{
  "abstract": "Objectives Suicide risk assessments currently rely on subjective clinical judgement, lacking objective measures. This study aimed to evaluate the association between biomarkers and suicide risk and to explore their predictive potential using machine learning (ML).Methods We analysed data from 2785 first-admission psychiatric inpatients across three institutions, including 103 biomarkers and 13 demographic and clinical variables. Suicide risk was assessed 1 week after admission using the Nurses’ Global Assessment of Suicide Risk.Results A total of 2785 patients met the inclusion criteria, from which 978 were selected via propensity score matching to minimise confounding from demographic factors, treatment differences and symptom severity. Multivariate random effects logistic regression identified nine biomarkers associated with elevated suicide risk and six with potential protective effects. Time-trend analyses further revealed that nine biomarkers showed significant changes following risk escalation. Integrating biomarkers with demographic data, treatment information and psychological scale scores substantially improved ML model performance, achieving an area under the receiver operating characteristic curve of 0.808 in the external testing cohort. The inclusion of biomarkers significantly enhanced predictive accuracy.Conclusion This study highlights the potential of biomarkers with ML to predict future risk, offering objective assessments and supporting early interventions.",
  "authors": [
    {
      "affiliations": [
        "Shanghai Pudong New Area Mental Health Center, School of Medicine, Tongji University, Shanghai, China"
      ],
      "name": "Zheya Cai"
    },
    {
      "affiliations": [
        "Shanghai Pudong New Area Mental Health Center, School of Medicine, Tongji University, Shanghai, China"
      ],
      "name": "Enzhao Zhu"
    },
    {
      "affiliations": [
        "Shanghai Pudong New Area Mental Health Center, School of Medicine, Tongji University, Shanghai, China"
      ],
      "name": "Jianmeng Dai"
    },
    {
      "affiliations": [
        "Shanghai Pudong New Area Mental Health Center, School of Medicine, Tongji University, Shanghai, China"
      ],
      "name": "Xu Zhang"
    },
    {
      "affiliations": [
        "Shanghai Pudong New Area Mental Health Center, School of Medicine, Tongji University, Shanghai, China"
      ],
      "name": "Jiayi Wang"
    },
    {
      "affiliations": [
        "Shanghai Pudong New Area Mental Health Center, School of Medicine, Tongji University, Shanghai, China"
      ],
      "name": "Xiuake Bahuojia"
    },
    {
      "affiliations": [
        "Shanghai Pudong New Area Mental Health Center, School of Medicine, Tongji University, Shanghai, China"
      ],
      "name": "Ruyi Shui"
    },
    {
      "affiliations": [
        "Shanghai Pudong New Area Mental Health Center, School of Medicine, Tongji University, Shanghai, China"
      ],
      "name": "Qiuyi Lu"
    },
    {
      "affiliations": [
        "Shanghai Pudong New Area Mental Health Center, School of Medicine, Tongji University, Shanghai, China"
      ],
      "name": "Duoduo Bai"
    },
    {
      "affiliations": [
        "Shanghai Pudong New Area Mental Health Center, School of Medicine, Tongji University, Shanghai, China"
      ],
      "name": "Shengbei Liu"
    },
    {
      "affiliations": [
        "School of Electronic and Information Engineering, Tongji University, Shanghai, China"
      ],
      "name": "Ruichen Tang"
    },
    {
      "affiliations": [
        "School of Electronic and Information Engineering, Tongji University, Shanghai, China"
      ],
      "name": "Xin Wang"
    },
    {
      "affiliations": [
        "Shanghai Pudong New Area Mental Health Center, School of Medicine, Tongji University, Shanghai, China"
      ],
      "name": "Qianyi Yu"
    },
    {
      "affiliations": [
        "School of Life Sciences and Technology, Tongji University, Shanghai, China"
      ],
      "name": "Han Yang"
    },
    {
      "affiliations": [
        "Shanghai Putuo District Mental Health Center, Shanghai, China"
      ],
      "name": "Guoquan Zhou"
    },
    {
      "affiliations": [
        "Shanghai Putuo District Mental Health Center, Shanghai, China"
      ],
      "name": "Siqi Liu"
    },
    {
      "affiliations": [
        "East China University of Science and Technology, Shanghai, China"
      ],
      "name": "Zhihao Chen"
    },
    {
      "affiliations": [
        "Shanghai Pudong New Area Mental Health Center, School of Medicine, Tongji University, Shanghai, China"
      ],
      "name": "Yuqin Weng"
    },
    {
      "affiliations": [
        "Shanghai Pudong New Area Mental Health Center, School of Medicine, Tongji University, Shanghai, China"
      ],
      "name": "Xinyi Tang"
    },
    {
      "affiliations": [
        "Shanghai Pudong New Area Mental Health Center, School of Medicine, Tongji University, Shanghai, China"
      ],
      "name": "Huan Wang"
    },
    {
      "affiliations": [
        "Shanghai Pudong New Area Mental Health Center, School of Medicine, Tongji University, Shanghai, China"
      ],
      "name": "Huiqing Pan"
    },
    {
      "affiliations": [
        "Shanghai Pudong New Area Mental Health Center, School of Medicine, Tongji University, Shanghai, China"
      ],
      "name": "Tongxing Ou"
    },
    {
      "affiliations": [
        "Shanghai Pudong New Area Mental Health Center, School of Medicine, Tongji University, Shanghai, China"
      ],
      "name": "Yue Liu"
    },
    {
      "affiliations": [
        "Shanghai Pudong New Area Mental Health Center, School of Medicine, Tongji University, Shanghai, China"
      ],
      "name": "Weiwei Xu"
    },
    {
      "affiliations": [
        "School of Basic Medical Sciences, Nanjing Medical University, Nanjing, Jiangsu, China"
      ],
      "name": "Kexin Chen"
    },
    {
      "affiliations": [
        "School of Public Health, Nanjing Medical University, Nanjing, Jiangsu, China"
      ],
      "name": "Xunuo Lu"
    },
    {
      "affiliations": [
        "School of Public Health, Capital Medical University, Beijing, China"
      ],
      "name": "Wenjing Wang"
    },
    {
      "affiliations": [
        "Shanghai Pudong New Area Mental Health Center, School of Medicine, Tongji University, Shanghai, China"
      ],
      "name": "Xuqi Song"
    },
    {
      "affiliations": [
        "Shanghai Pudong New Area Mental Health Center, School of Medicine, Tongji University, Shanghai, China"
      ],
      "name": "Zongyuan Wang"
    },
    {
      "affiliations": [
        "Clinical Research Center for Mental Disorders, Shanghai Pudong New Area Mental Health Center, School of Medicine, Tongji University, Shanghai, China"
      ],
      "name": "Feng Wang"
    },
    {
      "affiliations": [
        "Clinical Research Center for Mental Disorders, Shanghai Pudong New Area Mental Health Center, School of Medicine, Tongji University, Shanghai, China"
      ],
      "name": "Dong Wang"
    },
    {
      "affiliations": [
        "Shanghai Changning District Mental Health Center, Shanghai, China"
      ],
      "name": "Kang Ju"
    },
    {
      "affiliations": [
        "Shanghai Changning District Mental Health Center, Shanghai, China"
      ],
      "name": "Liangliang Chen"
    },
    {
      "affiliations": [
        "Shanghai Changning District Mental Health Center, Shanghai, China"
      ],
      "name": "Yichao Yin"
    },
    {
      "affiliations": [
        "Shanghai Key Laboratory of Psychotic Disorders, Shanghai Mental Health Center, Shanghai Jiaotong University School of Medicine, Shanghai, China"
      ],
      "name": "Chunbo Li"
    },
    {
      "affiliations": [
        "Shanghai Jinshan District Mental Health Center, Shanghai, China"
      ],
      "name": "Yanping Zhang"
    },
    {
      "affiliations": [
        "Shanghai Pudong New Area Mental Health Center, School of Medicine, Tongji University, Shanghai, China"
      ],
      "name": "Pu Ai"
    },
    {
      "affiliations": [
        "Shanghai Pudong New Area Mental Health Center, School of Medicine, Tongji University, Shanghai, China"
      ],
      "name": "Tianyu Ji"
    },
    {
      "affiliations": [
        "Shanghai Hospital Development Center, Shanghai, China"
      ],
      "name": "Weizhong Shi"
    },
    {
      "affiliations": [
        "University Clinic of Child and Adolescent Psychiatry, Psychosomatics and Psychotherapy, RWTH Aachen University, Aachen, Germany"
      ],
      "name": "Jiaojiao Hou"
    },
    {
      "affiliations": [
        "Clinical Research Center for Mental Disorders, Shanghai Pudong New Area Mental Health Center, School of Medicine, Tongji University, Shanghai, China"
      ],
      "name": "Fazhan Chen"
    },
    {
      "affiliations": [
        "Shanghai Key Laboratory of Psychotic Disorders, Shanghai Mental Health Center, Shanghai Jiaotong University School of Medicine, Shanghai, China"
      ],
      "name": "Hui Li"
    },
    {
      "affiliations": [
        "Shanghai Pudong New Area Mental Health Center, School of Medicine, Tongji University, Shanghai, China"
      ],
      "name": "Zisheng Ai"
    }
  ],
  "title": "Biomarkers associated with future suicide risk enhance predictive performance in psychiatric inpatients",
  "uid": "9ce286c5-52f5-5cc5-967e-d121182fa6fd"
}