The SAD PERSONS scale for suicide risk assessment: a systematic review.

The SAD PERSONS scale (SPS) is widely used for suicide risk assessment in clinical and educational settings. The study objective was to systematically review the SPS performance in clinical situations. A systematic search of electronic databases was conducted. Relevant descriptive, quality, and outcome data were reviewed. In the search, 149 studies were identified and 9 met inclusion criteria. Included studies were highly variable across outcome measures, populations, and assessment methods. Only 3 studies examined SPS performance in predicting suicide outcomes; none showed the scale accurately predicted suicidal behavior. Available literature is of limited quality and quantity. Insufficient evidence exists to support SPS use in assessment or prediction of suicidal behavior. Well-designed studies that address the observed limitations are required.