Abstract
Limitations of screening for depression as a proxy for suicide risk in adult medical inpatients
Mournet, A.M., Smith, J.T., Bridge, J.A., Boudreaux, E.D., Snyder, D.J., Claassen, C.A., ... Horowitz, L.M.
Objective
The present study aims to determine the effectiveness of a depression screening tool, the Patient Health Questionnaire-9 in detecting suicide risk among adult medical inpatients.
Methods
Participants were recruited from inpatient medical/surgical units in 4 hospitals as part of a larger validation study. Participants completed the Patient Health Questionnaire-9 and 2 suicide risk measures: the Ask Suicide-Screening Questions and the Adult Suicidal Ideation Questionnaire.
Results
The sample consisted of 727 adult medical inpatients (53.4% men; 61.8% white; mean age 50.1 ± 16.3 years). A total of 116 participants (116 of 727 [16.0%]) screened positive for suicide risk and 175 (175 of 727 [24.1%]) screened positive for depression. Of the 116 patients who screened positive for suicide risk, 36 (31.0%) screened negative for depression on the Patient Health Questionnaire-9. Of 116, 73 (62.9%) individuals who were at risk for suicide did not endorse item 9 (thoughts of harming oneself or of being better off dead) on the Patient Health Questionnaire-9.
Conclusion
Using depression screening tools as a proxy for suicide risk may be insufficient to detect adult medical inpatients at risk for suicide. Asking directly about suicide risk and using validated tools is necessary to effectively and efficiently screen for suicide risk in this population.