TY  - JOUR
PY  - 2023//
TI  - A risk calculator to predict suicide attempts among individuals with early-onset bipolar disorder
JO  - Focus : journal of life long learning in psychiatry
A1  - Goldstein, Tina R.
A1  - Merranko, John
A1  - Hafeman, Danella
A1  - Gill, Mary Kay
A1  - Liao, Fangzi
A1  - Sewall, Craig
A1  - Hower, Heather
A1  - Weinstock, Lauren
A1  - Yen, Shirley
A1  - Goldstein, Benjamin
A1  - Keller, Martin
A1  - Strober, Michael
A1  - Ryan, Neal
A1  - Birmaher, Boris
SP  - 412
EP  - 419
VL  - 21
IS  - 4
N2  - OBJECTIVES: To build a one-year risk calculator (RC) to predict individualized risk for suicide attempt in early-onset bipolar disorder. <br><br>METHODS: Youth numbering 394 with bipolar disorder who completed ≥2 follow-up assessments (median follow-up length = 13.1 years) in the longitudinal Course and Outcome of Bipolar Youth (COBY) study were included. Suicide attempt over follow-up was assessed via the A-LIFE Self-Injurious/Suicidal Behavior scale. Predictors from the literature on suicidal behavior in bipolar disorder that are readily assessed in clinical practice were selected and trichotomized as appropriate (presence past 6 months/lifetime history only/no lifetime history). The RC was trained via boosted multinomial classification trees; predictions were calibrated via Platt scaling. Half of the sample was used to train, and the other half to independently test the RC. <br><br>RESULTS: There were 249 suicide attempts among 106 individuals. Ten predictors accounted for >90% of the cross-validated relative influence in the model (AUC = 0.82; in order of relative influence): (1) age of mood disorder onset; (2) non-suicidal self-injurious behavior (trichotomized); (3) current age; (4) psychosis (trichotomized); (5) socioeconomic status; (6) most severe depressive symptoms in past 6 months (trichotomized none/subthreshold/threshold); (7) history of suicide attempt (trichotomized); (8) family history of suicidal behavior; (9) substance use disorder (trichotomized); (10) lifetime history of physical/sexual abuse. For all trichotomized variables, presence in the past 6 months reliably predicted higher risk than lifetime history. <br><br>CONCLUSIONS: This RC holds promise as a clinical and research tool for prospective identification of individualized high-risk periods for suicide attempt in early-onset bipolar disorder.Reprinted from Bipolar Disord 2022; 24:749-757, with permission from John Wiley and Sons. Copyright © 2022.<p />  <p>Language: en</p>
LA  - en
SN  - 1541-4094
UR  - http://dx.doi.org/10.1176/appi.focus.23021023
ID  - ref1
ER  -