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The comparison of psychological scales as hospitalization predictors between adult and elderly suicide attempters.
Am J Emerg Med. 2021 Sep; 47:131-137.AJ

Abstract

BACKGROUND

During the process of managing suicide attempters in the emergency department (ED), the importance of hospitalization has been emphasized. Lethality and intent have been suggested as hospitalization determinants of suicide attempters, but their predictive values remain limited in adult and elderly populations.

METHODS

Using prospectively collected the ED-based Suicide Registry, data from suicide attempters over 18 years old was retrospectively studied (2010-2020). The enrolled participants were divided into adult (N = 832) and elderly (>65 years, N = 378) groups. Suicide lethality and intent were assessed by the Risk-Rescue Rating Scale (RRRS) and Suicide Intent Scale (SIS), respectively. The moderating effects of age on the relationship between the psychological scales and hospitalization were examined by entering the interaction terms into a multivariable regression model. The predictive ability of each scale for hospitalization was evaluated in terms of performance and goodness-of-fit.

RESULTS

Both scales' scores in both age groups were significantly higher in hospitalized patients than non-hospitalized patients. Interaction result indicated that only the odds of RRRS for hospitalization significantly differed by age group. Moreover, the predictive performance for hospitalization significantly differed by age group in RRRS but not SIS. In predicting hospitalization, the AUC of the RRRS was significantly higher than that of the SIS in the elderly group but not in the adult group. Comparing the two groups, the RRRS of the elderly group tended to have higher AUC than the adult group, whereas the AUC of the SIS was similar. The RRRS in both groups had a better overall fit compared to the SIS for hospitalization, but its best overall fit and strength with greater power were observed in the elderly group.

CONCLUSIONS

The age-by-RRRS interaction is significantly associated with hospitalization, and the RRRS implementation as a hospitalization determinant is more useful and suitable for elderly suicide attempters than for adult suicide attempters in an emergency setting.

Authors+Show Affiliations

Department of Emergency Medicine, Kyung Hee University Medical Center, Seoul, Republic of Korea; Department of Emergency Medicine, School of Medicine, Kyung Hee University, Seoul, Republic of Korea; Center for Suicide Prevention, Kyung Hee University Medical Center, Seoul, Republic of Korea. Electronic address: emergency0599@khu.ac.kr.Department of Emergency Medicine, Kyung Hee University Medical Center, Seoul, Republic of Korea. Electronic address: bpm480@khu.ac.kr.Department of Emergency Medicine, Kyung Hee University Medical Center, Seoul, Republic of Korea; Department of Emergency Medicine, School of Medicine, Kyung Hee University, Seoul, Republic of Korea. Electronic address: hsg3748@hanmail.net.Department of Emergency Medicine, Kyung Hee University Medical Center, Seoul, Republic of Korea; Department of Emergency Medicine, School of Medicine, Kyung Hee University, Seoul, Republic of Korea. Electronic address: seok918@khu.ac.kr.

Pub Type(s)

Comparative Study
Journal Article

Language

eng

PubMed ID

33812328

Citation

Jeong, Ki Young, et al. "The Comparison of Psychological Scales as Hospitalization Predictors Between Adult and Elderly Suicide Attempters." The American Journal of Emergency Medicine, vol. 47, 2021, pp. 131-137.
Jeong KY, Ko SH, Choi HS, et al. The comparison of psychological scales as hospitalization predictors between adult and elderly suicide attempters. Am J Emerg Med. 2021;47:131-137.
Jeong, K. Y., Ko, S. H., Choi, H. S., & Lee, J. S. (2021). The comparison of psychological scales as hospitalization predictors between adult and elderly suicide attempters. The American Journal of Emergency Medicine, 47, 131-137. https://doi.org/10.1016/j.ajem.2021.03.070
Jeong KY, et al. The Comparison of Psychological Scales as Hospitalization Predictors Between Adult and Elderly Suicide Attempters. Am J Emerg Med. 2021;47:131-137. PubMed PMID: 33812328.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - The comparison of psychological scales as hospitalization predictors between adult and elderly suicide attempters. AU - Jeong,Ki Young, AU - Ko,Seok Hoon, AU - Choi,Han Sung, AU - Lee,Jong Seok, Y1 - 2021/03/27/ PY - 2021/01/16/received PY - 2021/03/22/revised PY - 2021/03/24/accepted PY - 2021/4/4/pubmed PY - 2021/9/3/medline PY - 2021/4/3/entrez KW - Age groups KW - Attempted KW - Hospitalizations KW - Intent KW - Lethality KW - Suicide SP - 131 EP - 137 JF - The American journal of emergency medicine JO - Am J Emerg Med VL - 47 N2 - BACKGROUND: During the process of managing suicide attempters in the emergency department (ED), the importance of hospitalization has been emphasized. Lethality and intent have been suggested as hospitalization determinants of suicide attempters, but their predictive values remain limited in adult and elderly populations. METHODS: Using prospectively collected the ED-based Suicide Registry, data from suicide attempters over 18 years old was retrospectively studied (2010-2020). The enrolled participants were divided into adult (N = 832) and elderly (>65 years, N = 378) groups. Suicide lethality and intent were assessed by the Risk-Rescue Rating Scale (RRRS) and Suicide Intent Scale (SIS), respectively. The moderating effects of age on the relationship between the psychological scales and hospitalization were examined by entering the interaction terms into a multivariable regression model. The predictive ability of each scale for hospitalization was evaluated in terms of performance and goodness-of-fit. RESULTS: Both scales' scores in both age groups were significantly higher in hospitalized patients than non-hospitalized patients. Interaction result indicated that only the odds of RRRS for hospitalization significantly differed by age group. Moreover, the predictive performance for hospitalization significantly differed by age group in RRRS but not SIS. In predicting hospitalization, the AUC of the RRRS was significantly higher than that of the SIS in the elderly group but not in the adult group. Comparing the two groups, the RRRS of the elderly group tended to have higher AUC than the adult group, whereas the AUC of the SIS was similar. The RRRS in both groups had a better overall fit compared to the SIS for hospitalization, but its best overall fit and strength with greater power were observed in the elderly group. CONCLUSIONS: The age-by-RRRS interaction is significantly associated with hospitalization, and the RRRS implementation as a hospitalization determinant is more useful and suitable for elderly suicide attempters than for adult suicide attempters in an emergency setting. SN - 1532-8171 UR - https://www.unboundmedicine.com/medline/citation/33812328/The_comparison_of_psychological_scales_as_hospitalization_predictors_between_adult_and_elderly_suicide_attempters_ L2 - https://linkinghub.elsevier.com/retrieve/pii/S0735-6757(21)00257-6 DB - PRIME DP - Unbound Medicine ER -