Melhem et al identified a number of factors predictive of suicide attempts in a high-risk patient. These can help to identify a patient who may benefit from more aggressive management. The authors are from the University of Pittsburgh, University of Pennsylvania, and Columbia University.
Patient selection: child of a parent (proband) with a mood disorder
Outcome: future suicide attempt
Predictors:
(1) class 3 depressive symptoms
(2) personal history of suicide attempt(s)
(3) suicide attempt in parent (proband)
(4) young age (age <= 30 years)
(5) history of childhood abuse
(6) mood disorder (unipolar or bipolar)
Depressive symptoms include hopelessness, impulsivity, aggression, impulsive aggression, irritability. Class 3 was not explicitly defiined but may indicate severe symptoms.
The presence of 3 or more predictors was associated with a greater risk for suicide attempts.
