The prediction of suicide in severe mental illness: development and validation of a clinical prediction rule (OxMIS).

Translational Psychiatry
Seena FazelThomas R Fanshawe

Abstract

Assessment of suicide risk in individuals with severe mental illness is currently inconsistent, and based on clinical decision-making with or without tools developed for other purposes. We aimed to develop and validate a predictive model for suicide using data from linked population-based registers in individuals with severe mental illness. A national cohort of 75,158 Swedish individuals aged 15-65 with a diagnosis of severe mental illness (schizophrenia-spectrum disorders, and bipolar disorder) with 574,018 clinical patient episodes between 2001 and 2008, split into development (58,771 patients, 494 suicides) and external validation (16,387 patients, 139 suicides) samples. A multivariable derivation model was developed to determine the strength of pre-specified routinely collected socio-demographic and clinical risk factors, and then tested in external validation. We measured discrimination and calibration for prediction of suicide at 1 year using specified risk cut-offs. A 17-item clinical risk prediction model for suicide was developed and showed moderately good measures of discrimination (c-index 0.71) and calibration. For risk of suicide at 1 year, using a pre-specified 1% cut-off, sensitivity was 55% (95% confidence inter...Continue Reading

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Citations

Jun 30, 2019·Evidence-based Mental Health·Daniel Whiting, Seena Fazel
Oct 24, 2019·JAMA Psychiatry·Seena Fazel, Lauren O'Reilly
Jan 16, 2020·The New England Journal of Medicine·Seena Fazel, Bo Runeson
Oct 3, 2019·Psychological Medicine·Joseph R CohenBenjamin L Hankin
Jan 20, 2020·Current Psychiatry Reports·Jacob N Miller, Donald W Black
May 15, 2020·Social Psychiatry and Psychiatric Epidemiology·Francesco Domenico FritzAdrian P Mundt
Jan 13, 2021·Psychiatric Services : a Journal of the American Psychiatric Association·Nathaniel P Morris
Apr 17, 2021·The Lancet. Psychiatry·Stella Botchway, Seena Fazel
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Software Mentioned

OxMIS Ox ford M ental I llness and S uicide tool
OxMIS
STATA
R

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