Detecting Suicidality Among Adolescent Outpatients: Evaluation of Trained Clinicians’ Suicidality Assessment Against a Structured Diagnostic Assessment Made by Trained Raters

The authors evaluated trained clinicians’ ability to assess suicidality against a structured assessment made by trained raters. Treating clinicians classified 218 adolescent psychiatric outpatients with a depressive mood disorder into 3 classes: no suicide ideation, suicide ideation-no suicidal acts, or self-harming acts. This classification was compared with a classification with identical content derived from the Kiddie Schedule for Affective Disorders & Schizophrenia made by trained raters. The convergence was assessed by kappa & weighted kappa tests. There was only a modest agreement between the clinicians’ ratings & those from the scale evaluation, expecially concerning suicidal or self-harming acts. A wider use of structured scales is suggested. (40 refs.)