Noreen A Reilly-Harrington1, Richard C Shelton2, Masoud Kamali3, Dustin J Rabideau4, Leah W Shesler5, Madhukar H Trivedi6, Susan L McElroy7, Louisa G Sylvia8, Charles L Bowden9, Terence A Ketter10, Joseph R Calabrese11, Michael E Thase12, William V Bobo13, Thilo Deckersbach8, Mauricio Tohen14, Melvin G McInnis3, James H Kocsis15, Alexandra K Gold5, Vivek Singh9, Daniel M Finkelstein4, Gustavo Kinrys8, Andrew A Nierenberg8. 1. Department of Psychiatry, Massachusetts General Hospital, Boston, MA, USA; Harvard Medical School, Boston, MA, USA. Electronic address: nharrington11@mgh.harvard.edu. 2. Department of Psychiatry, University of Alabama at Birmingham, Birmingham, AL, USA. 3. Department of Psychiatry, University of Michigan, Ann Arbor, MI, USA. 4. Biostatistics Center, Massachusetts General Hospital, Boston, MA, USA. 5. Department of Psychiatry, Massachusetts General Hospital, Boston, MA, USA. 6. Department of Psychiatry, The University of Texas Southwestern Medical Center, Dallas, TX, USA. 7. Lindner Center of HOPE, Mason, OH, USA; Department of Psychiatry, University of Cincinnati College of Medicine, Cincinnati, OH, USA. 8. Department of Psychiatry, Massachusetts General Hospital, Boston, MA, USA; Harvard Medical School, Boston, MA, USA. 9. Department of Psychiatry, University of Texas Health Science Center, San Antonio, TX, USA. 10. Department of Psychiatry & Behavioral Sciences, Stanford University School of Medicine, Stanford, CA, USA. 11. Bipolar Disorders Research Center, University Hospital's Case Medical Center, Case Western Reserve University, Cleveland, OH, USA. 12. Department of Psychiatry, University of Pennsylvania School of Medicine, Philadelphia, PA, USA. 13. Department of Psychiatry and Psychology, Mayo Clinic, Rochester, MN, USA. 14. Department of Psychiatry, University of New Mexico, Health Sciences Center, Albuquerque, NM, USA. 15. Department of Psychiatry, Weill Cornell Medical College of Cornell University, New York, NY, USA.
Abstract
BACKGROUND: Few brief, self-report measures exist that can reliably predict adverse suicidality outcomes in patients with BD. This study utilized the Concise Health Risk Tracking Self-Report (CHRT) to assess suicidality in patients with BD and examined its psychometric performance, clinical correlates, and prospective value in predicting adverse events related to suicidality. METHODS: The CHRT was administered at baseline and follow-up to 482 adult patients in Bipolar CHOICE, a 6-month randomized comparative effectiveness trial. The Columbia Suicide Severity Rating Scale (CSSRS) was used at baseline to assess lifetime history of suicide attempts and related behaviors. Clinician-rated measures of mood (Bipolar Inventory of Symptoms Scale) and bipolar symptoms (Clinical Global Impressions-Bipolar Version) were conducted at baseline and follow-up. RESULTS: The CHRT showed excellent internal consistency and construct validity and was highly correlated with clinician ratings of depression, anxiety, and overall functioning at baseline and throughout the study. Baseline CHRT scores significantly predicted risk of subsequent suicidality-related Serious Adverse Events (sSAEs), after controlling for mood and comorbidity. Specifically, the hazard of a sSAE increased by 76% for every 10-point increase in baseline CHRT score. Past history of suicide attempts and related behaviors, as assessed by the CSSRS, did not predict subsequent sSAEs. LIMITATIONS: The CSSRS was used to assess static risk factors in terms of past suicidal behaviors and may have been a more powerful predictor over longer-term follow-up. CONCLUSIONS: The CHRT offers a quick and robust self-report tool for assessing suicidal risk and has important implications for future research and clinical practice.
RCT Entities:
BACKGROUND: Few brief, self-report measures exist that can reliably predict adverse suicidality outcomes in patients with BD. This study utilized the Concise Health Risk Tracking Self-Report (CHRT) to assess suicidality in patients with BD and examined its psychometric performance, clinical correlates, and prospective value in predicting adverse events related to suicidality. METHODS: The CHRT was administered at baseline and follow-up to 482 adult patients in Bipolar CHOICE, a 6-month randomized comparative effectiveness trial. The Columbia Suicide Severity Rating Scale (CSSRS) was used at baseline to assess lifetime history of suicide attempts and related behaviors. Clinician-rated measures of mood (Bipolar Inventory of Symptoms Scale) and bipolar symptoms (Clinical Global Impressions-Bipolar Version) were conducted at baseline and follow-up. RESULTS: The CHRT showed excellent internal consistency and construct validity and was highly correlated with clinician ratings of depression, anxiety, and overall functioning at baseline and throughout the study. Baseline CHRT scores significantly predicted risk of subsequent suicidality-related Serious Adverse Events (sSAEs), after controlling for mood and comorbidity. Specifically, the hazard of a sSAE increased by 76% for every 10-point increase in baseline CHRT score. Past history of suicide attempts and related behaviors, as assessed by the CSSRS, did not predict subsequent sSAEs. LIMITATIONS: The CSSRS was used to assess static risk factors in terms of past suicidal behaviors and may have been a more powerful predictor over longer-term follow-up. CONCLUSIONS: The CHRT offers a quick and robust self-report tool for assessing suicidal risk and has important implications for future research and clinical practice.
Authors: Katherine Sanchez; Michael O Killian; Taryn L Mayes; Tracy L Greer; Joseph M Trombello; Robert Lindblad; Bruce D Grannemann; Thomas J Carmody; A John Rush; Robrina Walker; Madhukar H Trivedi Journal: J Psychiatr Res Date: 2018-03-27 Impact factor: 4.791
Authors: C M Celano; E E Beale; C A Mastromauro; J G Stewart; R A Millstein; R P Auerbach; C A Bedoya; J C Huffman Journal: Psychol Med Date: 2016-11-23 Impact factor: 7.723
Authors: Joseph M Trombello; Michael O Killian; Bruce D Grannemann; Augustus John Rush; Taryn L Mayes; Ramin V Parsey; Melvin McInnis; Manish K Jha; Aasia Ali; Patrick J McGrath; Phil Adams; Maria A Oquendo; Myrna M Weissman; Thomas J Carmody; Madhukar H Trivedi Journal: J Psychopharmacol Date: 2019-01-17 Impact factor: 4.153