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  • Title: Predictive value of suicidal risk assessment using data from China's largest suicide prevention hotline.
    Author: Tong Y, Yin Y, Conner KR, Zhao L, Wang Y, Wang X, Conwell Y.
    Journal: J Affect Disord; 2023 May 15; 329():141-148. PubMed ID: 36842651.
    Abstract:
    BACKGROUND: Suicide hotlines are widely used, with potential for identification of callers at especially high risk. METHODS: This prospective study was conducted at the largest psychological support hotline in China. From 2015 to 2017, all distressed callers were consecutively included and assessed, using a standardized scale consisting of 12 elements, yielding scores of high risk (8-16), moderate risk (4-7), and low risk (0-3) for suicidal act. All high-risk and half of moderate- and low-risk callers were scheduled for a 12-month follow-up. Main outcomes were suicidal acts (nonlethal attempt, death) over follow-up. RESULTS: Of 21,346 fully assessed callers, 5822, 11,791, and 3733 were classified as high-, moderate-, or low-risk for suicidal acts, with 8869 callers (4076 high-, 3258 moderate-, and 1535 low-risk) followed up over 12 months. Over follow-up, 802 (9.0 %) callers attempted suicide or died by suicide. The high-risk callers (15.1 %) had 3-fold higher risk for subsequent suicidal acts than moderate- (5.1 %) and 12-fold higher risk than low-risk callers (1.3 %). The weighted sensitivity, specificity, and positive predictive value of high risk scores were 56.4 %, 74.9 %, and 14.4 %. LIMITATIONS: Assessed callers with different risk levels were followed disproportionally. CONCLUSIONS: Suicidal risk assessment during a hotline call is both feasible and predictive of risk, guiding resource allocation to higher risk callers.
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