Tammy Jiang1, Dávid Nagy2, Anthony J Rosellini3, Erzsébet Horváth-Puhó2, Katherine M Keyes4, Timothy L Lash5, Sandro Galea6, Henrik T Sørensen7, Jaimie L Gradus8. 1. Department of Epidemiology, Boston University School of Public Health, Boston, MA, USA. Electronic address: tjiang1@bu.edu. 2. Department of Clinical Epidemiology, Aarhus University Hospital, Aarhus, Denmark. 3. Center for Anxiety and Related Disorders, Department of Psychological and Brain Sciences, Boston University, Boston, MA, USA. 4. Department of Epidemiology, Columbia University Mailman School of Public Health, New York, NY, USA. 5. Department of Clinical Epidemiology, Aarhus University Hospital, Aarhus, Denmark; Department of Epidemiology, Rollins School of Public Health, Emory University, Atlanta, GA, USA. 6. Department of Epidemiology, Boston University School of Public Health, Boston, MA, USA; Department of Family Medicine, Boston University School of Medicine, Boston, MA, USA. 7. Department of Epidemiology, Boston University School of Public Health, Boston, MA, USA; Department of Clinical Epidemiology, Aarhus University Hospital, Aarhus, Denmark. 8. Department of Epidemiology, Boston University School of Public Health, Boston, MA, USA; Department of Clinical Epidemiology, Aarhus University Hospital, Aarhus, Denmark; Department of Psychiatry, Boston University School of Medicine, Boston, MA, USA.
Abstract
BACKGROUND: Accurate identification of persons at risk of suicide is challenging because suicide is a rare outcome with a multifactorial origin. The purpose of this study was to predict suicide among persons with depression using machine learning methods. METHODS: A case-cohort study was conducted in Denmark between January 1, 1995 and December 31, 2015. Cases were all persons who died by suicide and had an incident depression diagnosis in Denmark (n = 2,774). The comparison subcohort was a 5% random sample of all individuals in Denmark at baseline, restricted to persons with an incident depression diagnosis during the study period (n = 11,963). Classification trees and random forests were used to predict suicide. RESULTS: In men with depression, there was a high risk of suicide among those who were prescribed other analgesics and antipyretics (i.e., non-opioid analgesics such as acetaminophen), prescribed hypnotics and sedatives, and diagnosed with a poisoning (n = 96; risk = 81%). In women with depression, there was an elevated risk of suicide among those who were prescribed other analgesics and antipyretics, anxiolytics, and hypnotics and sedatives, but were not diagnosed with poisoning nor cerebrovascular diseases (n = 338; risk = 58%). DISCUSSION: Psychiatric disorders and their associated medications were strongly indicative of suicide risk. Notably, anti-inflammatory medications (e.g., acetaminophen) prescriptions, which are used to treat chronic pain and illnesses, were associated with suicide risk in persons with depression. Machine learning may advance our ability to predict suicide deaths.
BACKGROUND: Accurate identification of persons at risk of suicide is challenging because suicide is a rare outcome with a multifactorial origin. The purpose of this study was to predict suicide among persons with depression using machine learning methods. METHODS: A case-cohort study was conducted in Denmark between January 1, 1995 and December 31, 2015. Cases were all persons who died by suicide and had an incident depression diagnosis in Denmark (n = 2,774). The comparison subcohort was a 5% random sample of all individuals in Denmark at baseline, restricted to persons with an incident depression diagnosis during the study period (n = 11,963). Classification trees and random forests were used to predict suicide. RESULTS: In men with depression, there was a high risk of suicide among those who were prescribed other analgesics and antipyretics (i.e., non-opioid analgesics such as acetaminophen), prescribed hypnotics and sedatives, and diagnosed with a poisoning (n = 96; risk = 81%). In women with depression, there was an elevated risk of suicide among those who were prescribed other analgesics and antipyretics, anxiolytics, and hypnotics and sedatives, but were not diagnosed with poisoning nor cerebrovascular diseases (n = 338; risk = 58%). DISCUSSION: Psychiatric disorders and their associated medications were strongly indicative of suicide risk. Notably, anti-inflammatory medications (e.g., acetaminophen) prescriptions, which are used to treat chronic pain and illnesses, were associated with suicide risk in persons with depression. Machine learning may advance our ability to predict suicide deaths.
Authors: Ronald C Kessler; Christopher H Warner; Christopher Ivany; Maria V Petukhova; Sherri Rose; Evelyn J Bromet; Millard Brown; Tianxi Cai; Lisa J Colpe; Kenneth L Cox; Carol S Fullerton; Stephen E Gilman; Michael J Gruber; Steven G Heeringa; Lisa Lewandowski-Romps; Junlong Li; Amy M Millikan-Bell; James A Naifeh; Matthew K Nock; Anthony J Rosellini; Nancy A Sampson; Michael Schoenbaum; Murray B Stein; Simon Wessely; Alan M Zaslavsky; Robert J Ursano Journal: JAMA Psychiatry Date: 2015-01 Impact factor: 21.596
Authors: Deborah S Hasin; Aaron L Sarvet; Jacquelyn L Meyers; Tulshi D Saha; W June Ruan; Malka Stohl; Bridget F Grant Journal: JAMA Psychiatry Date: 2018-04-01 Impact factor: 21.596
Authors: Qi Chen; Yanli Zhang-James; Eric J Barnett; Paul Lichtenstein; Jussi Jokinen; Brian M D'Onofrio; Stephen V Faraone; Henrik Larsson; Seena Fazel Journal: PLoS Med Date: 2020-11-06 Impact factor: 11.069