Parameters:
(1) suicidal thoughts (either a plan not acted on, or act of self-harm prior to or during admission)
(2) recent bereavement
(3) delusions
(4) chronic mental illness (for > 5 years)
(5) suicide committed by a first-degree relative
|
Risk Factor
|
Positive LR from modified model
|
Post-Test Probability in final model
|
|
suicidal thoughts
|
4.1 (for plan), 4.9 (for act)
|
0.006 (for plan), 0.007 (for act)
|
|
bereavement
|
3.9
|
0.006
|
|
delusions
|
2.2
|
0.003
|
|
chronic mental illness
|
2.2
|
0.003
|
|
first degree relative
|
4.6
|
0.007
|
number of risk factors =
= SUM (risk factors present)
Interpretation:
• minimum number of risk factors: 0
• maximum number of risk factors: 5
• The risk of suicide is 30-40% in a person with 5 risk factors.
• A risk of suicide > 5% is seen in a patient with:
(a) 3 or 4 risk factors, or
(b) delusions + chronic mental disease + 2 others <which would be 4 risk factors>
• A risk of suicide > 1% to 5% is seen a patient with:
(a) 2 risk factors, or
(b) delusions + chronic mental disease + 1 other
Limitations:
• Only 2 patients out of 97 who committed suicide were in the high risk group.
• Suicide is a raw event and predictors are often of low sensitivity.
