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Predictors of suicide attempt in patients with obsessive-compulsive disorder: an exploratory study with machine learning analysis

Published online by Cambridge University Press:  16 July 2020

Neusa Aita Agne Open the ORCID record for Neusa Aita Agne [Opens in a new window] ,
Caroline Gewehr Tisott ,
Pedro Ballester ,
Ives Cavalcante Passos  and
Ygor Arzeno Ferrão
Neusa Aita Agne*
Affiliation:
Federal University of Health Sciences of Porto Alegre (UFCSPA), Porto Alegre (RS), Brazil
Caroline Gewehr Tisott
Affiliation:
Federal University of Health Sciences of Porto Alegre (UFCSPA), Porto Alegre (RS), Brazil
Pedro Ballester
Affiliation:
Department of Psychiatry and Behavioural Neurosciences, McMaster University, Hamilton, ON, Canada
Ives Cavalcante Passos
Affiliation:
Laboratory of Molecular Psychiatry, Centro de Pesquisa Experimental (CPE) and Centro de Pesquisa Clínica (CPC), Hospital de Clínicas de Porto Alegre (HCPA), Instituto Nacional de Ciência e Tecnologia Translacional em Medicina (INCT-TM), Porto Alegre (RS), Brazil Department of Psychiatry, Universidade Federal do Rio Grande do Sul, School of Medicine, Graduate Program in Psychiatry and Behavioral Sciences, Porto Alegre, Brazil
Ygor Arzeno Ferrão
Affiliation:
Federal University of Health Sciences of Porto Alegre (UFCSPA), Porto Alegre (RS), Brazil Brazilian Research Consortium on Obsessive-Compulsive Spectrum Disorders (C-TOC), Porto Alegre, Brazil
*
Author for correspondence: Neusa Aita Agne, E-mail: neusaagne@gmail.com
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Abstract

Background

Patients with obsessive-compulsive disorder (OCD) are at increased risk for suicide attempt (SA) compared to the general population. However, the significant risk factors for SA in this population remains unclear – whether these factors are associated with the disorder itself or related to extrinsic factors, such as comorbidities and sociodemographic variables. This study aimed to identify predictors of SA in OCD patients using a machine learning algorithm.

Methods

A total of 959 outpatients with OCD were included. An elastic net model was performed to recognize the predictors of SA among OCD patients, using clinical and sociodemographic variables.

Results

The prevalence of SA in our sample was 10.8%. Relevant predictors of SA founded by the elastic net algorithm were the following: previous suicide planning, previous suicide thoughts, lifetime depressive episode, and intermittent explosive disorder. Our elastic net model had a good performance and found an area under the curve of 0.95.

Conclusions

This is the first study to evaluate risk factors for SA among OCD patients using machine learning algorithms. Our results demonstrate an accurate risk algorithm can be created using clinical and sociodemographic variables. All aspects of suicidal phenomena need to be carefully investigated by clinicians in every evaluation of OCD patients. Particular attention should be given to comorbidity with depressive symptoms.

Keywords

Algorithmelastic netmachine learningobsessive-compulsive disorderpredictors of suicidesuicide attempts
Type
Original Article
Information
Psychological Medicine , Volume 52 , Issue 4 , March 2022 , pp. 715 - 725
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Copyright
Copyright © The Author(s) 2020. Published by Cambridge University Press

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References

Albert, U., De Ronchi, D., Maina, G., & Pompili, M. (2018). Suicide risk in obsessive-compulsive disorder and exploration of risk factors: A systematic review. Current Neuropharmacology, 17(8), 681–696. https://doi.org/10.2174/1570159X16666180620155941.CrossRefGoogle Scholar
Alonso, P., Segalàs, C., Real, E., Pertusa, A., Labad, J., Jiménez-Murcia, S., & … Menchón, J. M. (2010). Suicide in patients treated for obsessive-compulsive disorder: A prospective follow-up study. Journal of Affective Disorders, 124(3), 300–308. https://doi.org/10.1016/j.jad.2009.12.001.CrossRefGoogle ScholarPubMed
American Psychiatric Association. (2013). Diagnostic and statistical manual of mental disorders (5th ed.). Washington, DC: Author.Google Scholar
Angelakis, I., Gooding, P., Tarrier, N., & Panagioti, M. (2015). Suicidality in obsessive compulsive disorder (OCD): A systematic review and meta-analysis. Clinical Psychology Review, 39, 1–15. https://doi.org/10.1016/j.cpr.2015.03.002.CrossRefGoogle ScholarPubMed
Angst, J., Gamma, A., Endrass, J., Goodwin, R., Ajdacic, V., Eich, D., & Rössler, W. (2004). Obsessive-compulsive severity spectrum in the community: Prevalence, comorbidity, and course. European Archives of Psychiatry and Clinical Neuroscience, 254(3), 156–164. https://doi.org/10.1007/s00406-004-0459-4.CrossRefGoogle ScholarPubMed
Arsenault-Lapierre, G., Kim, C., & Turecki, G. (2004). Psychiatric diagnoses in 3275 suicides: A meta-analysis. BMC Psychiatry, 37(4). https://doi.org/10.1186/1471-244X-4-37.Google Scholar
Asbahr, F. R., Lotufo, N. F., Turecki, G. X., & Miguel, E. C. (1996). Escala Yale-Brown de Sintomas Obsessivo-Compulsivos, tradução brasileira., in: Transtornos Do Espectro Obsessivo-Compulsivo. Guanabara-Koogan, Rio de Janeiro, pp. 219–230.Google Scholar
Balci, V., & Sevincok, L. (2010). Suicidal ideation in patients with obsessive-compulsive disorder. Psychiatry Research, 175(1-2), 104–108. https://doi.org/10.1016/j.psychres.2009.03.012.CrossRefGoogle ScholarPubMed
Beck, A. T., Epstein, N., Brown, G., & Steer, R. A. (1988). An inventory for measuring clinical anxiety: Psychometric properties. Journal of Consulting and Clinical Psychology, 56(6), 893–897. https://doi.org/10.1037//0022-006x.56.6.893.CrossRefGoogle ScholarPubMed
Beck, A. T., Ward, C. H., Mendelson, M., Mock, J., & Erbaugh, J. (1961). An inventory for measuring depression. Archives of General Psychiatry, 4, 561–571. https://doi.org/10.1001/archpsyc.1961.01710120031004.CrossRefGoogle ScholarPubMed
Belsher, B. E., Smolenski, D. J., Pruitt, L. D., Bush, N. E., Beech, E. H., Workman, D. E., … Skopp, N. A. (2019). Prediction models for suicide attempts and deaths: A systematic review and simulation. JAMA Psychiatry, 76(6), 642–651. doi:10.1001/jamapsychiatry.2019.0174.CrossRefGoogle ScholarPubMed
Berk, R. A. (2008). Statistical learning from a regression perspective (1st ed.). New York: Springer.Google Scholar
Bertolote, J. M., Fleischmann, A., De Leo, D., Bolhari, J., Botega, N., De Silva, D., … Wasserman, D. (2005). Suicide attempts, plans, and ideation in culturally diverse sites: The WHO SUPRE-MISS community survey. Psychological Medicine, 35(10), 1457–1465. https://doi.org/10.1017/S0033291705005404.CrossRefGoogle ScholarPubMed
Borges, G., Nock, M. K., Haro Abad, J. M., Hwang, I., Sampson, N. A., Alonso, J., … Kessler, R. C. (2010). Twelve-month prevalence of and risk factors for suicide attempts in the World Health Organization World Mental Health Surveys. Journal of Clinical Psychiatry, 71(12), 1617–1628. https://doi.org/10.4088/JCP.08m04967blu.CrossRefGoogle ScholarPubMed
Burke, T. A., Ammerman, B. A., & Jacobucci, R. (2019). The use of machine learning in the study of suicidal and non-suicidal self-injurious thoughts and behaviors: A systematic review. Journal of Affective Disorders, 245, 869–884.10.1016/j.jad.2018.11.073CrossRefGoogle Scholar
Coryell, W. (1981). Obsessive-compulsive disorder and primary unipolar depression. Comparisons of background, family history, course, and mortality. The Journal of Nervous Mental Disease, 164(4), 220–224. https://doi.org.CrossRefGoogle Scholar
de Ávila Berni, G., Rabelo-da-Ponte, F. D., Librenza-Garcia, D., Boeira, M. V., Kauer-Sant'Anna, M., Passos, I. C., … Kapczinski, F. (2018). Potential use of text classification tools as signatures of suicidal behavior: A proof-of-concept study using Virginia Woolf's personal writings. PLoS ONE, 13(10), e0204820. https://doi.org/10.1371/journal.pone.0204820.CrossRefGoogle ScholarPubMed
Dell'Osso, B., Benatti, B., Arici, C., Palazzo, C., Altamura, A.C., Hollander, E., … Zohar, J. (2018). Prevalence of suicide attempt and clinical characteristics of suicide attempters with obsessive-compulsive disorder: A report from the International College of Obsessive-Compulsive Spectrum Disorders (ICOCS). CNS Spectrums, 23(1), 59–66. https://doi.org/10.1017/S1092852917000177.CrossRefGoogle ScholarPubMed
DiGangi, J. A., Gomez, D., Mendoza, L., Jason, L. A., Keys, C. B., & Koenen, K. C. (2013). Pretrauma risk factors for posttraumatic stress disorder: A systematic review of the literature. Clinical Psychology Review, 33(6), 728–744. https://doi.org/10.1016/j.cpr.2013.05.002.CrossRefGoogle ScholarPubMed
Dwyer, D. B., Falkai, P., & Koutsouleris, N. (2018). Machine learning approaches for clinical psychology and psychiatry. Annual Review of Clinical Psychology, 14(1), 91–118. https://doi.org/10.1146/annurev-clinpsy-032816-045037.CrossRefGoogle ScholarPubMed
Eisen, J. L., Mancebo, M. A., Pinto, A., Coles, M. E., Pagano, M. E., Stout, R., … Rasmussen, S. A. (2006). Impact of obsessive-compulsive disorder on quality of life. Comprehensive Psychiatry, 47(4), 270–275. https://doi.org/10.1016/j.comppsych.2005.11.006.CrossRefGoogle ScholarPubMed
Fernández de la Cruz, L., Rydell, M., Runeson, B., D'Onofrio, B. M., Brander, G., Rück, C., … Mataix-Cols, D. (2017). Suicide in obsessive-compulsive disorder: A population-based study of 36 788 Swedish patients. Molecular Psychiatry, 22(11), 1626–1632. https://doi.org/10.1038/mp.2016.115.CrossRefGoogle ScholarPubMed
First, M. B., Spitzer, R. L., Gibbon, M., & Williams, J. B. (1997). Structured clinical interview for DSM-IV axis I disorders: clinical version (SCID-CV). Washington, DC: American Psychiatric Press.Google Scholar
Franklin, J. C., Ribeiro, J. D., Fox, K. R., Bentley, K. H., Kleiman, E. M., Huang, X., … Nock, M. K. (2017). Risk factors for suicidal thoughts and behaviors: A meta-analysis of 50 years of research. Psychological Bulletin, 143(2), 187–232. https://doi.org/10.1037/bul0000084.CrossRefGoogle ScholarPubMed
Gelegen, V., & Tamam, L. (2018). Prevalence and clinical correlates of intermittent explosive disorder in Turkish psychiatric outpatients. Comprehensive Psychiatry, 83, 64–70. https://doi.org/10.1016/j.comppsych.2018.03.003.CrossRefGoogle ScholarPubMed
Goodwin, D. W., Guze, S. B., & Robins, E. (1969). Follow-up studies in obsessional neurosis. Archives of General Psychiatry, 20(2), 182–187. https://10.1001/archpsyc.1969.01740140054006.10.1001/archpsyc.1969.01740140054006CrossRefGoogle ScholarPubMed
Gorenstein, C., & Andrade, L. (1996). Validation of a Portuguese version of the Beck Depression Inventory and the State-Trait Anxiety Inventory in Brazilian subjects. Brazilian Journal of Medical and Biological Research, 29(4), 453–457.Google ScholarPubMed
Greenhalgh, T., Howick, J., & Maskrey, N. (2014). Evidence based medicine: A movement in crisis? British Medical Journal, 348, g3725. https://doi.org/10.1136/bmj.g3725.CrossRefGoogle ScholarPubMed
Gupta, G., Avasthi, A., Grover, S., & Singh, S. M. (2014). Factors associated with suicidal ideations and suicidal attempts in patients with obsessive compulsive disorder. Asian Journal of Psychiatry, 12, 140–146. https://doi.org/10.1016/j.ajp.2014.09.004.CrossRefGoogle ScholarPubMed
Hawton, K., & van Heeringen, K. (2009). Suicide. Lancet (London, England), 373(9672), 1372–1381. https://doi.org/10.1016/S0140-6736(09)60372-X.CrossRefGoogle ScholarPubMed
Hettige, N. C., Nguyen, T. B., Yuan, C., Rajakulendran, T., Baddour, J., Bhagwat, N., … De Luca, V. (2017). Classification of suicide attempters in schizophrenia using sociocultural and clinical features: A machine learning approach. General Hospital Psychiatry, 47, 20–28. https://doi.org/10.1016/j.genhosppsych.2017.03.001.CrossRefGoogle ScholarPubMed
Hollander, E., Greenwald, S., Neville, D., Johnson, J., Hornig, C. D., & Weissman, M. M. (1996). Uncomplicated and comorbid obsessive-compulsive disorder in an epidemiologic sample. Depression and Anxiety, 4(3), 111–119. https://doi.org/10.1002/(SICI)1520-6394(1996)4:3<111::AID-DA3>3.0.CO;2-J.3.0.CO;2-J>CrossRefGoogle Scholar
Hung, T.-C., Tang, H.-S., Chiu, C.-H., Chen, Y.-Y., Chou, K.-R., Chiou, H.-C., … Chang, H. J. (2010). Anxiety, depressive symptom and suicidal ideation of outpatients with obsessive compulsive disorders in Taiwan. Journal of Clinical Nursing, 19(2122), 3092–3101. https://doi.org/10.1111/j.1365-2702.2010.03378.x.CrossRefGoogle ScholarPubMed
Huys, Q. J. M., Maia, T. V., & Frank, M. J. (2016). Computational psychiatry as a bridge from neuroscience to clinical applications. Nature Neuroscience, 19, 404–413. https://doi.org/10.1038/nn.4238.CrossRefGoogle ScholarPubMed
Jacoby, R. J., Leonard, R. C., Riemann, B. C., & Abramowitz, J. S. (2014). Predictors of quality of life and functional impairment in obsessive-compulsive disorder. Comprehensive Psychiatry, 55(5), 1195–1202. https://doi.org/10.1016/j.comppsych.2014.03.011.CrossRefGoogle ScholarPubMed
Kamath, P., Reddy, Y. C. J., & Kandavel, T. (2007). Suicidal behavior in obsessive-compulsive disorder. Journal of Clinical Psychiatry, 68(11), 1741–1750. https://doi.org/10.4088/jcp.v68n1114.CrossRefGoogle ScholarPubMed
Kanwar, A., Malik, S., Prokop, L. J., Sim, L. A., Feldstein, D., Wang, Z., … Murad, M. H. (2013). The association between anxiety disorders and suicidal behaviors: A systematic review and meta-analysis. Depression and Anxiety, 30(10), 917–929. https://doi.org/10.1002/da.22074.Google ScholarPubMed
Kaufman, J., Birmaher, B., Brent, D., Rao, U., Flynn, C., Moreci, P., … Ryan, N. (1997). Schedule for affective disorders and schizophrenia for school-age children-present and lifetime version (K-SADS-PL): Initial reliability and validity data. Journal of the American Academy Child Adolescent Psychiatry, 36(10), 980–988. https://doi.org/10.1097/00004583-199707000-00021.CrossRefGoogle ScholarPubMed
Kessler, R. C., Chiu, W. T., Demler, O., Merikangas, K. R., & Walters, E. E. (2005). Prevalence, severity, and comorbidity of 12-month DSM-IV disorders in the National Comorbidity Survey Replication. Archives of General Psychiatry, 62(6), 617–627. https://doi.org/10.1001/archpsyc.62.6.617.CrossRefGoogle ScholarPubMed
Kuhn, M. (2008). Building predictive models in R using the caret package. Journal of Statistical Software, 28(5), 1–26. https://doi.org/10.18637/jss.v028.i05.CrossRefGoogle Scholar
Larsen, M. E., Cummins, N., Boonstra, T. W., O'Dea, B., Tighe, J., Nicholas, J., … Christensen, H. (2015). The use of technology in Suicide Prevention. Paper presented at the 37th annual international conference of the IEEE Engineering in Medicine and Biology Society, Milano, Italy, pp. 7316–7319. https://doi.org/10.1109/EMBC.2015.7320081.CrossRefGoogle Scholar
Lee, S., Fung, S. C., Tsang, A., Liu, Z. R., Huang, Y. Q., He, Y. L., … Kessler, R. C. (2007). Lifetime prevalence of suicide ideation, plan, and attempt in metropolitan China. Acta Psychiatrica Scandinavica, 116(6), 429–437. https://doi.org/10.1111/j.1600-0447.2007.01064.x.CrossRefGoogle ScholarPubMed
Leonard Westgate, C., Shiner, B., Thompson, P., & Watts, B. V. (2015). Evaluation of veterans’ suicide risk with the use of linguistic detection methods. Psychiatric Services, 66(10), 1051–1056. https://doi.org/10.1176/appi.ps.201400283.CrossRefGoogle ScholarPubMed
Lozano, R., Naghavi, M., Foreman, K., Lim, S., Shibuya, K., Aboyans, V., … Memish, Z. A. (2012). Global and regional mortality from 235 causes of death for 20 age groups in 1990 and 2010: A systematic analysis for the Global Burden of Disease Study 2010. Lancet (London, England), 380(9859), 2095–2128. https://doi.org/10.1016/S0140-6736(12)61728-0.CrossRefGoogle ScholarPubMed
Maina, G., Salvi, V., Tiezzi, M. N., Albert, U., & Bogetto, F. (2007). Is OCD at risk for suicide? A case-control study. Clinical Neuropsychiatry: Journal of Treatment Evaluation, 4(3), 117–121.Google Scholar
Maziade, M., Roy, M. A., Fournier, J. P., Cliche, D., Mérette, C., Caron, C., … Dion, C. (1992). Reliability of best-estimate diagnosis in genetic linkage studies of major psychoses: Results from the Quebec pedigree studies. American Journal of Psychiatry, 149(12), 1674–1686. https://doi.org/10.1176/ajp.149.12.1674.Google ScholarPubMed
Miguel, E. C., Ferrão, Y. A., do Rosário, M. C. de Mathis, M. A., Torres, A. R., Fontenelle, L. F., … da Silva, E. D.. (2008). The Brazilian Research Consortium on Obsessive-Compulsive Spectrum Disorders: Recruitment, assessment instruments, methods for the development of multicenter collaborative studies and preliminary results. Revista Brasileira de Psiquiatria, 30(3), 185–196. http://dx.doi.org/10.1590/S1516-44462008000300003.CrossRefGoogle Scholar
Murray, C. J. L., Lopez, A. D., & World Health Organization, World Bank & Harvard School of Public Health. (1996). The Global burden of disease: a comprehensive assessment of mortality and disability from diseases, injuries, and risk factors in 1990 and projected to 2020. In Murray, Christopher J. L., Lopez, Alan D. (Eds.), Boston: Harvard School of Public Health. Retrieved from https://apps.who.int/iris/handle/10665/41842.Google Scholar
Mwangi, B., Ebmeier, K. P., Matthews, K., & Steele, J. D. (2012). Multi-centre diagnostic classification of individual structural neuroimaging scans from patients with major depressive disorder. Brain, 135, 1508–1521.CrossRefGoogle ScholarPubMed
Niculescu, A. B., Levey, D. F., Phalen, P. L., Le-Niculescu, H., Dainton, H. D., Jain, N., … Salomon, D. R. (2015). Understanding and predicting suicidality using a combined genomic and clinical risk assessment approach. Molecular Psychiatry, 20(11), 1266–1285. https://doi.org/10.1038/mp.2015.112.CrossRefGoogle ScholarPubMed
Nock, M. K., Hwang, I., Sampson, N. A., & Kessler, R. C. (2010). Mental disorders, comorbidity and suicidal behavior: Results from the National Comorbidity Survey Replication. Molecular Psychiatry, 15(8), 868–876. https://doi.org/10.1038/mp.2009.29.CrossRefGoogle ScholarPubMed
O'Dea, B., Wan, S., Batterham, P. J., Calear, A. L., Paris, C., & Christensen, H. (2015). Detecting suicidality on Twitter. Internet Interventions, 2(2), 183–188. https://doi.org/10.1016/j.invent.2015.03.005.CrossRefGoogle Scholar
Oh, J., Yun, K., Hwang, J.-H., & Chae, J. H. (2017). Classification of suicide attempts through a machine learning algorithm based on multiple systemic psychiatric scales. Frontiers in Psychiatry, 8, 192. https://doi.org/10.3389/fpsyt.2017.00192.CrossRefGoogle ScholarPubMed
Ozer, E. J., Best, S. R., Lipsey, T. L., & Weiss, D. S. (2003). Predictors of posttraumatic stress disorder and symptoms in adults: A meta-analysis. Psychological Bulletin, 129, 52–73. https://doi.org/10.1037/0033-2909.129.1.52.CrossRefGoogle ScholarPubMed
Passos, I. C., Ballester, P. L., Barros, R. C., Librenza-Garcia, D., Mwangi, B., Birmaher, B., … Kapczinski, F. (2019a). Machine learning and big data analytics in bipolar disorder: A position paper from the International Society for Bipolar Disorders Big Data Task Force. Bipolar Disorders, 21(7), 582–594. https://doi.org/10.1111/bdi.12828.CrossRefGoogle ScholarPubMed
Passos, I. C., & Mwangi, B. (2018). Machine learning-guided intervention trials to predict treatment response at an individual patient level: An important second step following randomized clinical trials. Molecular Psychiatry, 25(4), 701–702. https://doi.org/10.1038/s41380-018-0250-y.CrossRefGoogle Scholar
Passos, I. C., Mwangi, B., Cao, B., Hamilton, J. E., Wu, M. J., Zhang, X. Y., … Soares, J.C. (2016). Identifying a clinical signature of suicidality among patients with mood disorders: A pilot study using a machine learning approach. Journal of Affective Disorders, 193, 109–116. https://doi.org/10.1016/j.jad.2015.12.066.CrossRefGoogle ScholarPubMed
Passos, I. C., Mwangi, B., & Kapczinski, F. (2019b). Personalized psychiatry: Big data analytics in mental Health (1st ed.)). New York, United States: Springer International Publishing Company, Incorporated.10.1007/978-3-030-03553-2CrossRefGoogle Scholar
Perlis, R. H. (2013). A clinical risk stratification tool for predicting treatment resistance in major depressive disorder. Biological Psychiatry, 74(1), 7–14. https://doi.org/10.1016/j.biopsych.2012.12.007.CrossRefGoogle ScholarPubMed
Rajkomar, A., Dean, J., & Kohane, I. (2019). Machine learning in medicine. The New England Journal of Medicine, 380, 1347–1358. https://doi.org/10.1056/NEJMra1814259.CrossRefGoogle ScholarPubMed
R Core Team (2013) A language and environment for statistical computing. R Foundation for Statistical Computing, Vienna, Austria. Retrieved from: http://www.R-project.org.Google Scholar
Rosario-Campos, M. C., Miguel, E. C., Quatrano, S., Chacon, P., Ferrao, Y., Findley, D., … Leckman, J. F. (2006). The Dimensional Yale-Brown Obsessive-Compulsive Scale (DY-BOCS): An instrument for assessing obsessive-compulsive symptom dimensions. Molecular Psychiatry, 11(5), 495–504. https://doi.org/10.1038/sj.mp.4001798.CrossRefGoogle ScholarPubMed
Ruscio, A. M., Stein, D. J., Chiu, W. T., & Kessler, R. C. (2010). The epidemiology of obsessive-compulsive disorder in the National Comorbidity Survey Replication. Molecular Psychiatry, 15(1), 53–63. https://doi.org/10.1038/mp.2008.94.CrossRefGoogle ScholarPubMed
Sareen, J., Cox, B. J., Afifi, T. O., de Graaf, R., Asmundson, G. J. G., & ten Have, M. (2005). Anxiety disorders and risk for suicidal ideation and suicide attempts: A population-based longitudinal study of adults. Archives of General Psychiatry, 62(11), 1249–1257. https://doi.org/10.1001/archpsyc.62.11.1249.CrossRefGoogle ScholarPubMed
Scocco, P., de Girolamo, G., Vilagut, G., & Alonso, J. (2008). Prevalence of suicide ideation, plans, and attempts and related risk factors in Italy: Results from the European Study on the Epidemiology of Mental Disorders – World Mental Health study. Comprehensive Psychiatry, 49(1), 13–21. https://doi.org/10.1016/j.comppsych.2007.08.004.CrossRefGoogle Scholar
Simon, G. E., Johnson, E., Lawrence, J. M., Rossom, R. C., Ahmedani, B., Lynch, F. L., … Shortreed, S. M. (2018). Predicting suicide attempts and suicide deaths following outpatient visits using electronic health records. American Journal of Psychiatry, 175(10), 951–960. https://doi.org/10.1176/appi.ajp.2018.17101167.CrossRefGoogle ScholarPubMed
SPSS Inc. Released (2009). PASW Statistics for Windows, Version 18.0. Chicago: SPSS Inc.Google Scholar
Tolin, D. F., & Foa, E. B. (2006). Sex differences in trauma and posttraumatic stress disorder: A quantitative review of 25 years of research. Psychological Bulletin, 132(6), 959–992. https://doi.org/10.1037/0033-2909.132.6.959.CrossRefGoogle ScholarPubMed
Torous, J., Larsen, M. E., Depp, C., Cosco, T. D., Barnett, I., Nock, M. K., … Firth, J. (2018). Smartphones, sensors, and machine learning to advance real-time prediction and interventions for suicide prevention: A review of current progress and next steps. Current Psychiatry Reports, 20(7), 51. https://doi.org/10.1007/s11920-018-0914-y.CrossRefGoogle ScholarPubMed
Torres, A. R., de Abreu Ramos-Cerqueira, A. T., Torresan, R. C., de Souza Domingues, M., Hercos, A. C. R., & Guimarães, A. B. C. (2007). Prevalence and associated factors for suicidal ideation and behaviors in obsessive-compulsive disorder. CNS Spectrums, 12, 771–778. https://doi.org/10.1017/s1092852900015467.CrossRefGoogle ScholarPubMed
Torres, A. R., Prince, M. J., Bebbington, P. E., Bhugra, D., Brugha, T. S., Farrell, M., … Singleton, N. (2006). Obsessive-compulsive disorder: Prevalence, comorbidity, impact and help-seeking in the British National Psychiatric Morbidity Survey of 2000. American Journal of Psychiatry, 163(11), 1978–1985. https://doi:10.1176/ajp.2006.163.11.1978.CrossRefGoogle ScholarPubMed
Torres, A. R., Ramos-Cerqueira, A. T. A., Ferrão, Y. A., Fontenelle, L. F., do Rosário, M. C., & Miguel, E. C. (2011). Suicidality in obsessive-compulsive disorder: Prevalence and relation to symptom dimensions and comorbid conditions. The Journal of Clinical Psychiatry, 72(1), 17–26. https://doi.org/10.4088/JCP.09m05651blu.CrossRefGoogle ScholarPubMed
Tükel, R., Meteris, H., Koyuncu, A., Tecer, A., & Yazici, O. (2006). The clinical impact of mood disorder comorbidity on obsessive-compulsive disorder. European Archives of Psychiatry and Clinical Neuroscience, 256(4), 240–245. https://doi.org/10.1007/s00406-006-0632-z.CrossRefGoogle ScholarPubMed
Velloso, P., Piccinato, C., Ferrão, Y., Aliende Perin, E., Cesar, R., Fontenelle, L., … do Rosário, M. C. (2016). The suicidality continuum in a large sample of obsessive-compulsive disorder (OCD) patients. European Psychiatry: The Journal of the Association of European Psychiatrists, 38, 1–7. https://doi.org/10.1016/j.eurpsy.2016.05.003.CrossRefGoogle Scholar
World Health Organization. (2014). Preventing suicide: A global imperative. Retrieved from: https://apps.who.int/iris/bitstream/handle/10665/131056/9789241564779_eng.pdf?sequence=1.Google Scholar
World Health Organization. (2017). Depression and other common mental disorders: Global health estimates. Retrieved from: https://apps.who.int/iris/bitstream/handle/10665/254610/WHO-MSD-MER-2017.2-eng.pdf.Google Scholar
Zou, H., & Hastie, T. (2005). Regularization and variable selection via the elastic net. Journal of the Royal Statistical Society: Series B (Statistical Methodology), 67(2), 301–320. https://doi.org/10.1111/j.1467-9868.2005.00503.x.CrossRefGoogle Scholar
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