who did not attempt suicide, with patients being visited the same day or within 1 week of case study (n = 431). Broad sociodemographic and clinical factors were gathered and analyzed using multivariate logistic regression, to obtain a set of risk factors. Scores for each indicator were weighted, assigned, and summed to create a total risk score, which was divided into low, moderate, and high-risk suicide attempt groups. Results: Six statistically significant indicators associated with suicide attempts were included in the risk-scoring scheme: depression, psychotic symptom(s), number of previous suicide attempts, stressful life event(s), medication adherence, and BD treatment years. A total risk score (possible range -1.5 to 11.5) explained an 88.6% probability of suicide attempts based on the receiver operating characteristic (ROC) analysis. Likelihood ratios of suicide attempts with low risk scores (below 2.5), moderate risk scores (2.5-8.0), and high risk scores (above 8.0) were 0.11 (95% CI 0.04-0.32), 1.72 (95% CI 1.41-2.10), and 19.0 (95% CI 6.17-58.16), respectively. Conclusion: The proposed risk-scoring scheme is BD-specific, comprising six key indicators for simple, routine assessment and classification of patients to three risk groups. Further validation is required before adopting this scheme in other clinical settings. © 2012 Ruengorn et al, publisher and licensee Dove Medical Press Ltd.
format Journal
author Ruengorn C.
Sanichwankul K.
Niwatananun W.
Suwat M.
Wanida P.
Patumanond J.
spellingShingle Ruengorn C.
Sanichwankul K.
Niwatananun W.
Suwat M.
Wanida P.
Patumanond J.
A risk-scoring scheme for suicide attempts among patients with bipolar disorder in a Thai patient cohort
author_facet Ruengorn C.
Sanichwankul K.
Niwatananun W.
Suwat M.
Wanida P.
Patumanond J.
author_sort Ruengorn C.
title A risk-scoring scheme for suicide attempts among patients with bipolar disorder in a Thai patient cohort
title_short A risk-scoring scheme for suicide attempts among patients with bipolar disorder in a Thai patient cohort
title_full A risk-scoring scheme for suicide attempts among patients with bipolar disorder in a Thai patient cohort
title_fullStr A risk-scoring scheme for suicide attempts among patients with bipolar disorder in a Thai patient cohort
title_full_unstemmed A risk-scoring scheme for suicide attempts among patients with bipolar disorder in a Thai patient cohort
title_sort risk-scoring scheme for suicide attempts among patients with bipolar disorder in a thai patient cohort
publishDate 2017
url https://www.scopus.com/inward/record.uri?partnerID=HzOxMe3b&scp=84875390396&origin=inward
http://cmuir.cmu.ac.th/jspui/handle/6653943832/42710
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