Suicidal Behavior on Axis VI

Background. Oquendo and colleagues ( Oquendo, Baca-García, Mann, & Giner, 2008 ; Oquendo & Currier, 2009 ) recommend that DSM-V emphasize suicide risk assessment on a sixth axis, thereby increasing regularity of suicide risk assessments. Aims. We propose that evidence of nonredundancy with Axis V – Global Assessment of Functioning (GAF) is one piece of data that can serve as a starting point for a line of research establishing incremental predictive utility for a separate suicide risk assessment in the DSM framework. Methods. A standardized suicide risk assessment protocol, measures of depressive, anxious, and eating disordered symptomatology, as well as an index of comorbidity were administered to a sample of 412 adult outpatients. Results. Our data indicate that data from standardized suicide risk assessments are associated with indices of symptomatology severity as well as comorbidity, controlling for GAF. Conclusions. These results support the nonredundancy of the assessments and suggest the utility of longitudinal investigations of the predictive utility of a sixth DSM axis in the assessment of suicide risk.

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The Standard of Care in Suicide Risk Assessment: An Elusive Concept

CNS Spectrums ◽

10.1017/s1092852900014656 ◽

2006 ◽

Vol 11 (6) ◽

pp. 442-445 ◽

Cited By ~ 4

Author(s):

Robert I. Simon ◽

Daniel W. Shuman

Keyword(s):

Risk Assessment ◽

Suicide Risk ◽

Core Competency ◽

Standard Of Care ◽

Risk Assessments ◽

Patient Treatment ◽

Decision Making Process ◽

Evidence Based ◽

Suicide Risk Assessment ◽

Elusive Concept

ABSTRACTSuicide risk assessment is now a core competency requirement in the residency training of psychiatrists.The purpose of suicide risk assessment is to identify modifiable or treatable acute, high-risk suicide factors, and available protective factors that inform patient treatment and safety management.The standard of care varies according to state statutory definitions. Heretofore, most states adopted an average physician or “ordinarily employed standard.” Currently, more states are adopting a “reasonable, prudent physician” standard. No single source or authority defines the standard of care for suicide risk assessment. Evidence-based psychiatry can inform clinicians' suicide risk assessments. Carefully documented risk assessments will assist the courts in evaluating clinicians' decision-making process.

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A School-Based Suicide Risk Assessment Protocol

Journal of Applied School Psychology ◽

10.1080/15377903.2014.963272 ◽

2015 ◽

Vol 31 (1) ◽

pp. 31-62

Author(s):

Dana E. Boccio

Keyword(s):

Risk Assessment ◽

Suicide Risk ◽

Suicide Risk Assessment ◽

Assessment Protocol ◽

School Based

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What is commonly missed in the suicidal risk assessments in the emergency room?

European Psychiatry ◽

10.1016/j.eurpsy.2017.01.815 ◽

2017 ◽

Vol 41 (S1) ◽

pp. S562-S562

Author(s):

N. Alavi ◽

T. Reshetukha ◽

E. Prost ◽

A. Kristen ◽

D. Groll

Keyword(s):

Risk Factors ◽

Risk Assessment ◽

Emergency Medicine ◽

Emergency Room ◽

Educational Intervention ◽

Suicide Risk ◽

Chart Review ◽

Risk Assessments ◽

Suicidal Risk ◽

Suicide Risk Assessment

IntroductionSuicidal behaviour remains the most common reason for presentation to the emergency rooms. In spite of identifiable risk factors, suicide remains essentially unpredictable by current tools and assessments. Moreover, some factors may not be included consistently in the suicidal risk assessments in the emergency room by either emergency medicine physicians or psychiatrists.MethodStep 1 involved the administration of a survey on the importance of suicide predictors for assessment between psychiatry and emergency medicine specialties. In step 2 a chart review of psychiatric emergency room patients in Kingston, Canada was conducted to determine suicide predictor documentation rates. In step 3, based on the result of the first 2 steps a suicide risk assessment tool (Suicide RAP [Risk Assessment Prompt]) was developed and presented to both teams. A second patient chart review was conducted to determine the effectiveness of the educational intervention and suicide RAP in suicide risk assessment.ResultsSignificant differences were found in the rating of importance and the documentation rates of suicide predictors between the two specialties. Several predictors deemed important, have low documentation rates. Thirty of the suicide predictors showed increased rates of documentation after the educational intervention and the presentation of the suicide RAP.ConclusionThough a surfeit of information regarding patient risk factors for suicide is available, clinicians and mental health professionals face difficulties in integrating and applying this information to individuals. Based on the result of this study suicide RAP and educational intervention could be helpful in improving the suicidal risk assessment.Disclosure of interestThe authors have not supplied their declaration of competing interest.

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Evaluation of the Reliability and Validity of Two Clinician- Judgment Suicide Risk Assessment Instruments

Crisis ◽

10.1027/0227-5910/a000003 ◽

2010 ◽

Vol 31 (2) ◽

pp. 76-85 ◽

Cited By ~ 2

Author(s):

Prachi Kene-Allampalli ◽

Joseph D. Hovey ◽

Gregory J. Meyer ◽

Joni L. Mihura

Keyword(s):

Risk Assessment ◽

Factor Analysis ◽

Internal Consistency ◽

Suicide Risk ◽

Reliability And Validity ◽

Future Research ◽

Assessment Instruments ◽

Suicide Risk Assessment ◽

Starting Point ◽

Clinician Judgment

Background: This study evaluates the psychometric properties and factor structure of two clinician-judgment suicide risk assessment instruments – the Suicide Assessment Checklist developed by Yufit and the other developed by Rogers. Methods: As an archival study, 85 client records were obtained through a university psychology clinic. Results: Internal consistency was high for only one subscale of the Yufit checklist after deleting items for factor analyses, whereas internal consistency was high for the overall Rogers checklist after deleting items. Interrater reliability was excellent for both instruments. Both checklists correlated with self-reported suicidality on the Personality Assessment Inventory. Preliminary analyses indicated that data from the Yufit checklist are unsuitable for factor analysis, whereas factor analysis of the Rogers checklist identified one depressive factor. Conclusions: These findings provided evidence supporting the reliability and validity of the Rogers checklist. The findings also provided a good starting point for future research of the Yufit checklist.

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