Michael J Ostacher1, Andrew A Nierenberg2, Dustin Rabideau3, Noreen A Reilly-Harrington2, Louisa G Sylvia2, Alexandra K Gold4, Leah W Shesler4, Terence A Ketter5, Charles L Bowden6, Joseph R Calabrese7, Edward S Friedman8, Dan V Iosifescu9, Michael E Thase10, Andrew C Leon11, Madhukar H Trivedi12. 1. VA Palo Alto Health Care System, Palo Alto, CA, USA; Department of Psychiatry & Behavioral Sciences, Stanford University School of Medicine, Stanford, CA, USA. Electronic address: ostacher@stanford.edu. 2. Department of Psychiatry, Massachusetts General Hospital, Boston, MA, USA; Harvard Medical School, Boston, MA, USA. 3. Biostatistics Center, Massachusetts General Hospital, Boston, MA, USA. 4. Department of Psychiatry, Massachusetts General Hospital, Boston, MA, USA. 5. Department of Psychiatry & Behavioral Sciences, Stanford University School of Medicine, Stanford, CA, USA. 6. Department of Psychiatry, University of Texas Health Science Center, San Antonio, TX, USA. 7. Bipolar Disorders Research Center, University Hospital's Case Medical Center, Case Western Reserve University, Cleveland, OH, USA. 8. Department of Psychiatry, University of Pittsburgh School of Medicine, Pittsburgh, PA, USA. 9. Department of Psychiatry, Icahn School of medicine at Mount Sinai, New York, NY, USA. 10. Department of Psychiatry, University of Pennsylvania School of Medicine, USA. 11. Biostatistics in Psychiatry & Public Health, Weill Cornell Medical College, New York, NY, USA. 12. Department of Psychiatry, The University of Texas Southwestern Medical Center, USA.
Abstract
OBJECTIVE:People with bipolar disorder are at high risk of suicide, but no clinically useful scale has been validated in this population. The aim of this study was to evaluate the psychometric properties in bipolar disorder of the 7- and 12-item versions of the Concise Health Risk Tracking Self-Report (CHRT-SR), a scale measuring suicidal ideation, suicidal behavior, and associated symptoms. METHODS: The CHRT was administered to 283 symptomatic outpatients with bipolar I or II disorder who were randomized to receive lithium plus optimized personalized treatment (OPT), or OPT without lithium in a six month longitudinal comparative effectiveness trial. Participants were assessed using structured diagnostic interviews, clinician-rated assessments, and self-report questionnaires. RESULTS: The internal consistency (Cronbach α) was 0.80 for the 7-item CHRT-SR and 0.90 for the 12-item CHRT-SR with a consistent factor structure, and three independent factors (current suicidal thoughts and plans, hopelessness, and perceived lack of social support) for the 7-item version. CHRT-SR scores are correlated with measures of depression, functioning, and quality of life, but not with mania scores. CONCLUSIONS: The 7- and 12-item CHRT-SR both had excellent psychometric properties in a sample of symptomatic subjects with bipolar disorder. The scale is highly correlated with depression, functioning, and quality of life, but not with mania. Future research is needed to determine whether the CHRT-SR will be able to predict suicide attempts in clinical practice. Published by Elsevier Ltd.
RCT Entities:
OBJECTIVE:People with bipolar disorder are at high risk of suicide, but no clinically useful scale has been validated in this population. The aim of this study was to evaluate the psychometric properties in bipolar disorder of the 7- and 12-item versions of the Concise Health Risk Tracking Self-Report (CHRT-SR), a scale measuring suicidal ideation, suicidal behavior, and associated symptoms. METHODS: The CHRT was administered to 283 symptomatic outpatients with bipolar I or II disorder who were randomized to receive lithium plus optimized personalized treatment (OPT), or OPT without lithium in a six month longitudinal comparative effectiveness trial. Participants were assessed using structured diagnostic interviews, clinician-rated assessments, and self-report questionnaires. RESULTS: The internal consistency (Cronbach α) was 0.80 for the 7-item CHRT-SR and 0.90 for the 12-item CHRT-SR with a consistent factor structure, and three independent factors (current suicidal thoughts and plans, hopelessness, and perceived lack of social support) for the 7-item version. CHRT-SR scores are correlated with measures of depression, functioning, and quality of life, but not with mania scores. CONCLUSIONS: The 7- and 12-item CHRT-SR both had excellent psychometric properties in a sample of symptomatic subjects with bipolar disorder. The scale is highly correlated with depression, functioning, and quality of life, but not with mania. Future research is needed to determine whether the CHRT-SR will be able to predict suicide attempts in clinical practice. Published by Elsevier Ltd.
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