用青少年修改的患者健康问卷-9评估自杀企图的风险
Fuchiang Tsui1,2,3, Victor M Ruiz1, Neal D Ryan4
1Tsui Laboratory, Department of Biomedical and Health Informatics, Children's Hospital of Philadelphia, Philadelphia, Pennsylvania.
JAMA network open
|October 8, 2024
概括
对青少年 (PHQ-9M) 查进行修改的患者健康问卷-9的补充项目显著改善了青少年自杀企图的预测. 这表明,将全方位的PHQ-9M纳入青少年门诊访问中可以提高自杀风险评估.
科学领域:
- 青少年健康 青少年健康
- 心理健康查 心理健康查
- 自杀预防 自杀预防
背景情况:
- 自杀是美国年轻人面临的重要公共卫生问题.
- 准确预测自杀企图对于及时干预至关重要.
- 为青少年修改的患者健康问卷-9 (PHQ-9M) 用于抑郁症查.
研究的目的:
- 评估PHQ-9M的补充项目 (10-13) 是否可以提高自杀企图的预测,超出标准PHQ-9 (项目1-9).
- 为了比较不同PHQ-9M模型对青少年自杀企图的预测性能.
主要方法:
- 在2016-2022年期间选的青少年 (12-17岁) 的回顾性队列研究.
- 使用PHQ-9和PHQ-9M数据开发和比较了三种Cox回归模型 (CR-9,CR-13,CR-3).
- 在 30,90,180,和365天的时间范围内使用接收器操作特征曲线 (AUROC) 下面的区域和精度回调曲线 (AUPRC) 下面的区域进行评估的模型.
主要成果:
- 该研究包括130,028名门诊患者,272,402名PHQ-9M查;549名 (0.4%) 在一年内进行了随后的自杀企图.
- 完整的PHQ-9M模型 (CR-13) 与PHQ-9模型 (CR-9,AUROC: 0.77) 相比,显示出更高的预测准确度 (AUROC: 0.80).
- 补充项目,特别是终身自杀企图 (项目13),抑郁情绪严重程度 (项目10) 和严重的自杀念头 (项目12),是显著的预测因素.
结论:
- 与单独的PHQ-9相比,PHQ-9M上的补充项目显著改善了青少年自杀企图的预测.
- 这些发现支持在青少年门诊环境中常规使用完整的PHQ-9M,以加强自杀风险评估.
- 改进的预测模型可以帮助识别有风险的年轻人进行有针对性的预防干预.
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