Risk Rulers for Rapid Screening and Detection of Suicide Risk in Acute Care.

IF 2.5 3区医学 Q2 PSYCHIATRY

Suicide and Life-Threatening Behavior Pub Date : 2026-06-01 DOI:10.1111/sltb.70112

Edwin D Boudreaux, Hyein S Lee, Celine Larkin, Rachel Davis-Martin, David G Beiser, Robert Gibbons

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引用次数: 0

Abstract

Introduction: To develop fast, intuitive, and accurate suicide risk screening, this study aimed to optimize 0-to-10 point suicide risk rulers.

Methods: 662 adult patients from two emergency departments (EDs) completed five risk rulers, two best-practice screeners, and the Columbia Suicide Severity Rating Scale (CSSRS). Using the CSSRS as the reference, we calculated optimized cutoffs, performance metrics, and AUROCs for differentiating between negligible vs. elevated risk and non-high vs. high risk. Performances of rulers and best-practice screeners were compared.

Results: The rulers demonstrated acceptable performance when identifying elevated risk (AUROCs: 0.71-0.81) and stronger performance when identifying high risk (AUROCs: 0.91-0.95). The sadness ruler best predicted elevated risk (AUROC: 0.81 [95% CI: 0.76-0.86]; optimized score: 5 [3-7]; sensitivity: 0.71 [0.50-0.88]; specificity: 0.74 [0.61-0.89]). The suicidal ideation frequency ruler best predicted high risk (AUROC: 0.95 [0.85-1.00], optimized score: 2 [2-5]; sensitivity: 0.89 [0.60-1.00]; specificity: 0.95 [0.93-0.98]). The rulers outperformed a three-item primary screener, but not a longer 10-item primary and secondary screener, which best predicted both risk thresholds.

Conclusions: Suicide risk rulers offer a fast, intuitive primary screening method for initial risk detection with acceptable operating characteristics. Our findings can inform the screening approach that best fits the needs of a given ED.

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急性护理中自杀风险快速筛查与检测的风险指标。

前言：为实现快速、直观、准确的自杀风险筛查，本研究旨在优化0- 10分自杀风险标尺。方法：来自两个急诊科（ed）的662名成年患者完成了5项风险标尺、2项最佳实践筛查和哥伦比亚自杀严重程度评定量表（CSSRS）。使用CSSRS作为参考，我们计算了优化的截止点、性能指标和auroc，以区分可忽略的风险与升高的风险以及非高风险与高风险。比较了尺子和最佳实践筛选器的性能。结果：尺子在识别高风险时表现良好（auroc: 0.71 ~ 0.81），在识别高风险时表现较好（auroc: 0.91 ~ 0.95）。悲伤尺子最能预测风险升高（AUROC: 0.81 [95% CI: 0.76-0.86]；优化评分：5[3-7]；敏感性：0.71[0.50-0.88]；特异性：0.74[0.61-0.89]）。自杀意念频率标尺最能预测高风险（AUROC: 0.95[0.85-1.00]，优化得分：2[2-5]，敏感性：0.89[0.60-1.00]，特异性：0.95[0.93-0.98]）。尺子的表现优于三个项目的主要筛选，但不优于10个项目的主要和次要筛选，后者最能预测两个风险阈值。结论：自杀风险标尺提供了一种快速、直观、操作特性可接受的初步风险检测初级筛查方法。我们的发现可以为最适合特定ED需求的筛查方法提供信息。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Suicide and Life-Threatening Behavior Medicine-Public Health, Environmental and Occupational Health

CiteScore

5.40

自引率

3.10%

发文量

期刊介绍： An excellent resource for researchers as well as students, Social Cognition features reports on empirical research, self-perception, self-concept, social neuroscience, person-memory integration, social schemata, the development of social cognition, and the role of affect in memory and perception. Three broad concerns define the scope of the journal: - The processes underlying the perception, memory, and judgment of social stimuli - The effects of social, cultural, and affective factors on the processing of information - The behavioral and interpersonal consequences of cognitive processes.