RT Journal Article
SR Electronic
T1 Improving Suicide Risk Screening to Identify the Highest Risk Patients: Results From the PRImary Care Screening Methods (PRISM) Study
JF The Annals of Family Medicine
JO Ann Fam Med
FD American Academy of Family Physicians
SP 492
OP 498
DO 10.1370/afm.2729
VO 19
IS 6
A1 Craig J. Bryan
A1 Michael H. Allen
A1 Cynthia J. Thomsen
A1 Alexis M. May
A1 Justin C. Baker
A1 AnnaBelle O. Bryan
A1 Julia A. Harris
A1 Craig A. Cunningham
A1 Kara B. Taylor
A1 Michelle D. Wine
A1 Johnnie Young
A1 Sean Williams
A1 Kirsi White
A1 Logan Smith
A1 W. Cole Lawson
A1 Timothy Hope
A1 William Russell
A1 Kent D. Hinkson
A1 Tyler Cheney
A1 Kimberly Arne
YR 2021
UL http://www.annfammed.org/content/19/6/492.abstract
AB PURPOSE Over 95% of patients who screen positive on the Patient Health Questionnaire-9 (PHQ-9) suicide risk item do not attempt or die by suicide, which could lead to unnecessary treatment and/or misallocation of limited resources. The present study seeks to determine if suicide risk screening can be meaningfully improved to identify the highest-risk patients.METHODS Patients eligible to receive medical treatment from the US Department of Defense medical system were recruited from 6 military primary care clinics located at 5 military installations around the United States. Patients completed self-report measures including the PHQ-9 and 16 items from the Suicide Cognitions Scale (SCS) during routine primary care clinic visits. Postbaseline suicidal behaviors (suicide attempts, interrupted attempts, and aborted attempts) were assessed by evaluators who were blind to screening results using the Self-Injurious Thoughts and Behaviors Interview.RESULTS Among 2,744 patients, 13 (0.5%) engaged in suicidal behavior in the 30 days after screening and 28 (1.0%) displayed suicidal behavior in the 90 days after screening. Multiple SCS items differentiated patients with suicidal behavior less than 30 days after screening positive for suicide risk. Augmenting the PHQ-9 suicide risk item with SCS items improved the identification of patients who were most likely to have suicidal behavior within a month of screening positive without sacrificing sensitivity.CONCLUSION Among primary care patients who screen positive for suicide risk on the PHQ-9, SCS items improved screening efficiency by identifying those patients who are most likely to engage in suicidal behavior within the next 30 days.