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  1. Home
  2. A Risk Calculator To Predict Suicide Attempts Among Individuals With Early-onset Bipolar Disorder.
  1. Home
  2. A Risk Calculator To Predict Suicide Attempts Among Individuals With Early-onset Bipolar Disorder.

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A Risk Calculator to Predict Suicide Attempts Among Individuals With Early-Onset Bipolar Disorder.

Tina R Goldstein1, John Merranko1, Danella Hafeman1

  • 1Department of Psychiatry, Western Psychiatric Hospital, University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania, USA (Goldstein, Merranko, Hafeman, Gill, Liao, Sewall, Ryan, Birmaher); Department of Psychiatry and Human Behavior, Warren Alpert Medical School of Brown University, Providence, Rhode Island, USA (Hower, Weinstock, Yen, Keller); Massachusetts Mental Health Center and the Department of Psychiatry, Harvard Medical School at Beth Israel Deaconess Medical Center, Boston, Massachusetts, USA (Yen); Centre for Addiction and Mental Health (CAMH), Toronto, Ontario, Canada (Goldstein); Department of Psychiatry, University of California, Los Angeles, California, USA (Strober).

Focus (American Psychiatric Publishing)
|May 2, 2024

View abstract on PubMed

Summary
This summary is machine-generated.

This study developed a risk calculator to predict suicide attempts in youth with early-onset bipolar disorder. Key predictors include age of onset, self-injurious behavior, and psychosis, aiding in early identification of high-risk individuals.

Keywords:
bipolar disorderchild and adolescentrisk calculatorsuicide

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Area of Science:

  • Psychiatry
  • Clinical Psychology
  • Epidemiology

Background:

  • Bipolar disorder in youth is associated with a high risk of suicide attempts.
  • Accurate prediction of suicide risk is crucial for timely intervention in early-onset bipolar disorder.

Purpose of the Study:

  • To develop and validate a one-year risk calculator (RC) for predicting individualized suicide attempt risk in early-onset bipolar disorder.
  • To identify key clinical predictors readily available in practice for suicide risk assessment.

Main Methods:

  • Utilized data from 394 youth in the longitudinal Course and Outcome of Bipolar Youth (COBY) study.
  • Trained a risk calculator using boosted multinomial classification trees and calibrated predictions with Platt scaling.
  • Validated the RC on an independent half of the sample, assessing suicide attempts using the A-LIFE scale.

Main Results:

  • The final model included ten predictors, with age of mood disorder onset, non-suicidal self-injurious behavior, and current age being most influential.
  • The risk calculator achieved an AUC of 0.82, indicating good predictive performance.
  • Recent (past 6 months) presence of risk factors reliably predicted higher suicide attempt risk compared to lifetime history.

Conclusions:

  • The developed risk calculator shows promise as a clinical and research tool for identifying individuals at high risk for suicide attempts in early-onset bipolar disorder.
  • This tool can aid in prospective identification of high-risk periods, enabling targeted interventions.
  • Further validation and implementation in clinical settings are warranted.