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Columbia-Suicide Severity Rating Scale Screen Version: initial screening for suicide risk in a psychiatric emergency department
Psychological Medicine ( IF 5.9 ) Pub Date : 2021-03-26 , DOI: 10.1017/s0033291721000751
Johan Bjureberg 1, 2 , Marie Dahlin 3 , Andreas Carlborg 3 , Hanna Edberg 3 , Axel Haglund 4 , Bo Runeson 3
Affiliation  

Background

Suicide screening is routine practice in psychiatric emergency (PE) departments, but evidence for screening instruments is sparse. Improved identification of nascent suicide risk is important for suicide prevention. The aim of the current study was to evaluate the association between the novel Colombia Suicide Severity Rating Scale Screen Version (C-SSRS Screen) and subsequent clinical management and suicide within 1 week, 1 month and 1 year from screening.

Methods

Consecutive patients (N = 18 684) attending a PE department in Stockholm, Sweden between 1 May 2016 and 31 December 2017 were assessed with the C-SSRS Screen. All patients (52.1% women; mean age = 39.7, s.d. = 16.9) were followed-up in the National Cause of Death Register. Logistic regression and receiver operating characteristic curves analyses were conducted. Optimal cut-offs and accuracy statistics were calculated.

Results

Both suicidal ideation and behaviour were prevalent at screening. In total, 107 patients died by suicide during follow-up. Both C-SSRS Screen Ideation Severity and Behaviour Scales were associated with death by suicide within 1-week, 1-month and 1-year follow-up. The optimal cut-off for the ideation severity scale was associated with at least four times the odds of dying by suicide within 1 week (adjusted OR 4.7, 95% confidence interval 1.5–14.8). Both scales were also associated with short-term clinical management.

Conclusions

The C-SSRS Screen may be feasible to use in the actual management setting as an initial step before the clinical assessment of suicide risk. Future research may investigate the utility of combining the C-SSRS Screen with a more thorough assessment.



中文翻译:


哥伦比亚自杀严重程度评定量表筛查版:精神科急诊科自杀风险的初步筛查


 背景


自杀筛查是精神科急诊 (PE) 部门的常规做法,但筛查仪器的证据很少。更好地识别新生自杀风险对于预防自杀很重要。本研究的目的是评估新型哥伦比亚自杀严重程度评定量表筛查版(C-SSRS 筛查)与筛查后 1 周、1 个月和 1 年内的后续临床管理和自杀之间的关联。

 方法


使用 C-SSRS 筛查对 2016 年 5 月 1 日至 2017 年 12 月 31 日期间在瑞典斯德哥尔摩 PE 科就诊的连续患者 ( N = 18 684) 进行评估。所有患者(52.1% 为女性;平均年龄 = 39.7 岁,标准差= 16.9)均在国家死因登记处进行了随访。进行逻辑回归和受试者工作特征曲线分析。计算了最佳截止值和准确性统计数据。

 结果


筛选时自杀意念和行为都很普遍。随访期间共有 107 名患者死于自杀。 C-SSRS 筛选意念严重程度和行为量表均与 1 周、1 个月和 1 年内随访期间的自杀死亡相关。意念严重程度量表的最佳截止点与 1 周内自杀死亡几率的至少四倍相关(调整后 OR 4.7,95% 置信区间 1.5-14.8)。这两种量表也与短期临床管理相关。

 结论


C-SSRS 筛查可能可以在实际管理环境中使用,作为临床评估自杀风险之前的第一步。未来的研究可能会调查将 C-SSRS 筛查与更彻底的评估相结合的效用。

更新日期:2021-03-26
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