Interrater reliability of the Silverman et al. nomenclature for suicide-related ideations, behaviors, and communications.
Kattimani, S.~~Bharadwaj, B.~~et al.
There is need for a common and uniform nomenclature for suicide and related behaviors. Many nomenclatures exist to address the same. Aims: Study proposes to assess the inter-rater reliability of Silverman et al. nomenclature on suicide and suicidal behaviors. Method: The present study was conducted at the crisis intervention clinic of a tertiary care centre. Case records of patients referred to the centre were evaluated by two trained psychiatrists and were rated according to the SilvermanÕs nomenclature in the domains of suicide related ideation, suicide related communication and suicide related behavior. Inter-rater reliability was measured using kappa coefficient. The relationship of suicide intent item of a structured scale with suicide related ideation, communication and behavior were explored. Results: Inter-rater reliability of the two evaluators using the SilvermanÕs nomenclature on 198 case records was in the moderate range for suicidal related ideation and behavior domains (kappa of 0.476 and 0.502 respectively), but low for communication domain (kappa value of 0.016). The stated intent item of the Pierce Suicide Intent Scale correlated highly with suicide related ideation and behavior as assessed using the Silverman et al. nomenclature (Kendall tau = 0.723 and 0.747 respectively). Conclusions: Based upon the same case record material, evaluators rate suicide related ideations and behaviors with moderate degree of concordance. However, the concordance is poor for suicide related communication.