Suicide and all-cause mortality in a high-risk cohort: A latent class approach

Gen Hosp Psychiatry. 2020 Mar-Apr:63:62-67. doi: 10.1016/j.genhosppsych.2018.11.004. Epub 2018 Nov 22.

Abstract

Objective: To use latent class analysis to group patients consulted to an emergency psychiatry consultation service and assess occurrence of suicide attempts and all-cause mortality across groups.

Method: Latent class analysis was used to classify individuals assessed by psychiatry in the emergency department of the two teaching hospitals in Winnipeg, Canada. A second latent class analysis was done on individuals presenting with a suicide attempt. Indicators variables included a variety of clinically assessed factors, such as presentation suicidality and occurrence of anxiety/depression/psychosis, and prior medical treatment. Two post-treatment indicators were used; suicide attempt hospitalizations and all-cause mortality within 12 months of assessment.

Results: Latent class analysis identified 8 classes for all presentations (n = 5292) and 3 classes for the attempter subgroup (n = 730). Although there is considerable overlap in indicators among the classes certain indicators differentiated between the groups: suicide attempt presentation, prior psychiatric treatment, psychotropic medication polypharmacy, childhood abuse, and addictions. Although the presence of deaths and future attempts varied between the identified groups, there were no groups with a >10% proportion of individuals with either of these outcomes.

Conclusions: Potential exists for latent class-based assessments, but additional samples with better indicators are needed.

Keywords: Incidence; Latent class analysis; Psychiatry; Suicide.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adolescent
  • Adult
  • Cause of Death*
  • Child Abuse / statistics & numerical data
  • Emergency Service, Hospital / statistics & numerical data*
  • Emergency Services, Psychiatric / statistics & numerical data*
  • Female
  • Hospitals, Teaching / statistics & numerical data
  • Humans
  • Incidence
  • Latent Class Analysis
  • Male
  • Manitoba / epidemiology
  • Mental Disorders / epidemiology
  • Middle Aged
  • Psychotropic Drugs
  • Suicidal Ideation*
  • Suicide, Attempted / classification
  • Suicide, Attempted / statistics & numerical data*
  • Young Adult

Substances

  • Psychotropic Drugs

Grants and funding