Accurate Diagnosis of Suicide Ideation/Behavior Using Robust Ensemble Machine Learning: A University Student Population in the Middle East and North Africa (MENA) Region
Abstract
:1. Introduction
2. Materials and Methods
2.1. Sample Size Calculation and Sampling
2.2. PTSD Checklist (PCL-5)
2.3. Post-Traumatic Growth Inventory (PTGI)
2.4. Patient Health Questionnaire (PHQ-9)
2.5. Multidimensional Scale of Perceived Social Support (MSPSS)
2.6. Positive Mental Health Scale (PMH)
2.7. Suicide Behaviors Questionnaire-Revised (SBQ-R)
2.8. Ethical Considerations
2.9. Methods
2.10. Validation
3. Results
4. Discussion
4.1. Limitations and Strength
4.2. Implications
5. Conclusions
Author Contributions
Funding
Acknowledgments
Conflicts of Interest
Appendix A
Total (N = 573) | (L.R) N = 430 | (H.R) N = 143 | p-Value 1 | |
---|---|---|---|---|
Fathers’ job | Unemployed | 20 (4.7%) | 3 (2.1%) | 0.047 |
Employed | 87 (20.2%) | 36 (25.2%) | ||
Self-employed | 174 (40.5%) | 60 (42%) | ||
Retired | 149 (34.7%) | 44 (30.8%) | ||
Mothers’ job | Housewife | 334 (77.7%) | 98 (68.5%) | 0.023 |
Employed | 48 (11.2%) | 26 (18.2%) | ||
Self-employed | 20 (4.7%) | 4 (2.8%) | ||
Retired | 28 (6.5%) | 15 (10.5%) | ||
Economic status | Weak | 25 (5.8%) | 3 (2.1%) | 0.268 |
Middle | 227 (52.8%) | 78 (54.5%) | ||
Good | 168 (39.1%) | 61 (42.7%) | ||
Excellent | 10 (2.3%) | 1 (0.7%) | ||
Accommodation | with family | 341 (79.3%) | 106 (74.1%) | 0.195 |
dormitory | 89 (20.7%) | 37 (25.9%) | ||
History of physical illness | None | 364 (84.7%) | 105 (73.4%) | 0.003 |
High blood pressure | 2 (0.5%) | - | ||
Cardiovascular | 3 (0.7%) | 7 (4.9%) | ||
Musculoskeletal | 9 (2.1%) | 4 (2.8%) | ||
Digestive | 26 (6%) | 7 (4.9%) | ||
Diabetes | 1 (0.2%) | 3 (2.1%) | ||
Hashimoto | 2 (0.5%) | - | ||
Hepatitis B | 1 (0.2%) | - | ||
Respiratory | 5 (1.2%) | - | ||
Kidney | 1 (0.2%) | 2 (1.4%) | ||
Migraine | 1 (0.2%) | 3 (2.1%) | ||
Obesity | 1 (0.2%) | 1 (0.7%) | ||
Minor Thalassemia | 2 (0.5%) | 2 (1.4%) | ||
Fauvism | - | 1 (0.7%) | ||
Visual impairment | 1 (0.2%) | 2 (1.4%) | ||
Epilepsy | 4 (0.9%) | - | ||
Skin problem | 1 (0.2%) | - | ||
Cancer | 3 (0.7%) | 3 (2.1%) | ||
Polycystic ovary syndrome | 2 (0.5%) | 3 (2.1%) | ||
Genital issues | 1 (0.2%) | - | ||
History of using psychological medicine (Yes, %) | 31 (7.2%) | 27 (18.9%) | <0.001 | |
History of using drugs, smoking, and alcohol (Yes, %) | 35 (8.1%) | 26 (18.2%) | 0.001 | |
Types of trauma (Yes, %) | Sudden loss | 154 (35.8%) | 49 (34.3%) | 0.7373 |
Serious ill diagnosis | 85 (19.8%) | 29 (20.3%) | 0.865 | |
Road accident | 48 (11.2%) | 10 (7%) | 0.158 | |
Earthquake | 8 (1.9%) | 9 (6.3%) | 0.007 | |
Loss of romantic relationship | 105 (24.4%) | 62 (43.4%) | <0.001 | |
Loss of important things | 30 (7%) | 9 (6.3%) | 0.774 | |
Suicide | 14 (3.3%) | 5 (3.5%) | 0.889 | |
Flood | 2 (0.5%) | 2 (1.4%) | 0.557 | |
Sexual abuse | 23 (5.3%) | 20 (14%) | 0.001 | |
Homicide | 2 (0.5%) | 1 (0.7%) | 1.000 | |
Attack and violent | 10 (2.3%) | 11 (7.7%) | 0.003 | |
Death treated | 3 (0.7%) | 2 (1.4%) | 0.026 | |
Fire and explosion | 4 (9%) | 2 (1.4%) | 1.000 | |
War and terror | 6 (1.4%) | - | 0.156 | |
Air accident | 2 (0.5%) | 1 (0.7%) | 1.000 | |
How to experience trauma | It happened to me directly. | 177 (41.2%) | 95 (66.4%) | <0.001 |
I witnessed it. | 105 (24.4%) | 20 (14%) | ||
It happened to a close person. | 56 (13%) | 8 (5.6%) | ||
I was exposed to it as part of my job. | - | 1 (0.7%) |
Q | Not at All | A Little Bit | Middle | Quite a Bit | Extremely | p-Value 1 | |||||
---|---|---|---|---|---|---|---|---|---|---|---|
L.R | H.R | L.R | H.R | L.R | H.R | L.R | H.R | L.R | H.R | ||
1 | 52 (12.1%) | 13 (9.1%) | 129 (30%) | 25 (17.5%) | 107 (24.9%) | 31 (21.7%) | 97 (22.6%) | 35 (24.5%) | 44 (10.2%) | 39 (27.3%) | <0.001 |
2 | 124 (28.8%) | 29 (20.3%) | 119 (27.7%) | 30 (21%) | 92 (21.4) | 30 (21%) | 66 (15.3%) | 30 (21%) | 29 (6.7%) | 24 (16.8%) | <0.001 |
3 | 170 (39.5%) | 29 (20.3%) | 102 (23.7%) | 28 (19.6%) | 84 (19.5%) | 26 (18.2%) | 48 (11.2%) | 35 (24.5%) | 25 (5.8%) | 25 (17.5%) | <0.001 |
4 | 97 (22.6%) | 17 (11.9%) | 115 (26.7%) | 12 (8.4%) | 106 (24.7%) | 27 (18.9%) | 78 (18.1) | 50 (35%) | 33 (7.7%) | 37 (25.9%) | <0.001 |
5 | 198 (46%) | 33 (23.1%) | 110 (25.6%) | 27 (18.9%) | 66 (15.3%) | 36 (25.2%) | 39 (9.1%) | 28 (19.6%) | 16 (3.7%) | 19 (13.3%) | <0.001 |
6 | 104 (24.2%) | 19 (13.3%) | 107 (24.9%) | 32 (22.4%) | 117 (27.2%) | 35 (24.5%) | 63 (14.7%) | 34 (23.8%) | 39 (9.1%) | 23 (16.1%) | <0.001 |
7 | 127 (29.5%) | 26 (18.2%) | 99 (33%) | 30 (21%) | 108 (25.1%) | 30 (21%) | 63 (14.7%) | 37 (25.9%) | 33 (7.7%) | 20 (14%) | <0.001 |
8 | 229 (53.3%) | 64 (44.8%) | 107 (24.9%) | 38 (26.6%) | 58 (13.5%) | 25 (17.5%) | 24 (5.6%) | 12 (8.4%) | 12 (2.8%) | 4 (2.8%) | 0.056 |
9 | 157 (36.5%) | 18 (12.6) | 94 (21.9%) | 22 (15.4%) | 86 (20%) | 22 (15.4%) | 58 (13.5%) | 33 (23.1%) | 34 (7.9%) | 48 (38.6%) | <0.001 |
10 | 127 (29.5%) | 19 (13.3%) | 99 (23%) | 19 (13.3%) | 93 (21.6%) | 22 (15.4%) | 74 (17.2%) | 37 (25.9%) | 36 (8.4%) | 46 (32.2%) | <0.001 |
11 | 126 (29.3%) | 16 (11.2%) | 119 (27.7%) | 24 (16.8%) | 82 (19.1%) | 16 (11.2%) | 69 (16%) | 42 (29.4%) | 33 (7.7%) | 45 (315%) | <0.001 |
12 | 153 (35.6%) | 24 (16.8%) | 107 (24.9%) | 18 (12.6%) | 78 (18.1%) | 37 (25.9%) | 61 (14.2%) | 33 (23.1%) | 30 (7%) | 31 (21.7%) | <0.001 |
13 | 200 (46.5%) | 34 (23.8%) | 106 (24.7%) | 33 (23.1%) | 69 (16%) | 27 (18.9%) | 45 (10.5%) | 33 (23.1%) | 10 (2.3%) | 16 (11.2%) | <0.001 |
14 | 188 (43.7%) | 29 (20.3%) | 109 (25.3%) | 27 (18.9%) | 80 (18.6%) | 23 (16.1%) | 41 (9.5%) | 32 (22.4%) | 12 (2.8%) | 32 (22.4%) | <0.001 |
15 | 185 (43%) | 28 (19.6%) | 122 (28.4%) | 25 (17.5%) | 69 (16%) | 32 (22.4%) | 39 (9.1%) | 33 (23.1%) | 15 (3.5%) | 25 (17.5%) | <0.001 |
16 | 285 (66.3%) | 61 (42.7%) | 87 (20.2%) | 31 (21.7%) | 40 (9.3%) | 24 (16.8%) | 14 (3.3%) | 18 (12.6%) | 4 (0.9%) | 9 (6.3%) | <0.001 |
17 | 145 (33.7%) | 34 (23.8%) | 133 (30.9%) | 21 (14.7%) | 83 (19.3%) | 37 (25.9%) | 44 (10.2%) | 32 (22.4%) | 25 (5.8%) | 19 (13.3%) | <0.001 |
18 | 201 (46.7%) | 44 (30.8) | 123 (28.6%) | 31 (21.7%) | 55 (12.8%) | 30 (21%) | 37 (8.6%) | 21 (14.7%) | 14 (3.3%) | 17 (11.9%) | <0.001 |
19 | 116 (27%) | 18 (12.6%) | 128 (29.8%) | 22 (15.4%) | 82 (19.1%) | 35 (24.5%) | 66 (15.3%) | 41 (28.7%) | 37 (8.6%) | 27 (18.9%) | <0.001 |
20 | 165 (38.4%) | 33 (22.4%) | 113 (26.3%) | 33 (22.4%) | 69 (16%) | 23 (16.1%) | 48 (11.2%) | 21 (14.7%) | 35 (8.1%) | 35 (24.5%) | <0.001 |
Q | Not at All | A Little Bit | A Little | Middle | Quite a Bit | Extremely | p-Value 1 | ||||||
---|---|---|---|---|---|---|---|---|---|---|---|---|---|
L.R | H.R | L.R | H.R | L.R | H.R | L.R | H.R | L.R | H.R | L.R | H.R | ||
1 | 56 (13%) | 23 (16.1%) | 82 (19.1%) | 14 (9.8%) | 80 (18.6%) | 22 (15.4%) | 123 (28.6%) | 41 (28.7%) | 60 (14%) | 25 (17.5%) | 28 (6.5%) | 18 (12.6%) | 0.044 |
2 | 10 (2.3%) | 25 (17.5%) | 34 (7.9%) | 22 (15.4%) | 45 (10.5%) | 29 (20.3%) | 95 (22.1%) | 28 (19.6%) | 127 (29.5%) | 27 (18.9%) | 119 (27.7%) | 12 (8.4%) | <0.001 |
3 | 34 (7.9%) | 18 (12.6%) | 42 (9.8%) | 27 (18.9%) | 62 (14.4%) | 24 (16.8%) | 128 (29.8%) | 36 (25.2%) | 92 (21.4%) | 25 (17.5%) | 72 (16.7%) | 13 (9.1%) | <0.001 |
4 | 44 (10.2%) | 36 (25.2%) | 49 (11.4%) | 31 (21.7%) | 77 (17.9%) | 30 (21%) | 108 (25.1%) | 24 (16.8%) | 101 (23.5%) | 11(.7%) | 50 (11.6%) | 11 (7.7%) | <0.001 |
5 | 47 (10.9%) | 44 (30.8%) | 49 (11.4%) | 21 (14.7%) | 76 (17.7%) | 20 (14%) | 94 (21.9%) | 21 (14.7%) | 69 (16%) | 21 (14.7%) | 95 (22.1%) | 16 (11.2%) | <0.001 |
6 | 50 (11.6%) | 41 (28.7%) | 78 (18.1%) | 39 (27.3%) | 97 (22.6%) | 21 (14.7%) | 101 (23.5%) | 22 (15.4%) | 67 (15.6%) | 16 (11.2%) | 58 (13.5%) | 14 (9.8%) | <0.001 |
7 | 28 (6.5%) | 19 (3.3%) | 38 (8.8%) | 31 (21.7%) | 81 (18.8%) | 28 (19.6%) | 132 (30.7%) | 30 (21%) | 93 (21.6%) | 21 (14.7%) | 37 (8.6%) | 5 (3.5%) | <0.001 |
8 | 58 (13.5%) | 45 (31.5%) | 86 (20%) | 29 (20.3%) | 96 (22.3%) | 39 (27.3%) | 105 (24.4%) | 17 (11.9%) | 48 (11.2%) | 8 (5.6%) | 47 (10.9%) | 8 (5.6%) | <0.001 |
9 | 51 (11.9%) | 43 (30.1%) | 88 (20.5%) | 31 (21.7%) | 84 (19.5%) | 22 (15.4%) | 87 (20.2%) | 19 (13.3%) | 72 (16.7%) | 20 (14%) | 47 (10.9%) | 8 (5.6%) | <0.001 |
10 | 16 (3.7%) | 10 (7%) | 34 (7.9%) | 21 (14.7%) | 62 (14.4%) | 32 (22.4%) | 109 (25.3%) | 42 (29.4%) | 132 (30.7%) | 23 (16.1%) | 77 (17.9%) | 15 (10.5%) | <0.001 |
11 | 19 (4.4%) | 21 (14.7%) | 46 (10.7%) | 31 (21.7%) | 71 (16.5%) | 29 (20.3%) | 118 (27.4%) | 34 (23.8%) | 100 (23.3%) | 13 (9.1%) | 76 (17.7%) | 15 (10.5%) | <0.001 |
12 | 14 (3.3%) | 10 (7%) | 28 (6.5%) | 16 (11.2%) | 53 (12.3%) | 27 (18.9%) | 130 (30.2%) | 41 (28.7%) | 122 (28.4%) | 29 (20.3%) | 82 (19.1%) | 20 (14%) | 0.001 |
13 | 19 (4.4%) | 26 (18.2%) | 29 (6.7%) | 25 (17.5%) | 52 (12.1%) | 34 (23.8%) | 121 (28.1%) | 24 (16.8%) | 108 (25.1%) | 17 (11.9%) | 100 (23.3%) | 17 (11.9%) | <0.001 |
14 | 33 (7.7%) | 20 (14%) | 39 (9.1%) | 30 (21%) | 66 (15.3%) | 29 (20.3%) | 113 (26.3%) | 28 (19.6%) | 101 (23.5%) | 21 (14.7%) | 78 (18.1%) | 15 (10.5%) | <0.001 |
15 | 14 (3.3%) | 12 (8.4%) | 30 (7%) | 19 (13.3%) | 62 (14.4%) | 22 (15.4%) | 98 (22.8%) | 27 (18.9%) | 128 (29.8%) | 36 (25.2%) | 98 (22.8%) | 27 (18.9%) | 0.009 |
16 | 29 (6.7%) | 25 (17.5%) | 33 (7.7%) | 27 (18.5%) | 77 (17.9%) | 24 (16.8%) | 122 (28.4%) | 28 (19.6%) | 93 (21.6%) | 24 (16.8%) | 76 (17.7%) | 15 (10.5%) | <0.001 |
17 | 19 (4.4%) | 15 (10.5%) | 39 (9.1%) | 23 (16.1%) | 57 (13.3%) | 29 (20.3%) | 119 (27.7%) | 32 (22.4%) | 126 (29.3%) | 33 (23.1%) | 69 (16%) | 11 (7.7%) | <0.001 |
18 | 77 (17.9%) | 58 (40.6%) | 76 (17.7%) | 24 (16.8%) | 57 (13.3%) | 21 (14.7%) | 82 (19.1%) | 15 (10.5%) | 74 (17.2%) | 13 (9.1%) | 64 (14.9%) | 12 (8.4%) | <0.001 |
19 | 22 (5.1%) | 18 (12.6%) | 28 (6.5%) | 20 (14%) | 52 (12.1%) | 23 (16.1%) | 100 (23.3%) | 28 (19.6%) | 133 (30.9%) | 29 (20.3%) | 95 (22.1%) | 25 (17.5%) | <0.001 |
20 | 40 (9.3%) | 28 (19.6%) | 29 (6.7%) | 14 (9.8%) | 57 (13.3%) | 18 (12.6%) | 94 (21.9%) | 28 (19.6%) | 102 (23.7%) | 330 (21%) | 107 (24.9%) | 25 (17.5%) | 0.002 |
21 | 18 (4.2%) | 14 (9.8%) | 28 (6.5%) | 17 (11.9%) | 40 (9.3%) | 19 (13.3%) | 96 (22.3%) | 28 (19.6%) | 112 (26%) | 30 (21%) | 136 (31.6%) | 35 (24.5%) | 0.002 |
Q | Very Strongly Disagree | Strongly Disagree | Mildly Disagree | Neutral | Mildly Agree | Strongly Agree | Very Strongly Agree | p-Value 1 | |||||||
---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
L.R | H.R | L.R | H.R | L.R | H.R | L.R | H.R | L.R | H.R | L.R | H.R | L.R | H.R | ||
1 | 26 (6%) | 18 (12.6%) | 34 (7.9%) | 20 (14%) | 40 (9.3%) | 16 (11.2%) | 66 (15.3%) | 16 (11.2%) | 85 (19.85%) | 25 (17.5%) | 76 (17.7%) | 30 (21%) | 103 (24%) | 18 (12.6%) | 0.001 |
2 | 30 (7%) | 25 (17.5%) | 22 (5.1%) | 13 (9.1%) | 29 (6.7%) | 14 (9.8%) | 50 (11.6%) | 11 (7.7%) | 81 (18.8%) | 19 (13.3%) | 89 (20.7%) | 33 (23.1%) | 129 (30%) | 28 (19.6%) | 0.001 |
3 | 12 (2.8%) | 12 (8.4%) | 12 (2.8%) | 14 (9.8%) | 25 (5.8%) | 15 (10.5%) | 53 (12.3%) | 19 (13.3%) | 79 (18.4%) | 17 (18.9%) | 80 (18.6%) | 30 (21%) | 168 (39.1%) | 26 (18.2%) | <0.001 |
4 | 15 (3.5%) | 17 (11.9%) | 22 (5.1%) | 15 (10.5%) | 31 (7.2%) | 13 (9.1%) | 45 (10.5%) | 20 (14%) | 73 (17%) | 28 (19.6%) | 102 (23.7%) | 30 (21%) | 142 (33%) | 20 (14%) | <0.001 |
5 | 35 (8.1%) | 34 (23.8%) | 24 (5.6%) | 16 (11.2%) | 31 (7.2%) | 14 (9.8%) | 51 (11.9%) | 9 (6.3%) | 63 (14.7%) | 18 (12.6%) | 64 (14.9%) | 18 (12.6%) | 162 (37.7%) | 34 (23.8%) | <0.001 |
6 | 35 (8.1%) | 15 (10.5%) | 39 (9.1%) | 20 (14%) | 47 (10.9%) | 32 (22.4%) | 86 (20%) | 15 (10.5%) | 81 (18.8%) | 27 (18.9%) | 67 (15.6%) | 14 (9.8%) | 74 (17.2%) | 20 (14%) | 0.005 |
7 | 45 (10.5%) | 28 (19.6%) | 46 (10.7%) | 27 (18.9%) | 55 (12.8%) | 20 (14%) | 81 (18.8%) | 14 (9.8%) | 89 (20.7%) | 26 (18.2%) | 62 (14.4%) | 13 (19.1%) | 52 (12.1%) | 15 (10.5%) | 0.001 |
8 | 37 (8.6%) | 30 (21%) | 45 (10.5%) | 30 (21%) | 39 (9.1%) | 20 (14%) | 61 (14.2%) | 17 (11.9%) | 93 (21.6%) | 26 (18.2%) | 74 (17.2%) | 13 (9.1%) | 81 (18.8%) | 7 (4.9%) | <0.001 |
9 | 35 (8.1%) | 18 (12.6%) | 34 (7.9%) | 24 (16.8%) | 36 (8.4%) | 19 (13.3%) | 67 (15.6%) | 15 (10.5%) | 80 (18.6%) | 27 (18.9%) | 85 (19.8%) | 17 (11.9%) | 93 (21.6%) | 23 (16.1%) | <0.001 |
10 | 22 (5.1%) | 17 (11.9%) | 18 (4.2%) | 18 (12.6%) | 25 (5.8%) | 11 (7.7%) | 52 (12.1%) | 16 (11.2%) | 62 (14.4%) | 25 (17.5%) | 71 (16.5%) | 19 (13.3%) | 180 (41.9%) | 37 (25.9%) | <0.001 |
11 | 17 (4%) | 10 (7%) | 15 (3.5%) | 16 (11.2%) | 22 (5.1%) | 22 (15.4%) | 60 (14%) | 23 (16.1%) | 92 (21.4%) | 24 (16.8%) | 101 (23.5%) | 21 (14.7%) | 123 (28.6%) | 27 (18.9%) | <0.001 |
12 | 35 (8.1%) | 25 (17.5%) | 46 (10.7%) | 22 (15.4%) | 37 (8.6%) | 20 (14%) | 64 (14.9%) | 14 (9.8%) | 102 (23.7%) | 23 (16.1%) | 61 (14.2%) | 21 (14.7%) | 85 (19.8%) | 18 (12.6%) | <0.001 |
Q | Not at All | Several Days | More than Half the Days | Nearly Every Day | p-Value 1 | ||||
---|---|---|---|---|---|---|---|---|---|
L.R | H.R | L.R | H.R | L.R | H.R | L.R | H.R | ||
1 | 96 (22.3%) | 10 (7%) | 171 (39.8%) | 52 (36.4%) | 121 (28.1%) | 44 (30.8%) | 42 (9.8%) | 37 (25.9%) | <0.001 |
2 | 83 (19.3%) | 7 (4.9%) | 194 (45.1%) | 44 (30.8%) | 108 (25.1%) | 52 (36.4%) | 44 (10.2%) | 40 (28%) | <0.001 |
3 | 170 (39.5%) | 37 (25.9%) | 120 (27.9%) | 37 (25.9%) | 78 (18.1%) | 28 (19.6%) | 62 (14.4%) | 41 (28.7%) | <0.001 |
4 | 81 (18.8%) | 10 (7%) | 154 (35.8%) | 33 (23.1%) | 131 (30.5%) | 43 (30.1%) | 64 (14.9%) | 57 (39.9%) | <0.001 |
5 | 187 (43.5%) | 32 (22.4%) | 122 (28.4%) | 30 (21%) | 85 (19.8%) | 45 (31.5%) | 35 (8.1%) | 36 (25.2%) | <0.001 |
6 | 215 (50%) | 27 (18.9%) | 114 (26.5%) | 33 (23.1%) | 66 (15.3%) | 41 (28.7%) | 35 (8.1%) | 42 (29.4%) | <0.001 |
7 | 175 (40.7%) | 39 (27.3%) | 135 (31.4%) | 29 (20.3%) | 84 (19.5%) | 34 (23.8%) | 36 (8.4%) | 41 (28.7%) | <0.001 |
8 | 234 (54.4%) | 52 (36.4%) | 127 (29.5%) | 33 (23.1%) | 43 (10%) | 29 (20.3%) | 26 (6%) | 29 (20.3%) | <0.001 |
9 | 347 (80.7%) | 65 (45.5%) | 55 (12.8%) | 24 (16.8%) | 21 (4.9%) | 23 (16.1%) | 6 (1.4%) | 31 (21.7%) | <0.001 |
Q | Disagree | Mildly Disagree | Mildly Agree | Agree | p-Value 1 | ||||
---|---|---|---|---|---|---|---|---|---|
L.R | H.R | L.R | H.R | L.R | H.R | L.R | H.R | ||
1 | 73 (17%) | 45 (31.5%) | 141 (32.8%) | 52 (36.4%) | 167 (38.8%) | 36 (25.2%) | 49 (11.4%) | 10 (7%) | <0.001 |
2 | 19 (4.4%) | 32 (22.4%) | 91 (21.2%) | 57 (39.9%) | 200 (46.5%) | 43 (30.1%) | 120 (27.9%) | 11 (7.7%) | <0.001 |
3 | 24 (5.6%) | 35 (24.5%) | 92 (21.4%) | 50 (35%) | 183 (42.6%) | 49 (34.3%) | 131 (30.5%) | 9 (6.3%) | <0.001 |
4 | 41 (9.5%) | 39 (27.3%) | 100 (23.3%) | 40 (28%) | 182 (42.3%) | 49 (34.3%) | 107 (24.9%) | 15 (10.5%) | <0.001 |
5 | 27 (6.3%) | 29 (20.3%) | 94 (21.9%) | 45 (31.5%) | 209 (48.6%) | 58 (40.6%) | 100 (23.3%) | 11 (7.7%) | <0.001 |
6 | 28 (6.5%) | 38 (26.6%) | 107 (24.9%) | 48 (33.6%) | 179 (41.6%) | 45 (31.5%) | 116 (27%) | 12 (8.4%) | <0.001 |
7 | 32 (7.4%) | 41 (28.7%) | 96 (22.3%) | 42 (29.4%) | 214 (49.8%) | 48 (33.6%) | 88 (20.5%) | 12 (8.4%) | <0.001 |
8 | 20 (4.7%) | 35 (24.5%) | 113 (26.3%) | 51 (35.7%) | 196 (45.6%) | 47 (32.9%) | 101 (23.5%) | 10 (7%) | <0.001 |
9 | 18 (4.2%) | 32 (22.4%) | 63 (14.7%) | 41 (28.7%) | 221 (51.4%) | 51 (35.7%) | 128 (29.8%) | 19 (13.3%) | <0.001 |
Q | L.R | H.R | |
---|---|---|---|
1 | Never | 322 (74.9%) | 2 (1.4%) |
It was just a brief passing thought | 102 (23.7%) | 60 (42%) | |
I have had a plan at least once to kill myself but did not try to do it. | 6 (1.4%) | 37 (25.9%) | |
I have had a plan at least once to kill myself and really wanted to die. | - | 23 (16.1%) | |
I have attempted to kill myself but did not want to die. | - | 11 (7.7%) | |
I have attempted to kill myself and really hoped to die. | - | 10 (7%) | |
2 | Never | 385 (89.5%) | 22 (15.4%) |
Rarely (1 time) | 41 (9.5%) | 47 (32.5%) | |
Sometimes (2 times) | 4 (0.9%) | 36 (25.2%) | |
Often (3–4 times) | - | 22 (15.4%) | |
Very often (5 or more times) | - | 16 (11.2%) | |
3 | No | 385 (89.5%) | 53 (37.1%) |
Yes, at one time, but did not really want to die | 40 (9.3%) | 36 (25.2%) | |
Yes, at one time, and really wanted to die | 3 (0.7%) | 21 (14.7%) | |
Yes, more than once, but did not want to do it | 2 (0.5%) | 17 (11.9%) | |
Yes, more than once, and really wanted to do it | - | 16 (11.2%) | |
4 | Never | 346 (80.5%) | 12 (8.4%) |
No chance at all | 44 (10.2%) | 22 (15.4%) | |
Rather unlikely | 32 (7.4%) | 45 (31.5%) | |
Unlikely | 5 (1.2%) | 23 (16.1%) | |
Likely | 3 (0.7%) | 32 (22.4%) | |
Rather likely | - | 7 (4.9%) | |
Very likely | - | 2 (1.4%) |
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Total (N = 573) | Low Risk (L.R) N = 430 | High Risk (H.R) N = 143 | p-Value 1 | |
---|---|---|---|---|
Gender (Female) | 310 (72.1%) | 109 (76.2%) | 0.384 | |
Age (year) | 25.08 ± 6.8 [18–52] | 22.4 ± 3.9 [19–43] | <0.001 | |
Grade | Bachelor | 253 (58.8%) | 108 (75.5%) | 0.008 |
Masters | 136 (31.6%) | 22 (15.4%) | ||
PhD | 41 (9.5%) | 13 (9.1%) | ||
The field of study | Liberal Arts | 286 (62.3%) | 80 (55.9%) | 0.114 |
Basic Sciences | 22 (5.1%) | 11 (7.7%) | ||
Engineering Sciences | 100 (23.3%) | 35 (24.5%) | ||
Medical Sciences | 28 (6.5%) | 13 (9.1%) | ||
Foreign Languages | 12 (2.8%) | 4 (2.8%) | ||
Educational level | Weak | 2 (0.5%) | 7 (4.9%) | 0.001 |
Middle | 82 (19.1%) | 34 (23.8%) | ||
Good | 252 (58.6%) | 75 (52.4%) | ||
Excellent | 93 (21.6%) | 27 (189%) | ||
Occupational status | Unemployed | 265 (61.6%) | 105 (73.4%) | 0.003 |
Part time | 99 (23%) | 31 (21.7%) | ||
Full time | 66 (15.3%) | 7 (4.9%) | ||
Marital status | Single | 328 (76.3%) | 126 (88.1%) | 0.002 |
Married | 98 (22.8%) | 16 (11.2%) | ||
Divorced | 3 (0.7%) | 1 (0.7%) | ||
Widow | 1 (0.2%) | - | ||
History of psychological illness | None | 342 (79.5%) | 85 (59.4%) | 0.001 |
Bipolar | - | 2 (1.4%) | ||
Depression | 25 (5.8%) | 31 (21.7%) | ||
Obsession | 20 (4.7) | 10 (7%) | ||
Anxiety | 43 (10%) | 14 (9.8%) | ||
Panic | - | 1 (0.7%) |
Index | Name | Weight | Index | Name | Weight |
---|---|---|---|---|---|
1 | Exposure to Trauma | 0.96 | 13 | PMH 3 | 1 |
2 | PCL 4 | 0.81 | 14 | PMH6 | 0.91 |
3 | PCL 5 | 0.72 | 15 | PMH7 | 0.79 |
4 | PCL 9 | 1 | 16 | PMH8 | 0.97 |
5 | PCL 10 | 0.86 | 17 | PMH9 | 0/97 |
6 | PCL 11 | 0.98 | 18 | PHQ2 | 0.66 |
7 | PCL 12 | 0.66 | 19 | PHQ6 | 1 |
8 | PCL 14 | 1 | 20 | PHQ9 | 1 |
9 | PCL 15 | 1 | 21 | PTG2 | 1 |
10 | PCL 16 | 0.61 | 22 | PTG13 | 0.96 |
11 | Psychological Illness | 0.91 | 23 | MSPSS8 | 0.72 |
12 | PMH 2 | 1 |
Indices Folds | TP | TN | FP | FN | Se (%) | Sp (%) | PPV (%) | AUC | MCC | DOR | DP | K(C) |
---|---|---|---|---|---|---|---|---|---|---|---|---|
1 | 39 | 143 | 1 | 9 | 81 | 99 | 98 | 0.90 | 0.86 | 620 | 2.73 | 0.85 |
2 | 40 | 139 | 4 | 8 | 83 | 97 | 91 | 0.90 | 0.83 | 174 | 2.19 | 0.83 |
3 | 37 | 140 | 3 | 10 | 79 | 98 | 93 | 0.88 | 0.81 | 173 | 2.19 | 0.81 |
Overall | 116 | 422 | 8 | 27 | 81 | 98 | 94 | 0.90 | 0.83 | 227 | 2.30 | 0.83 |
CI 95% | - | - | - | - | [75–88] | [97–99] | [89–98] | [0.86–0.93] | [0.81–0.86] | [100–512] | [1.96–2.65] | [0.78–0.88] |
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Naghavi, A.; Teismann, T.; Asgari, Z.; Mohebbian, M.R.; Mansourian, M.; Mañanas, M.Á. Accurate Diagnosis of Suicide Ideation/Behavior Using Robust Ensemble Machine Learning: A University Student Population in the Middle East and North Africa (MENA) Region. Diagnostics 2020, 10, 956. https://doi.org/10.3390/diagnostics10110956
Naghavi A, Teismann T, Asgari Z, Mohebbian MR, Mansourian M, Mañanas MÁ. Accurate Diagnosis of Suicide Ideation/Behavior Using Robust Ensemble Machine Learning: A University Student Population in the Middle East and North Africa (MENA) Region. Diagnostics. 2020; 10(11):956. https://doi.org/10.3390/diagnostics10110956
Chicago/Turabian StyleNaghavi, Azam, Tobias Teismann, Zahra Asgari, Mohammad Reza Mohebbian, Marjan Mansourian, and Miguel Ángel Mañanas. 2020. "Accurate Diagnosis of Suicide Ideation/Behavior Using Robust Ensemble Machine Learning: A University Student Population in the Middle East and North Africa (MENA) Region" Diagnostics 10, no. 11: 956. https://doi.org/10.3390/diagnostics10110956
APA StyleNaghavi, A., Teismann, T., Asgari, Z., Mohebbian, M. R., Mansourian, M., & Mañanas, M. Á. (2020). Accurate Diagnosis of Suicide Ideation/Behavior Using Robust Ensemble Machine Learning: A University Student Population in the Middle East and North Africa (MENA) Region. Diagnostics, 10(11), 956. https://doi.org/10.3390/diagnostics10110956