Conference item : Abstract
Structured risk assessment in psychiatry
- Abstract:
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Background:
Current approaches to stratify psychiatric patients into groups based on violence risk are limited by inconsistency, variable accuracy, and unscalability.
Methods:
Based on a national cohort of 75 158 Swedish individuals aged 15–65 with a diagnosis of severe mental illness (schizophrenic-spectrum and bipolar disorders) with 574 018 patient episodes, we developed predictive models for violent offending through linkage of population-based registers. First, a derivation model was developed to determine strength of pre-specified criminal history, socio-demographic, and clinical risk factors, and tested it in external validation. We measured discrimination and calibration for prediction of violent offending at 1 year using specified risk cut-offs.
Results:
A 16 item model was developed from criminal history, socio-demographic and clinical risk factors, which are mostly routinely collected. In external validation, the model showed good measures of discrimination (c-index 0.89) and calibration. For risk of violent offending at 1 year, using a 5% cut off, sensitivity was 64% and specificity was 94%. Positive and negative predictive values were 11% and 99%, respectively. The model was used to generate a simple web-based risk calculator (OxMIV).
Discussion:
We have developed a prediction score in a national cohort of patients with psychosis that can be used as an adjunct to decision making in clinical practice by identifying those who are at low risk of violent offending.
- Publication status:
- Published
- Peer review status:
- Peer reviewed
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- Files:
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(Preview, Version of record, 92.4KB, Terms of use)
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- Publisher copy:
- 10.1093/schbul/sby014.055
Authors
- Publisher:
- Oxford University Press
- Journal:
- Schizophrenia Bulletin More from this journal
- Volume:
- 44
- Issue:
- S1
- Pages:
- S23-S24
- Publication date:
- 2018-04-01
- Event title:
- Sixth Biennial Schizophrenia International Research Society Conference (SIRS 2018)
- Event location:
- Florence, Italy
- Event website:
- https://www.emedevents.com/c/medical-conferences-2018/6th-biennial-schizophrenia-international-research-society-sirs-conference
- Event start date:
- 2018-04-04
- Event end date:
- 2018-04-08
- DOI:
- EISSN:
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1745-1701
- ISSN:
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0586-7614
- Language:
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English
- Keywords:
- Subtype:
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Abstract
- Pubs id:
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846631
- Local pid:
-
pubs:846631
- Deposit date:
-
2021-01-20
Terms of use
- Copyright holder:
- Maryland Psychiatric Research Center
- Copyright date:
- 2018
- Rights statement:
- © Maryland Psychiatric Research Center 2018. This is an Open Access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted reuse, distribution, and reproduction in any medium, provided the original work is properly cited.
- Notes:
- This paper was presented at the Sixth Biennial Schizophrenia International Research Society Conference (SIRS 2018), Florence, Italy, April 2018.
- Licence:
- CC Attribution (CC BY)
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