title: Predictors of Future Suicide Attempts Among Individuals Referred to Psychiatric Services in the Emergency Department: A Longitudinal Study.
abstract: This study examined which factors predict future suicide attempts (SAs) among people referred to psychiatric services in the emergency department (ED). It included consecutive adult (age >18 years) presentations (N = 6919) over a 3-year period to the two tertiary care hospitals in Manitoba, Canada. Medical professionals assessed each individual on 19 candidate risk factors. Stepwise logistic regression and receiver operating characteristic curves examined the association between the baseline variables and future SAs within the next 6 months. A total of 104 individuals re-presented to the ED with future SAs. Of the 19 baseline variables, only two independently accounted for the variance in future attempts. High-risk scores using this two-item model were associated with elevated odds of future SA (odds ratio, 3.22; 95% confidence interval, 1.62-6.42; p < 0.01), but this was tempered by a low positive predictive value. Further evaluation is required to determine if this two-item tool could help identify people requiring more comprehensive risk assessment referred to psychiatry in the ED.
authors.affiliation: Departments of *Psychology, †Psychiatry, and ‡Community Health Sciences, University of Manitoba, Winnipeg, Manitoba; and Departments of §Psychiatry and ∥Community Health Sciences, University of Calgary, Calgary, Alberta, Canada.
authors.forename: Yunqiao
authors.initials: Y
authors.lastname: Wang
authors.forename: Joanna
authors.initials: J
authors.lastname: Bhaskaran
authors.forename: Jitender
authors.initials: J
authors.lastname: Sareen
authors.forename: JianLi
authors.initials: J
authors.lastname: Wang
authors.forename: Rae
authors.initials: R
authors.lastname: Spiwak
authors.forename: James M
authors.initials: JM
authors.lastname: Bolton
mesh_terms: D000328:Adult; D000368:Aged; D004637:Emergency Services, Psychiatric; D005260:Female; D006784:Hospitals, Teaching; D006801:Humans; D008137:Longitudinal Studies; D008297:Male; D008350:Manitoba; D008875:Middle Aged; D011594:Psychometrics / Q000706:statistics & numerical data; D012008:Recurrence; D012017:Referral and Consultation; D015203:Reproducibility of Results; D018570:Risk Assessment / Q000706:statistics & numerical data*; D013406:Suicide, Attempted / Q000517:prevention & control / Q000523:psychology* / Q000706:statistics & numerical data*; D016019:Survival Analysis; D055815:Young Adult