Agreement between self- and clinician-rated suicidal symptoms in a clinical sample of young adults: explaining discrepancies.

This study compared self- versus clinician-rated suicide assessment among participants referred for suicidal ideation or behavior, with emphasis on understanding self- versus clinician-rated discrepancies. A total of 328 participants in a suicide-treatment project completed baseline measures of symptoms and personality (including self-report and clinician-rated indexes of suicidal tendency), and portions of the sample completed follow-up assessments at 6, 12, and 18 months. A high rate of discrepancy between self- and clinician ratings of suicidal tendency was noted: the nature of this discrepancy was such that clinicians were likely to see patients as high in suicidal tendency, whereas patients were less likely to see themselves as such. Data on future symptoms indicated that patients' self-ratings contained considerable predictive value. Variables such as history of previous attempts and histrionic personality style may help explain self-versus clinician-rated discrepancies.