Comprehensive Psychiatry
Volume 46, Issue 4 , Pages 296-303, July 2005

A comparison of statistical models in predicting violence in psychotic illness

  • Stuart Thomas

      Affiliations

    • Health Services Research Department, Institute of Psychiatry, De Crespigny Park, London SE5 8AF, UK
    • Corresponding Author InformationCorresponding author. Department of Forensic Mental Health Science, Institute of Psychiatry, De Crespigny Park, London SE5 8AF, UK. Tel.: +44 20 7848 0711; fax: +44 20 7848 0754.
  • ,
  • Morven Leese

      Affiliations

    • Health Services Research Department, Institute of Psychiatry, De Crespigny Park, London SE5 8AF, UK
  • ,
  • Elizabeth Walsh

      Affiliations

    • Section of Forensic Mental Health, Department of Psychological Medicine, Institute of Psychiatry, De Crespigny Park, London SE5 8AF, UK
  • ,
  • Paul McCrone

      Affiliations

    • Centre for the Economics of Mental Health, Health Services Research Department, Institute of Psychiatry, De Crespigny Park, London SE5 8AF, UK
  • ,
  • Paul Moran

      Affiliations

    • Section of Primary Care, Health Services Research Department, Institute of Psychiatry, De Crespigny Park, London SE5 8AF, UK
  • ,
  • Tom Burns

      Affiliations

    • Department of Psychiatry, St George's Hospital Medical School, London SW17 0RE, UK
  • ,
  • Francis Creed

      Affiliations

    • University Department of Psychiatry, Manchester Royal Infirmary, Manchester M13 9WL, UK
  • ,
  • Peter Tyrer

      Affiliations

    • Academic Unit of Psychiatry, St Mary's Hospital Medical School, St Charles Hospital, London W10 6DZ, UK
  • ,
  • Thomas Fahy

      Affiliations

    • Section of Forensic Mental Health, Department of Psychological Medicine, Institute of Psychiatry, De Crespigny Park, London SE5 8AF, UK

Received 12 March 2004; received in revised form 8 October 2004

Abstract 

Background

The application of statistical modeling techniques, including classification and regression trees, in the prediction of violence has increasingly received attention.

Methods

The predictive performance of logistic regression and classification tree methods in predicting violence was explored in a sample of patients with psychotic illness.

Results

Of 2 logistic regression models, the forward stepwise method produced a simpler model than the full model, but the latter performed better. The performance of the classification tree appeared to be high before cross-validation, but reduced when cross-validated.

The standard logistic model was the most robust model. A simplified tree with extra weight given to violent cases was a reasonable competitor and was simple to apply.

Conclusion

Although classification trees can be suitable for routine clinical practice, because of the simplicity of their decision-making processes, their robustness and therefore clinical utility was problematic in this sample. Further research is required to compare such models in large prospective epidemiologic studies of other psychiatric populations.

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PII: S0010-440X(04)00156-7

doi:10.1016/j.comppsych.2004.10.001

Comprehensive Psychiatry
Volume 46, Issue 4 , Pages 296-303, July 2005