Tools to detect risk of death by suicide: A systematic review and meta-analysis

Objective: There is limited knowledge about the ability of instruments to detect risk of suicide in a range of settings. Prior reviews have not considered whether the utility of instruments depends on prior probability of risk. We performed a systematic review to determine the diagnostic accuracy of instruments to detect risk of suicide in adults using […]

Reliability and validity of the Korean version of the Ask Suicide-Screening Questions (ASQ)

Background: The Ask Suicide-Screening Questions (ASQ) tool is a simple suicide screening tool developed to screen patient suicide risk (SR). The purpose of this study was to verify the reliability and validity of the ASQ tool in hospitalized patients. Methods: The internal consistency and test-retest reliability of the South Korean version of the ASQ tool […]

Trends in positive depression and suicide risk screens in pediatric primary care during COVID-19

Objective: Adolescent mental health concerns increased during COVID-19, but it is unknown whether early increases in depression and suicide risk have been sustained. We examined changes in positive screens for depression and suicide risk in a large pediatric primary care network through May 2022. Methods: Using an observational repeated cross-sectional design, we examined changes in depression and […]

Screening for depression and suicide risk in children and adolescents: Updated evidence report and systematic review for the US Preventive Services Task Force

Importance  Depression, suicidal ideation, and self-harm behaviors in youth are associated with functional impairment and suicide. Objective  To review the evidence on screening for depression or suicide risk in children and adolescents to inform the US Preventive Services Task Force (USPSTF). Data Sources  PubMed, Cochrane Library, PsycINFO, CINAHL, and trial registries through July 19, 2021; references, experts, and […]

Screening for anxiety in children and adolescents: Evidence report and systematic review for the US Preventive Services Task Force

Importance  Anxiety in children and adolescents is associated with impaired functioning, educational underachievement, and future mental health conditions. Objective  To review the evidence on screening for anxiety in children and adolescents to inform the US Preventive Services Task Force. Data Sources  PubMed, Cochrane Library, PsycINFO, CINAHL, and trial registries through July 19, 2021; references, experts, and surveillance through […]

Utilizing digital predictive biomarkers to identify Veteran suicide risk

Veteran suicide is one of the most complex and pressing health issues in the United States. According to the 2020 National Veteran Suicide Prevention Annual Report, since 2018 an average of 17.2 Veterans died by suicide each day. Veteran suicide risk screening is currently limited to suicide hotlines, patient reporting, patient visits, and family or […]

Validating the suicide status form for the Collaborative Assessment and Management of Suicidality in a psychiatric adolescent sample

Background For adults, the Collaborative Assessment and Management of Suicidality (CAMS; Jobes, (2006, Managing suicidal risk: A collaborative approach, New York, Guilford) and Jobes, (2016, Managing suicidal risk: A collaborative approach, New York, Guilford)) is a treatment framework with replicated evidenced-based support for effectiveness. The current study is a psychometric validation of the Suicide Status Form (SSF-IV), […]

Development and validation of static and adaptive screeners to assess suicidal thoughts and behavior

Objective The aim of the current study was to use a 23-item bank of self-reported symptoms of suicidal thoughts and behaviors to develop new brief measures of suicide risk using data-driven methods. Collectively referred to as the Rapid Measurement Toolkit for Suicidality (RMTS), the new brief static and adaptive measures would allow more efficient screening […]

Use of the Columbia-Suicide Severity Rating Scale (C-SSRS) in a large sample of veterans receiving mental health services in the Veterans Health Administration

Objective To evaluate the associations of self-reports of suicidal ideation and behavior using the Columbia-Suicide Severity Rating Scale (C-SSRS) in a survey of patients receiving mental health services in the Veterans Health Administration (VHA) with reports of attempts documented in medical records and administrative data. Method The C-SSRS was administered to 15,373 Veterans in the […]

Adolescents’ engagement with crisis hotline risk-management services: A report from the Emergency Department Screen for Teen Suicide Risk (ED-STARS) study

Objective This study examines the feasibility of a risk-management protocol for adolescent research participants at risk for suicide that relies on engagement with telephone crisis counselors. The study also examines whether engagement is moderated by adolescent demographics and clinical characteristics. Method Participants were 234 adolescents (83% female; 63% White) ages 12–18 (M = 15.3 years) drawn from the […]

Suicidal ideation in patients experiencing a first-episode psychosis: Findings from the 2-year follow-up of the “Parma Early Psychosis” program

Objective Although suicide behavior is relevant in first-episode psychosis (FEP), little is known about suicidal ideation and its longitudinal stability. The aim of this study was (1) to assess incidence rates of suicide attempts, completed suicide, and suicidal thinking in FEP individuals at baseline and over a 24-month follow-up period; (2) to explore any significant […]

Decomposing implicit associations about life and death improves our understanding of suicidal behavior

The Death/Suicide Implicit Association Test (IAT) is effective at detecting and prospectively predicting suicidal thoughts and behaviors. However, traditional IAT scoring procedures used in all prior studies (i.e., D-scores) provide an aggregate score that is inherently relative, obfuscating the separate associations (i.e., “Me = Death/Suicide,” “Me = Life”) that might be most relevant for understanding suicide-related implicit cognition. Here, we […]

Lethal means assessment and counseling in the emergency department: Differences by provider type and personal home firearms

Objective This study examined emergency department (ED) and behavioral health (BH) provider attitudes and behaviors related to lethal means screening and counseling of patients with suicide risk, specifically examining differences by provider type and whether providers had firearms in their own home. Methods Emergency department providers (physicians and mid-level practitioners) and behavioral health (BH) providers […]

C-SSRS performance in emergency department patients at high risk for suicide

Objective To evaluate the psychometric and predictive performance of the Columbia-Suicide Severity Rating Scale (C-SSRS) in emergency department (ED) patients with suicidal ideation or attempts (SI/SA). Methods Participants (n = 1,376, mean age 36.8, 55% female, 76.8% white) completed the C-SSRS during the ED visit and were followed for one year. Reliability analyses, exploratory structural equation modeling, […]

Utility of item 9 of the patient health questionnaire in the prospective identification of adolescents at risk of suicide attempt

Introduction Previous studies report that item 9 of the Patient Health Questionnaire (PHQ9) is useful for stratifying risk of suicide attempt in adults. This study re-produced the utility of item 9 of PHQ9 in assessing risk of suicide attempt in adolescents. Materials and Methods Individuals aged 13 to 17 years in 4 health systems with a […]

Comparing the predictive value of screening to the use of electronic health record data for detecting future suicidal thoughts and behavior in an urban pediatric emergency department: A preliminary analysis

Aim Brief screening and predictive modeling have garnered attention for utility at identifying individuals at risk of suicide. Although previous research has investigated these methods, little is known about how these methods compare against each other or work in combination in the pediatric population. Methods Patients were aged 8–18 years old who presented from January 1, […]

Do suicidal thoughts and behavior persist following juvenile justice involvement?

Introduction This study examines suicidal ideation and behavior of youth in the 3 months following their initial diversion appointment in the juvenile justice system. Method Participants were 99 adolescents (72.7% female; 65% racial minority) between the ages of 12 and 18 (Mage = 15.06, SD = 1.35) and a parent/caregiver (80% female; 54% racial minority; Mage = 42.7 years, SD = 8.9 years). Participants were eligible […]

The screen for nonsuicidal self-injury: Development and initial validation among veterans with psychiatric disorders

Introduction Nonsuicidal self-injury (NSSI) is associated with significant impairment and is a robust predictor of suicidal ideation, attempts, and death by suicide; however, the present lack of a brief screening instrument for NSSI coupled with consistent underidentification of NSSI in male adults has led to concerning rates of missed identification of NSSI. Methods The Screen […]

Comparative clinical utility of screening for Suicide Crisis Syndrome versus suicidal ideation in relation to suicidal ideation and attempts at one-month follow-up

Introduction Suicidal ideation (SI) has numerous limitations in predicting suicidal behavior. The Suicide Crisis Syndrome (SCS) is proposed as an alternative method of detecting risk. This study compares the relative utility of SI and SCS in statistically predicting SI and behaviors at one-month follow-up. Methods 382 psychiatric patients (98 inpatients, 284 outpatients) completed baseline measures and […]

Computer adaptive testing to assess impairing behavioral health problems in emergency department patients with somatic complaints

Objectives: To assess: (1) the prevalence of mental health and substance use in patients presenting to the emergency department (ED) through use of a computer adaptive test (CAT-MH), (2) the correlation among CAT-MH scores and self- and clinician-reported assessments, and (3) the association between CAT-MH scores and ED utilization in the year prior and 30 days […]

Discrepancies in suicide screenings: Results from an international study

Background When screening for suicidality, clinicians usually ask questions in ascending order of severity. Clinicians often discontinue questioning after negative responses to the first question or questions, presuming that these individuals are unlikely to endorse any further suicidality. In this study, the accuracy of this presumption is evaluated in a large international sample. Methods Participants […]

Prospective development and validation of the computerized adaptive screen for suicidal youth

Objective  To develop and independently validate a novel computerized adaptive screen for suicidal youth (CASSY) for use as a universal screen for suicide risk in medical emergency departments (EDs). Design, Setting, and Participants  Study 1 of this prognostic study prospectively enrolled adolescent patients at 13 geographically diverse US EDs in the Pediatric Emergency Care Applied Research Network. […]

A comparison of suicide attempt histories of pediatric and adult medical inpatients and implications for screening

Objective A suicide attempt is the most potent predictor of future suicidal behavior, yet little is known about how to manage and respond to reports of attempt histories in hospitalized medical patients. This study aims to describe the prevalence and characteristics of pediatric and adult medical inpatients who report a past suicide attempt. Method Participants […]