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Development and validation of the risk score for estimating suicide attempt in patients with major depressive disorder

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Abstract

Early identification of high-risk patients with Major depressive disorder (MDD) having suicide attempts (SAs) is essential for timely targeted and tailored psychological interventions and medications. This study aimed to develop and validate a web-based dynamic nomogram as a personalized predictor of SA in MDD patients. A dynamic nomogram was developed using data collected from 1718 patients in China. The dynamic model was established based on a machine learning-based regression technique in the training cohort. We validated the nomogram internally using 1000 bootstrap replications. The nomogram performance was assessed using estimates of discrimination (via the concordance index) and calibration (calibration plots). The nomogram incorporated five predictors, including Hamilton anxiety rating scale (odds ratio [OR]: 1.255), marital status (OR: 0.618), clinical global impressions (OR: 2.242), anti-thyroid peroxidase antibodies (OR: 1.002), and systolic pressure levels (OR: 1.037). The model demonstrated good overall discrimination (Harrell’s C-index = 0.823). Using decision curve analysis, this model also demonstrated good clinical applicability. An online web server was constructed (https://odywong.shinyapps.io/PRSM/) to facilitate the use of the nomogram. Based on these results, our study developed a nomogram to predict SA in MDD patients. The application of this nomogram may help for patients and clinicians to make decisions.

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Data availability

Contact Xiangyang Zhang by email at zhangxy@psych.ac.cn for additional information about the data used in this study.

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Acknowledgements

We sincerely thank all the participants in this study for their support and cooperation.

Author information

Author notes

  1. Zhi-Xin Huang and Qizhang Wang have contributed equally to this work.

Authors and Affiliations

  1. Department of Neurology, Guangdong Second Provincial General Hospital, Guangzhou, Guangdong, China

    Zhi-Xin Huang, Wenli Zhang & Ying Huang

  2. Jinan University Faculty of Medical Science, Guangzhou, Guangdong, China

    Zhi-Xin Huang & Shasha Lei

  3. Guangdong Medical University, Zhanjiang, Guangdong, China

    Zhi-Xin Huang & Caiping Zhang

  4. Department of Neurology, Shenzhen Hospital of Integrated Traditional Chinese and Western Medicine, Shenzhen, Guangdong, China

    Qizhang Wang

  5. CAS Key Laboratory of Mental Health, Institute of Psychology, Chinese Academy of Sciences, 16 Lincui Road, Chaoying District, Beijing, 100101, China

    Xiangyang Zhang

  6. Department of Psychology, University of Chinese Academy of Sciences, Beijing, China

    Xiangyang Zhang

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  1. Zhi-Xin Huang
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Contributions

Z-XH and XZ had full access to all of the data in the study and take responsibility for the integrity of the data and the accuracy of the data analysis. Study concept and design were contributed by Z-XH, QW, SL, WZ, CZ. Acquisition, analysis, or interpretation of data were contributed by all authors. Drafting of the manuscript was contributed by Z-XH, YH. Critical revision of the manuscript for important intellectual content was contributed by all authors. Statistical analysis was contributed by Z-XH, WZ, YH. Administrative, technical, or material support was contributed by all authors. Study supervision was contributed by XZ.

Corresponding author

Correspondence to Xiangyang Zhang.

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Huang, ZX., Wang, Q., Lei, S. et al. Development and validation of the risk score for estimating suicide attempt in patients with major depressive disorder. Soc Psychiatry Psychiatr Epidemiol 59, 1029–1037 (2024). https://doi.org/10.1007/s00127-023-02572-3

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  • DOI: https://doi.org/10.1007/s00127-023-02572-3

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