Identifying momentary suicidal ideation using machine learning in patients at high-risk for suicide

Strategies to detect the presence of suicidal ideation (SI) or characteristics of ideation that indicate marked suicide risk are critically needed to guide interventions and improve care during care transition periods. Some studies indicate that machine learning can be applied to momentary data to improve classification of SI. This study examined whether the classification accuracy of these models varies as a function of type of training data or characteristics of ideation.

A total of 257 psychiatric inpatients completed a 3-week battery of ecological momentary assessment and measures of suicide risk factors. The accuracy of machine learning models in classifying the presence, duration, or intensity of ideation was compared across models trained on baseline and/or momentary suicide risk data. Relative feature importance metrics were examined to identify the risk factors that were most important for outcome classification.

Models including both baseline and momentary features outperformed models with only one feature type, providing important information in both correctly classifying and differentiating individual characteristics of SI. Models classifying SI presence, duration, and intensity performed similarly.

Results of this study may not generalize beyond a high-risk, psychiatric inpatient sample, and additional work is needed to examine temporal ordering of the relationships identified.

Our results support using machine learning approaches for accurate identification of SI characteristics and underscore the importance of understanding the factors that differentiate and drive different characteristics of SI. Expansion of this work can support use of these models to guide intervention strategies.