Ask an expert to predict who is most at risk for suicide, and they’ll only be able to give you an educated guess. In fact, an analysis of 50 years of research on suicidal thoughts and attempts found medical professionals’ ability to predict suicidal behavior is slightly better than chance.
Researchers at the University of Pittsburgh are hoping to change that with a new predictive scoring tool they’ve developed. In a study published in JAMA Psychiatry, they showed the tool correctly predicted suicidal behavior in 87 percent of cases.
Nadine Melhem, a co-author of the study and an associate professor of psychiatry at Pitt’s School of Medicine, and her team developed the predictive risk scoring tool after studying 663 teens and children for 12 years. The children were considered at high risk for suicide because their parents had mood disorders.
Over the years, researchers evaluated the parents and children for psychiatric diagnoses and symptoms like depression, hopelessness, and irritability. They found the strongest predictor of suicidal behavior was not just the severity of depressive symptoms, but how much those symptoms varied over time.
Currently, many therapists rely on psychiatric diagnoses. Diagnoses don’t change, Melhem said, while suicidal behavior varies during the course of a psychiatric illness.
“We want to reflect and address what are the symptoms that change with that risk,” she said.
The study suggests therapists should think about how a patient feels in the moment, how severe their symptoms have been and how often the symptoms change.
Melhem and her colleagues combined this information with other known risk factors for suicide to create the predictive risk score. If a patient meets the criteria for more than three items on the scoring tool, it indicates they’re at high risk for suicidal behavior.
The tool identifies suicide risk about as well as a mammogram identifies cancerous masses, Melhem said. That means it may lead to some false positives, but she belives these are preferable to a false negative. The scoring tool has only been tested in the same population used to develop it, so further research is needed to verify its reliability.
It’s also unclear if it would work for all youth, or only those whose parents have mood disorders.
Moving forward, her team is hoping to find biological markers for suicide through blood tests and other physiological measures to increase accuracy.