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Parsaei M, Arvin A, Taebi M, Seyedmirzaei H, Cattarinussi G, Sambataro F, Pigoni A, Brambilla P, Delvecchio G. Machine Learning for prediction of violent behaviors in schizophrenia spectrum disorders: a systematic review. Front Psychiatry 2024; 15:1384828. [PMID: 38577400 PMCID: PMC10991827 DOI: 10.3389/fpsyt.2024.1384828] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/10/2024] [Accepted: 03/08/2024] [Indexed: 04/06/2024] Open
Abstract
Background Schizophrenia spectrum disorders (SSD) can be associated with an increased risk of violent behavior (VB), which can harm patients, others, and properties. Prediction of VB could help reduce the SSD burden on patients and healthcare systems. Some recent studies have used machine learning (ML) algorithms to identify SSD patients at risk of VB. In this article, we aimed to review studies that used ML to predict VB in SSD patients and discuss the most successful ML methods and predictors of VB. Methods We performed a systematic search in PubMed, Web of Sciences, Embase, and PsycINFO on September 30, 2023, to identify studies on the application of ML in predicting VB in SSD patients. Results We included 18 studies with data from 11,733 patients diagnosed with SSD. Different ML models demonstrated mixed performance with an area under the receiver operating characteristic curve of 0.56-0.95 and an accuracy of 50.27-90.67% in predicting violence among SSD patients. Our comparative analysis demonstrated a superior performance for the gradient boosting model, compared to other ML models in predicting VB among SSD patients. Various sociodemographic, clinical, metabolic, and neuroimaging features were associated with VB, with age and olanzapine equivalent dose at the time of discharge being the most frequently identified factors. Conclusion ML models demonstrated varied VB prediction performance in SSD patients, with gradient boosting outperforming. Further research is warranted for clinical applications of ML methods in this field.
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Affiliation(s)
- Mohammadamin Parsaei
- Maternal, Fetal & Neonatal Research Center, Family Health Research Institute, Tehran University of Medical Sciences, Tehran, Iran
| | - Alireza Arvin
- Center for Orthopedic Trans-disciplinary Applied Research (COTAR), Tehran University of Medical Sciences, Tehran, Iran
| | - Morvarid Taebi
- Center for Orthopedic Trans-disciplinary Applied Research (COTAR), Tehran University of Medical Sciences, Tehran, Iran
| | - Homa Seyedmirzaei
- Sports Medicine Research Center, Neuroscience Institute, Tehran University of Medical Sciences, Tehran, Iran
| | - Giulia Cattarinussi
- Department of Neuroscience (DNS), Padua Neuroscience Center, University of Padova, Padua, Italy
- Padua Neuroscience Center, University of Padova, Padua, Italy
- Department of Psychological Medicine, Institute of Psychiatry, Psychology and Neuroscience, Kings College London, London, United Kingdom
| | - Fabio Sambataro
- Department of Neuroscience (DNS), Padua Neuroscience Center, University of Padova, Padua, Italy
- Padua Neuroscience Center, University of Padova, Padua, Italy
| | - Alessandro Pigoni
- Social and Affective Neuroscience Group, MoMiLab, Institutions, Markets, Technologies (IMT) School for Advanced Studies Lucca, Lucca, Italy
- Department of Pathophysiology and Transplantation, University of Milan, Milan, Italy
| | - Paolo Brambilla
- Social and Affective Neuroscience Group, MoMiLab, Institutions, Markets, Technologies (IMT) School for Advanced Studies Lucca, Lucca, Italy
- Department of Pathophysiology and Transplantation, University of Milan, Milan, Italy
- Department of Neurosciences and Mental Health, Fondazione Istituto di Ricovero e Cura a Carattere Scientifico (IRCCS) Ca’ Granda Ospedale Maggiore Policlinico, Milan, Italy
| | - Giuseppe Delvecchio
- Department of Neurosciences and Mental Health, Fondazione Istituto di Ricovero e Cura a Carattere Scientifico (IRCCS) Ca’ Granda Ospedale Maggiore Policlinico, Milan, Italy
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Tortora L. Beyond Discrimination: Generative AI Applications and Ethical Challenges in Forensic Psychiatry. Front Psychiatry 2024; 15:1346059. [PMID: 38525252 PMCID: PMC10958425 DOI: 10.3389/fpsyt.2024.1346059] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/28/2023] [Accepted: 01/31/2024] [Indexed: 03/26/2024] Open
Abstract
The advent and growing popularity of generative artificial intelligence (GenAI) holds the potential to revolutionise AI applications in forensic psychiatry and criminal justice, which traditionally relied on discriminative AI algorithms. Generative AI models mark a significant shift from the previously prevailing paradigm through their ability to generate seemingly new realistic data and analyse and integrate a vast amount of unstructured content from different data formats. This potential extends beyond reshaping conventional practices, like risk assessment, diagnostic support, and treatment and rehabilitation plans, to creating new opportunities in previously underexplored areas, such as training and education. This paper examines the transformative impact of generative artificial intelligence on AI applications in forensic psychiatry and criminal justice. First, it introduces generative AI and its prevalent models. Following this, it reviews the current applications of discriminative AI in forensic psychiatry. Subsequently, it presents a thorough exploration of the potential of generative AI to transform established practices and introduce novel applications through multimodal generative models, data generation and data augmentation. Finally, it provides a comprehensive overview of ethical and legal issues associated with deploying generative AI models, focusing on their impact on individuals as well as their broader societal implications. In conclusion, this paper aims to contribute to the ongoing discourse concerning the dynamic challenges of generative AI applications in forensic contexts, highlighting potential opportunities, risks, and challenges. It advocates for interdisciplinary collaboration and emphasises the necessity for thorough, responsible evaluations of generative AI models before widespread adoption into domains where decisions with substantial life-altering consequences are routinely made.
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Affiliation(s)
- Leda Tortora
- School of Nursing and Midwifery, Trinity College Dublin, Dublin, Ireland
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Cheng N, Guo M, Yan F, Guo Z, Meng J, Ning K, Zhang Y, Duan Z, Han Y, Wang C. Application of machine learning in predicting aggressive behaviors from hospitalized patients with schizophrenia. Front Psychiatry 2023; 14:1016586. [PMID: 37020730 PMCID: PMC10067917 DOI: 10.3389/fpsyt.2023.1016586] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/11/2022] [Accepted: 03/01/2023] [Indexed: 04/07/2023] Open
Abstract
Objective To establish a predictive model of aggressive behaviors from hospitalized patients with schizophrenia through applying multiple machine learning algorithms, to provide a reference for accurately predicting and preventing of the occurrence of aggressive behaviors. Methods The cluster sampling method was used to select patients with schizophrenia who were hospitalized in our hospital from July 2019 to August 2021 as the survey objects, and they were divided into an aggressive behavior group (611 cases) and a non-aggressive behavior group (1,426 cases) according to whether they experienced obvious aggressive behaviors during hospitalization. Self-administered General Condition Questionnaire, Insight and Treatment Attitude Questionnaire (ITAQ), Family APGAR (Adaptation, Partnership, Growth, Affection, Resolve) Questionnaire (APGAR), Social Support Rating Scale Questionnaire (SSRS) and Family Burden Scale of Disease Questionnaire (FBS) were used for the survey. The Multi-layer Perceptron, Lasso, Support Vector Machine and Random Forest algorithms were used to build a predictive model for the occurrence of aggressive behaviors from hospitalized patients with schizophrenia and to evaluate its predictive effect. Nomogram was used to build a clinical application tool. Results The area under the receiver operating characteristic curve (AUC) values of the Multi-Layer Perceptron, Lasso, Support Vector Machine, and Random Forest were 0.904 (95% CI: 0.877-0.926), 0.901 (95% CI: 0.874-0.923), 0.902 (95% CI: 0.876-0.924), and 0.955 (95% CI: 0.935-0.970), where the AUCs of the Random Forest and the remaining three models were statistically different (p < 0.0001), and the remaining three models were not statistically different in pair comparisons (p > 0.5). Conclusion Machine learning models can fairly predict aggressive behaviors in hospitalized patients with schizophrenia, among which Random Forest has the best predictive effect and has some value in clinical application.
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Affiliation(s)
- Nuo Cheng
- Department of Clinical Medicine, Zhengzhou University, Zhengzhou, Henan, China
| | - Meihao Guo
- Department of Infection Prevention and Control, The Second Affiliated Hospital of Xinxiang Medical University, Xinxiang, Henan, China
| | - Fang Yan
- Department of Infection Prevention and Control, The Second Affiliated Hospital of Xinxiang Medical University, Xinxiang, Henan, China
| | - Zhengjun Guo
- Henan Mental Disease Prevention and Control Center, The Second Affiliated Hospital of Xinxiang Medical University, Xinxiang, Henan, China
| | - Jun Meng
- Editorial Department of Journal of Clinical Psychosomatic Diseases, The Second Affiliated Hospital of Xinxiang Medical University, Xinxiang, Henan, China
| | - Kui Ning
- Department of Medical Administration, The Second Affiliated Hospital of Xinxiang Medical University, Xinxiang, Henan, China
| | - Yanping Zhang
- Department of Medicine, Zhengzhou University, Zhengzhou, Henan, China
| | - Zitian Duan
- The Seventh Psychiatric Department, The Second Affiliated Hospital of Xinxiang Medical University, Xinxiang, Henan, China
| | - Yong Han
- Henan Key Laboratory of Biological Psychiatry, The Second Affiliated Hospital of Xinxiang Medical University, Xinxiang, Henan, China
- *Correspondence: Han Yong,
| | - Changhong Wang
- Department of Clinical Psychiatry, The Second Affiliated Hospital of Xinxiang Medical University, Xinxiang, Henan, China
- Wang Changhong,
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Yu T, Pei W, Xu C, Zhang X, Deng C. Prediction of violence in male schizophrenia using sMRI, based on machine learning algorithms. BMC Psychiatry 2022; 22:676. [PMID: 36320010 PMCID: PMC9628088 DOI: 10.1186/s12888-022-04331-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/19/2022] [Accepted: 10/24/2022] [Indexed: 11/06/2022] Open
Abstract
BACKGROUND Violent behavior in patients with schizophrenia (SCZ) is a major social problem. The early identification of SCZ patients with violence can facilitate implementation of targeted intervention. METHODS A total of 57 male SCZ patients were recruited into this study. The general linear model was utilized to compare differences in structural magnetic resonance imaging (sMRI) including gray matter volume, cortical surface area, and cortical thickness between 30 SCZ patients who had exhibited violence and 27 SCZ patients without a history of violence. Based on machine learning algorithms, the different sMRI features between groups were integrated into the models for prediction of violence in SCZ patients. RESULTS After controlling for the whole brain volume and age, the general linear model showed significant reductions in right bankssts thickness, inferior parietal thickness as well as left frontal pole volume in the patients with SCZ and violence relative to those without violence. Among seven machine learning algorithms, Support Vector Machine (SVM) have better performance in differentiating patients with violence from those without violence, with its balanced accuracy and area under curve (AUC) reaching 0.8231 and 0.841, respectively. CONCLUSIONS Patients with SCZ who had a history of violence displayed reduced cortical thickness and volume in several brain regions. Based on machine learning algorithms, structural MRI features are useful to improve predictive ability of SCZ patients at particular risk of violence.
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Affiliation(s)
- Tao Yu
- grid.452190.b0000 0004 1782 5367Anhui Mental Health Center; Affiliated Psychological Hospital of Anhui Medical University; Hefei Fourth People’s Hospital; Anhui Clinical Research Center for Mental Disorders, Hefei, 230022 Anhui China
| | - Wenzhi Pei
- grid.452190.b0000 0004 1782 5367Anhui Mental Health Center; Affiliated Psychological Hospital of Anhui Medical University; Hefei Fourth People’s Hospital; Anhui Clinical Research Center for Mental Disorders, Hefei, 230022 Anhui China
| | - Chunyuan Xu
- grid.452190.b0000 0004 1782 5367Anhui Mental Health Center; Affiliated Psychological Hospital of Anhui Medical University; Hefei Fourth People’s Hospital; Anhui Clinical Research Center for Mental Disorders, Hefei, 230022 Anhui China
| | - Xulai Zhang
- Anhui Mental Health Center; Affiliated Psychological Hospital of Anhui Medical University; Hefei Fourth People's Hospital; Anhui Clinical Research Center for Mental Disorders, Hefei, 230022, Anhui, China.
| | - Chenchen Deng
- Anhui Province Maternity & Child Health Hospital, Hefei, 230022, Anhui, China.
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Guo Y, Yang X, Wang D, Fan R, Liang Y, Wang R, Xiang H, Liu Y, Liu X. Prevalence of violence to others among individuals with schizophrenia in China: A systematic review and meta-analysis. Front Psychiatry 2022; 13:939329. [PMID: 35935404 PMCID: PMC9354073 DOI: 10.3389/fpsyt.2022.939329] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/09/2022] [Accepted: 07/04/2022] [Indexed: 01/28/2023] Open
Abstract
Background Violence to others (hereinafter referred to as "violence-TO") is common in individuals with schizophrenia. The reported prevalence of violence-TO among schizophrenics ranges widely in existing studies. Improved prevalence estimates and identification of moderators are needed to guide future management and research. Methods We searched EBSCO, EMBASE, Medline, PubMed, Science Direct, Web of Science, CNKI, VIP, WANFANG data, and CBM for relevant articles published before June 5, 2022. Meanwhile, violence-TO was summarized into four categories: (a) violence-TO on the reviews of official criminal or psychiatric records (type I); (b) less serious forms of violence-TO (type II); (c) physical acts causing demonstrable harm to victims (type III); (d) homicide (type IV). We did meta-analysis for the above types of violence-TO, respectively, and applied subgroup analyses and meta-regression analyses to investigate the source of heterogeneity. Results A total of 56 studies were eligible in this study and 34 of them were high-quality. The prevalence of type I to type IV in individuals with schizophrenia in China was 23.83% (95% CI: 18.38-29.75%), 23.16% (95% CI: 8.04-42.97%), 17.19% (95%CI: 8.52-28.04%), and 0.62% (95% CI: 0.08-1.54%) respectively. The results of the subgroup analysis showed that the prevalence of type I was higher among subjects in the inland than in the coastal non-economic zone, while the prevalence of type III was the highest in the coastal economic zone, followed by the inland region and the lowest in the coastal non-economic zone. The results of multivariate meta-regression analyses showed that: patient source in type I (β = 0.15, P < 0.01), patient source (β = 0.47, P < 0.01), and proportion of male (β = 0.19, P < 0.01) in type II, age (β = 0.25, P < 0.01), and GDP per capita (β = 0.05, P = 0.01) in type III were statistically significant. Conclusion The prevalence of different types of violence-TO and their influencing factors varied. Therefore, the authorities should take different management measures. In addition to individual factors, regional factors may also affect violence-TO, which suggests the need for a multi-sectorial approach to prevention and treatment for subjects in different regions and adopting targeted control strategies. Systematic Review Registration [www.ClinicalTrials.gov], identifier [CRD42021269767].
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Affiliation(s)
- Yi Guo
- Department of Epidemiology and Biostatistics, West China School of Public Health and West China Fourth Hospital, Sichuan University, Chengdu, China
| | - Xianmei Yang
- Sichuan Mental Health Center, The Third Hospital of Mianyang, Mianyang, China
| | - Dan Wang
- Sichuan Mental Health Center, The Third Hospital of Mianyang, Mianyang, China
| | - Ruoxin Fan
- Sichuan Mental Health Center, The Third Hospital of Mianyang, Mianyang, China
| | - Yiying Liang
- Department of Epidemiology and Biostatistics, West China School of Public Health and West China Fourth Hospital, Sichuan University, Chengdu, China
| | - Rongke Wang
- Sichuan Mental Health Center, The Third Hospital of Mianyang, Mianyang, China
| | - Hu Xiang
- Sichuan Mental Health Center, The Third Hospital of Mianyang, Mianyang, China
| | - Yuanyuan Liu
- Department of Epidemiology and Biostatistics, West China School of Public Health and West China Fourth Hospital, Sichuan University, Chengdu, China
| | - Xiang Liu
- Department of Health Behavior and Social Medicine, West China School of Public Health and West China Fourth Hospital, Sichuan University, Chengdu, China
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