Lisa M Horowitz1, Deborah J Snyder2, Edwin D Boudreaux3, Jian-Ping He4, Colin J Harrington5, June Cai6, Cynthia A Claassen7, Joan E Salhany5, Tram Dao6, John F Chaves6, David A Jobes8, Kathleen R Merikangas4, Jeffrey A Bridge9, Maryland Pao2. 1. Office of the Clinical Director, National Institute of Mental Health, Bethesda, MD. Electronic address: horowitzl@mail.nih.gov. 2. Office of the Clinical Director, National Institute of Mental Health, Bethesda, MD. 3. Department of Emergency Medicine, University of Massachusetts Medical School, Worcester, MA. 4. Genetic Epidemiology Research Branch, National Institute of Mental Health, National Institute of Mental Health, Bethesda, MD. 5. Department of Psychiatry, Rhode Island Hospital, Providence, RI. 6. Department of Psychiatry, Walter Reed National Military Medical Center, Bethesda, MD. 7. Department of Psychiatry, John Peter Smith Health Network, Fort Worth, TX. 8. Department of Psychology, Catholic University of America, Washington, DC. 9. Center for Innovation in Pediatric Practice, The Abigail Wexner Research Unit at Nationwide Children's Hospital and The Ohio State University, Columbus, OH.
Abstract
BACKGROUND: Few brief suicide risk screening instruments are validated for use in both adult and pediatric medical populations. Using the pediatric Ask Suicide-Screening Questions (ASQ) development study as a model, this study aimed to determine whether the ASQ is a valid suicide risk-screening instrument for use among adults medical patients, as well as to evaluate a set of other potential screening questions for use in adults. METHODS: Adult patients hospitalized on inpatient medical/surgical units from 4 hospitals were recruited to participate in a cross-sectional instrument-validation study. The 4-item ASQ and other candidate items were compared against the 25-item, previously validated Adult Suicidal Ideation Questionnaire as the criterion standard. RESULTS: A total of 727 adult medical inpatients completed the screening process. Compared with the Adult Suicidal Ideation Questionnaire, the ASQ performed best among the full set of candidate items, demonstrating strong psychometric properties, with a sensitivity of 100% (95% confidence interval = 90%-100%), a specificity of 89% (95% confidence interval = 86%-91%), and a negative predictive value of 100% (95% confidence interval = 99%-100%). A total of 4.8% (35/727) of the participants screened positive for suicide risk based on the standard criterion Adult Suicidal Ideation Questionnaire. CONCLUSIONS: The ASQ is a valid and brief suicide risk-screening tool for use among adults. Screening medical/surgical inpatients for suicide risk can be performed effectively for both adult and pediatric patients using this brief, primary screener. Published by Elsevier Inc.
BACKGROUND: Few brief suicide risk screening instruments are validated for use in both adult and pediatric medical populations. Using the pediatric Ask Suicide-Screening Questions (ASQ) development study as a model, this study aimed to determine whether the ASQ is a valid suicide risk-screening instrument for use among adults medical patients, as well as to evaluate a set of other potential screening questions for use in adults. METHODS: Adult patients hospitalized on inpatient medical/surgical units from 4 hospitals were recruited to participate in a cross-sectional instrument-validation study. The 4-item ASQ and other candidate items were compared against the 25-item, previously validated Adult Suicidal Ideation Questionnaire as the criterion standard. RESULTS: A total of 727 adult medical inpatients completed the screening process. Compared with the Adult Suicidal Ideation Questionnaire, the ASQ performed best among the full set of candidate items, demonstrating strong psychometric properties, with a sensitivity of 100% (95% confidence interval = 90%-100%), a specificity of 89% (95% confidence interval = 86%-91%), and a negative predictive value of 100% (95% confidence interval = 99%-100%). A total of 4.8% (35/727) of the participants screened positive for suicide risk based on the standard criterion Adult Suicidal Ideation Questionnaire. CONCLUSIONS: The ASQ is a valid and brief suicide risk-screening tool for use among adults. Screening medical/surgical inpatients for suicide risk can be performed effectively for both adult and pediatric patients using this brief, primary screener. Published by Elsevier Inc.
Entities:
Keywords:
adult medical inpatients; instrument validation study; medical settings; suicide risk screening
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