Comprehensive assessment of suicide attempters and their suicidal repetition within 6 years after discharge from hospital

Abstract

Objective To analyze the relationship between the results of comprehensive assessment of suicide attempters and their suicidal repetition within 6 years after discharge from hospital. Methods Suicide risk rating scale or questionnaire were used to assess 115 cases of hospitalized suicide attempters after treatment at the emergency room; follow-up studies were also carried out on the same subjects for six years. Twenty-one cases with repetitive suicidal behavior in the meantime were compared with the remaining 94 cases without such behavior. If the area under the curve (AUC) for the receiver operating characteristic (ROC) curve was larger than 0.5 and the difference was statistically significant (P<0.05), the corresponding rating scales or questionnaire were regarded as factors for repeated suicide risk assessment. A continuous outcome variable was converted to a dichotomous variable according to the best cut-off values of the factor′s ROC curve, odds ratio was used as weight value to calculate scores for all factors based on whether there was repeated suicide behavior. Attempters′ scores of all the factors were summed up as a comprehensive assessment result. The relationship of the result and repeated suicide behavior within 6 years was then evaluated. Results (1) Nine factors were selected for suicide repetition assessment because their AUC values were over 0.5 and their differences were statistically significant (P<0.05), including WHO (FIVE) Well-Being Index, Beck depression inventory, mental illness etc. (2) The total scores for all factors of the 115 suicide attempters ranged from 0 to 93.2, the average was 32.2 ± 31.0, the area under the ROC curve was 0.887. (3) One hundred and fifteen suicide attempters were divided into three groups based on their scores according to the cut-off values of ROC. The first group containing 59 attempters with scores lower than 30.5 only had 1 (1.7%) repeated suicide case; the second group containing 24 attempters with scores from 30.5 to 57.5 only had 2 (8.3%) repeated suicide cases; the third group containing the remaining 32 attempters with scores higher than 57.5 had 18 (56.4%) repeated suicide cases, including 5 fatalities. There were statistically significant differences (χ2=39.45，P=0.000) among the three groups. Conclusion Many risk factors derive from the comprehensive assessment of suicide attempters can be associate with their repetition of suicide behaviors within 6 years after discharge from hospitalization. Key words: Suicide,attempted; Repetition of suicide; ROC curve; Suicidal predicting assessment generalized