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    Limitations of Screening for Depression as a Proxy for Suicide Risk in Adult Medical Inpatients

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    Authors
    Mournet, Annabelle M.
    Smith, Jarrod T.
    Bridge, Jeffrey A.
    Boudreaux, Edwin D
    Snyder, Deborah J.
    Claassen, Cynthia A.
    Jobes, David A.
    Pao, Maryland
    Horowitz, Lisa M.
    UMass Chan Affiliations
    Department of Emergency Medicine
    Document Type
    Journal Article
    Publication Date
    2021-07-01
    Keywords
    PHQ-9
    depression
    inpatient
    medical
    screening
    suicide
    Emergency Medicine
    Mental and Social Health
    Psychiatry
    Psychiatry and Psychology
    
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    Link to Full Text
    https://doi.org/10.1016/j.jaclp.2021.02.002
    Abstract
    BACKGROUND: Medically ill hospitalized patients are at elevated risk for suicide. Hospitals that already screen for depression often use depression screening as a proxy for suicide risk screening. Extant research has indicated that screening for depression may not be sufficient to identify all patients at risk for suicide. OBJECTIVE: The present study aims to determine the effectiveness of a depression screening tool, the Patient Health Questionnaire-9, in detecting suicide risk among adult medical inpatients. METHODS: Participants were recruited from inpatient medical/surgical units in 4 hospitals as part of a larger validation study. Participants completed the Patient Health Questionnaire-9 and 2 suicide risk measures: the Ask Suicide-Screening Questions and the Adult Suicidal Ideation Questionnaire. RESULTS: The sample consisted of 727 adult medical inpatients (53.4% men; 61.8% white; mean age 50.1 +/- 16.3 years). A total of 116 participants (116 of 727 [16.0%]) screened positive for suicide risk and 175 (175 of 727 [24.1%]) screened positive for depression. Of the 116 patients who screened positive for suicide risk, 36 (31.0%) screened negative for depression on the Patient Health Questionnaire-9. Of 116, 73 (62.9%) individuals who were at risk for suicide did not endorse item 9 (thoughts of harming oneself or of being better off dead) on the Patient Health Questionnaire-9. CONCLUSION: Using depression screening tools as a proxy for suicide risk may be insufficient to detect adult medical inpatients at risk for suicide. Asking directly about suicide risk and using validated tools is necessary to effectively and efficiently screen for suicide risk in this population.
    Source

    Mournet AM, Smith JT, Bridge JA, Boudreaux ED, Snyder DJ, Claassen CA, Jobes DA, Pao M, Horowitz LM. Limitations of Screening for Depression as a Proxy for Suicide Risk in Adult Medical Inpatients. J Acad Consult Liaison Psychiatry. 2021 Jul-Aug;62(4):413-420. doi: 10.1016/j.jaclp.2021.02.002. Epub 2021 Feb 12. PMID: 34219655; PMCID: PMC8258235. Link to article on publisher's site

    DOI
    10.1016/j.jaclp.2021.02.002
    Permanent Link to this Item
    http://hdl.handle.net/20.500.14038/29941
    PubMed ID
    34219655
    Related Resources

    Link to Article in PubMed

    ae974a485f413a2113503eed53cd6c53
    10.1016/j.jaclp.2021.02.002
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    UMass Chan Faculty and Researcher Publications
    Emergency Medicine Publications

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