Tuesday, December 3, 2013

Common Screening Tool May Help Identify Patients at Risk of Suicide

While there is no screening tool proven to identify people at risk of suicide, a new study examining medical records of more than 84,000 patients who completed the Patient Health Questionnaire (PHQ-9) at every depression-care visit over several years suggests that the commonly used depression-assessment instrument may be a useful screening tool for detecting suicide risk.

Among outpatients completing PHQ-9 depression questionnaires, a response to item 9 predicted increased risk of suicide attempt or completed suicide over the following several months. That item reads: "Over the last two weeks, how often have you been bothered by thoughts that you would be better off dead, or of hurting yourself in some way.” Response options are "not at all," "several days," more than half the days," or "nearly every day." How patients answered was a strong predictor of suicide attempt and suicide death over the following year.

Researchers at the Group Health Cooperative in Seattle found that the cumulative risk of suicide attempt over one year was 0.4% among outpatients reporting thoughts of death or self-harm “not at all,” while it was 4% among those reporting thoughts of death or self-harm “nearly every day.” Even after accounting for treatment history and demographic factors, "item 9 remained a strong predictor of any suicide attempt," the researchers said. In their report "Does Response on the PHQ-9 Questionnaire Predict Subsequent Suicide Attempt or Suicide Death?" in the December Psychiatric Services, Gregory Simon, M.D., M.P.H., and colleagues explained that the immediate risk of suicide attempt was low but increased over several days and continued to grow for several months, indicating a need for follow-up care to address ongoing risk. “Suicidal ideation should be viewed as an enduring vulnerability rather than simply a short-term crisis,” they said.

To read more about recent research on suicide risk, see the Psychiatric News article "Psychotic Symptoms Found to Be Strong Suicide Risk Factor in Teens."

(image: Rommel Canlas/Shutterstock.com) 


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