预测青少年抑郁症患者非自杀性自伤的提名图:纵向分析。

IF 6 2区 医学 Q1 PEDIATRICS European Child & Adolescent Psychiatry Pub Date : 2024-11-18 DOI:10.1007/s00787-024-02603-7
Yingwen Li, Yarong Ma, Bin Sun, Robert Rosenheck, Jie Zhang, Hongbo He
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引用次数: 0

摘要

非自杀性自伤(NSSI)行为是青少年抑郁症患者的常见问题,但缺乏预后预测模型。本研究旨在为青少年抑郁症患者的 NSSI 行为建立一个提名图。在青少年抑郁症队列的基础上,共有 701 名患者被纳入分析。他们被进一步分为训练集和验证集。采用拉索回归和二元逻辑回归来选择提名图的变量。对提名图的区分度、校准、准确性、临床适用性和普适性的评估采用了接收者工作特征曲线下面积(ROC)、Hosmer-Lemeshow(HL)检验、Brier 评分、校准曲线、决策曲线分析(DCA)和内部验证等指标。德隆检验用于比较两种模型的 ROC 性能。这些患者的平均年龄为 19.3+/-3.3 岁,101 人(20.6%)报告了 NSSI。确定了 NSSI 的五个风险因素:年龄、首次服药年龄、以前的 NSSI 事件、青少年生活事件自评量表 (ASLEC) 中的学习压力得分以及汉密尔顿焦虑评定量表 (HAMA-14) 14 个项目中的躯体焦虑。基于二元逻辑回归模型的训练集和验证集显示出良好的区分度(曲线下面积(AUC)分别为 0.781,95% CI:0.735 ~ 0.827;0.757,95% CI:0.682 ~ 0.831)、校准度(P = 0.421)和准确度(Brier 评分分别为 0.119 ~ 0.155 和 0.109 ~ 0.168)。开发并验证了一种预后提名图,以帮助临床医生预测抑郁症青少年的 NSSI。
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A nomogram for predicting non-suicide self-injury in youth depression patients: a longitudinal analysis.

Non-suicidal self-injury (NSSI) behavior is a common issue in youth with depression while lacks a prognostic prediction model. This study aims to develop a nomogram for NSSI in youth with depression. A total of 701 patients were included in the analysis based a youth depression cohort. They were further divided into a training set and a validation set. The Lasso regression and binary logistic regression were used to select variables for the nomogram. The nomogram's discrimination, calibration, accuracy, clinical applicability, and generalization involved the use of metrics such as the area under the receiver operating characteristic curve (ROC), Hosmer-Lemeshow (HL) test, Brier score, calibration curve, decision curve analysis (DCA), and internal validation. The Delong test was employed to compare the ROC performance between the two models. These patients had an average age of 19.3+/-3.3 years, and 101 (20.6%) individuals reported NSSI. Five risk factors for NSSI were identified: age, age at first medication, previous instances of NSSI, academic stress score in the Adolescent Self-rating Life Events Check List (ASLEC), and somatic anxiety of the 14 item Hamilton Anxiety Rating Scale (HAMA-14). The training set and validation set of binary logistic regression-based model showed good discrimination (area under the curve (AUC) 0.781, 95% CI: 0.735 ~ 0.827; and 0.757, 95% CI: 0.682 ~ 0.831, respectively), calibration (P = 0.421 and 0.175, respectively), and accuracy (Brier score 0.119 to 0.155 and 0.109 to 0.168, respectively). A prognostic nomogram was developed and validated to assist clinicians in predicting NSSI of youth with depression.

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来源期刊
CiteScore
12.80
自引率
4.70%
发文量
186
审稿时长
6-12 weeks
期刊介绍: European Child and Adolescent Psychiatry is Europe''s only peer-reviewed journal entirely devoted to child and adolescent psychiatry. It aims to further a broad understanding of psychopathology in children and adolescents. Empirical research is its foundation, and clinical relevance is its hallmark. European Child and Adolescent Psychiatry welcomes in particular papers covering neuropsychiatry, cognitive neuroscience, genetics, neuroimaging, pharmacology, and related fields of interest. Contributions are encouraged from all around the world.
期刊最新文献
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