Clinical Prediction of Suicide Attempt in Schizophrenia Using a Machine Learning Approach

Abstract

Objective

Suicide is a major concern for those afflicted by schizophrenia. Identifying patients at the highest risk for future suicide attempts remains a complex problem for psychiatric intervention. Machine learning models allow for the integration of many risk factors in order to build an algorithm that predicts which patients are likely to attempt suicide. Currently, it is unclear how to integrate previously identified risk factors into a clinically relevant predictive tool to estimate the probability of a patient with schizophrenia for attempting suicide.

Methods

We conducted a cross-sectional assessment on a sample of 345 participants diagnosed with schizophrenia spectrum disorders. Suicide attempters and non-attempters were clearly identified using the Columbia Suicide Severity Rating Scale (C-SSRS) and the Beck Suicide Ideation Scale (BSS). We developed two classification algorithms using a regularized regression and random forest model with sociocultural and clinical variables as features to train the models.

Results

Both classification models performed similarly in identifying suicide attempters and non-attempters. Our regularized logistic regression model demonstrated an accuracy of 66% and an area under the curve (AUC) of 0.71, while the random forest model demonstrated 65% accuracy and an AUC of 0.67.

Conclusion

Machine learning algorithms offer a relatively successful method for incorporating many clinical features to predict individuals at risk for future suicide attempts. Increased performance of these models using clinically relevant variables offers the potential to facilitate early treatment and intervention to prevent future suicide attempts.

Disclosure of interest

The authors have not supplied their declaration of competing interest.