Assessment of near-term risk for suicide attempts using the suicide crisis inventory.
Risk assessment
Suicidal behavior
Suicidal ideation
Suicide
Suicide attempts
Journal
Journal of affective disorders
ISSN: 1573-2517
Titre abrégé: J Affect Disord
Pays: Netherlands
ID NLM: 7906073
Informations de publication
Date de publication:
01 11 2020
01 11 2020
Historique:
received:
12
08
2019
revised:
17
04
2020
accepted:
23
06
2020
pubmed:
23
7
2020
medline:
16
2
2021
entrez:
23
7
2020
Statut:
ppublish
Résumé
The Suicide Crisis Syndrome (SCS) describes a pre-suicidal mental state marked by entrapment accompanied by affective disturbances, loss of cognitive control, hyperarousal and social withdrawal. This study tested the consistency and validity of the Suicide Crisis Inventory (SCI), a proposed measure of SCS severity, amongst a large, heterogeneous patient sample. The SCI was used to assess 867 adult psychiatric inpatients and outpatients. Confirmatory factor analysis, logistic regressions and area under the curve analyses (AUC) were used to examine internal structure, construct validity and predictive validity for suicide ideation, plan and attempt one-month post-assessment. The five-factor model of the SCS demonstrated good fit and excellent internal consistency. SCI scores indicated significant associations but non-redundancy with depression, anxiety, and independence from other dimensions of psychiatric distress. SCI scores specifically predicted suicide attempts with an AUC of 0.733 and odds ratio=8.62 (p<0.001) at optimal cut-off point. SCI incremental predictive validity over and beyond suicidal ideation and attempts history reported at baseline was supported for predicting suicide attempts (β= 0.012, S.E = 0.006; p=0.046). The SCI is subject to self-report bias and does not include the SCS social withdrawal component. Follow-up assessment retention was partial (68%, n=591). The SCI is validated as a tool for the assessment of the SCS intensity and of imminent suicidal behavior. The SCI is suggested as a tool that could aid both researchers and clinicians in comprehensive assessment of a pre-suicidal mental state within moderate to high-risk populations, regardless of self-report on suicidal intent.
Sections du résumé
BACKGROUND
The Suicide Crisis Syndrome (SCS) describes a pre-suicidal mental state marked by entrapment accompanied by affective disturbances, loss of cognitive control, hyperarousal and social withdrawal. This study tested the consistency and validity of the Suicide Crisis Inventory (SCI), a proposed measure of SCS severity, amongst a large, heterogeneous patient sample.
METHODS
The SCI was used to assess 867 adult psychiatric inpatients and outpatients. Confirmatory factor analysis, logistic regressions and area under the curve analyses (AUC) were used to examine internal structure, construct validity and predictive validity for suicide ideation, plan and attempt one-month post-assessment.
RESULTS
The five-factor model of the SCS demonstrated good fit and excellent internal consistency. SCI scores indicated significant associations but non-redundancy with depression, anxiety, and independence from other dimensions of psychiatric distress. SCI scores specifically predicted suicide attempts with an AUC of 0.733 and odds ratio=8.62 (p<0.001) at optimal cut-off point. SCI incremental predictive validity over and beyond suicidal ideation and attempts history reported at baseline was supported for predicting suicide attempts (β= 0.012, S.E = 0.006; p=0.046).
LIMITATIONS
The SCI is subject to self-report bias and does not include the SCS social withdrawal component. Follow-up assessment retention was partial (68%, n=591).
CONCLUSION
The SCI is validated as a tool for the assessment of the SCS intensity and of imminent suicidal behavior. The SCI is suggested as a tool that could aid both researchers and clinicians in comprehensive assessment of a pre-suicidal mental state within moderate to high-risk populations, regardless of self-report on suicidal intent.
Identifiants
pubmed: 32697697
pii: S0165-0327(20)32450-2
doi: 10.1016/j.jad.2020.06.053
pii:
doi:
Types de publication
Journal Article
Research Support, Non-U.S. Gov't
Langues
eng
Sous-ensembles de citation
IM
Pagination
183-190Informations de copyright
Copyright © 2020. Published by Elsevier B.V.