Document Detail


School-based screening for suicide risk: balancing costs and benefits.
MedLine Citation:
PMID:  20634467     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
OBJECTIVES: We examined the effects of a scoring algorithm change on the burden and sensitivity of a screen for adolescent suicide risk. METHODS: The Columbia Suicide Screen was used to screen 641 high school students for high suicide risk (recent ideation or lifetime attempt and depression, or anxiety, or substance use), determined by subsequent blind assessment with the Diagnostic Interview Schedule for Children. We compared the accuracy of different screen algorithms in identifying high-risk cases. RESULTS: A screen algorithm comprising recent ideation or lifetime attempt or depression, anxiety, or substance-use problems set at moderate-severity level classed 35% of students as positive and identified 96% of high-risk students. Increasing the algorithm's threshold reduced the proportion identified to 24% and identified 92% of high-risk cases. Asking only about recent suicidal ideation or lifetime suicide attempt identified 17% of the students and 89% of high-risk cases. The proportion of nonsuicidal diagnosis-bearing students found with the 3 algorithms was 62%, 34%, and 12%, respectively. CONCLUSIONS: The Columbia Suicide Screen threshold can be altered to reduce the screen-positive population, saving costs and time while identifying almost all students at high risk for suicide.
Authors:
Michelle Scott; Holly Wilcox; Yanling Huo; J Blake Turner; Prudence Fisher; David Shaffer
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Publication Detail:
Type:  Journal Article; Research Support, N.I.H., Extramural; Research Support, Non-U.S. Gov't; Research Support, U.S. Gov't, P.H.S.     Date:  2010-07-15
Journal Detail:
Title:  American journal of public health     Volume:  100     ISSN:  1541-0048     ISO Abbreviation:  Am J Public Health     Publication Date:  2010 Sep 
Date Detail:
Created Date:  2010-08-13     Completed Date:  2010-09-14     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  1254074     Medline TA:  Am J Public Health     Country:  United States    
Other Details:
Languages:  eng     Pagination:  1648-52     Citation Subset:  AIM; IM    
Affiliation:
Department of Child Psychiatry, College of Physicians and Surgeons, Columbia University, New York, NY, USA. mscott@monmouth.edu
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MeSH Terms
Descriptor/Qualifier:
Adolescent
Adolescent Behavior
Adolescent Psychology*
Algorithms
Anxiety / diagnosis*,  pathology
Depression / diagnosis*,  psychology
Female
Humans
Interview, Psychological
Male
Mass Screening / organization & administration*
New York City
Predictive Value of Tests
Psychometrics
Questionnaires
Risk Factors
School Health Services / organization & administration*
Sensitivity and Specificity
Substance-Related Disorders / diagnosis*,  psychology
Suicide / prevention & control*,  psychology
Grant Support
ID/Acronym/Agency:
P30MH-43878/MH/NIMH NIH HHS; R49/CCR 202598//PHS HHS; T32MH-16434/MH/NIMH NIH HHS

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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