Discriminative Accuracy of Affective Temperaments in Assessing Suicide Risk

Abstract

Objective: This study aimed to evaluate whether individual and composite scores of affective temperaments can differentiate high-risk suicide groups among patients with major depressive disorder (MDD) and to compare their discriminative accuracy.

Methods: A retrospective review included 343 patients with MDD. Affective temperaments were assessed using the Temperament Evaluation of Memphis, Pisa, Paris, and San Diego Autoquestionnaire, while the Depressive Symptom Inventory-Suicidality Subscale was used to classify the high-risk suicide group. Receiver operating characteristic (ROC) curve analysis assessed the discriminative performance of five individual and three composite scores of affective temperaments, with area under the curve (AUC). Logistic regression analysis was conducted to examine whether depressive temperament and composite scores independently predicted suicide risk.

Results: Depressive temperament demonstrated the highest discriminative accuracy among individual scores (AUC=0.754). All composite scores also showed good accuracy (AUC range=0.729-0.739). The results indicated that depressive temperament and three composite scores demonstrated good accuracy, with no significant differences between them. Additionally, irritable (AUC=0.660) and cyclothymic (AUC=0.650) temperaments exhibited sufficient accuracy. Logistic regression analysis indicated that only depressive temperament was a significant independent predictor of suicide risk.

Conclusion: Depressive temperament and composite scores demonstrated good discriminative accuracy for identifying high-risk suicide groups in MDD. These findings highlight the importance of assessing affective temperaments as stable traits for evaluating and predicting suicide risk. Future longitudinal, multi-center studies are needed to further explore the role of affective temperaments in predicting suicide risk among patients with MDD.

Keywords: Depressive disorder; Suicide; Temperament.

Figure 1.

Comparison of receiver operating characteristic curve for suicidal risk evaluation using three composite scores and three single scores of affective temperaments. CYC, cyclothymic; DEP, depressive; IRR, irritable.

Figure 2.

Comparison of receiver operating characteristic curve for suicidal risk evaluation using individual scores of affective temperaments. CYC, cyclothymic; DEP, depressive; IRR, irritable; ANX, anxious; HYP, hyperthymic.

Figure 3.

Comparison of receiver operating characteristic curve for suicidal risk evaluation using three composite scores and three single scores of affective temperaments (minimal to moderate depression group). CYC, cyclothymic; DEP, depressive; IRR, irritable.

Figure 4.

Comparison of receiver operating characteristic curve for suicidal risk evaluation using three composite scores and depressive temperament (moderately severe to severe depression group). DEP, depressive.