TY  - JOUR
PY  - 2018//
TI  - Can risk assessment predict suicide in secondary mental healthcare? Findings from the South London and Maudsley NHS Foundation Trust Biomedical Research Centre (SLaM BRC) Case Register
JO  - Social psychiatry and psychiatric epidemiology
A1  - Lopez-Morinigo, Javier-David
A1  - Fernandes, Andrea C.
A1  - Shetty, Hitesh
A1  - Ayesa-Arriola, Rosa
A1  - Bari, Ashraful
A1  - Stewart, Robert
A1  - Dutta, Rina
SP  - 1161
EP  - 1171
VL  - 53
IS  - 11
N2  - PURPOSE: The predictive value of suicide risk assessment in secondary mental healthcare remains unclear. This study aimed to investigate the extent to which clinical risk assessment ratings can predict suicide among people receiving secondary mental healthcare. <br><br>METHODS: Retrospective inception cohort study (n = 13,758) from the South London and Maudsley NHS Foundation Trust (SLaM) (London, UK) linked with national mortality data (n = 81 suicides). Cox regression models assessed survival from the last suicide risk assessment and ROC curves evaluated the performance of risk assessment total scores. <br><br>RESULTS: Hopelessness (RR = 2.24, 95% CI 1.05-4.80, p = 0.037) and having a significant loss (RR = 1.91, 95% CI 1.03-3.55, p = 0.041) were significantly associated with suicide in the multivariable Cox regression models. However, screening statistics for the best cut-off point (4-5) of the risk assessment total score were: sensitivity 0.65 (95% CI 0.54-0.76), specificity 0.62 (95% CI 0.62-0.63), positive predictive value 0.01 (95% CI 0.01-0.01) and negative predictive value 0.99 (95% CI 0.99-1.00). <br><br>CONCLUSIONS: Although suicide was linked with hopelessness and having a significant loss, risk assessment performed poorly to predict such an uncommon outcome in a large case register of patients receiving secondary mental healthcare.<p />  <p>Language: en</p>
LA  - en
SN  - 0933-7954
UR  - http://dx.doi.org/10.1007/s00127-018-1536-8
ID  - ref1
ER  -