Instruments for Suicide Risk Assessment

This document was published more than 2 years ago. The nature of the evidence may have changed.

Suicide is one of the leading causes of death worldwide. Identifying individuals at risk of future suicide or suicide attempts is of clinical importance. However, suicidal behaviour is complex and difficult to predict. Instruments have been developed to facilitate the assessment of the risk of future suicidal acts.

Conclusions

  • None of the included studies provided scientific evidence to support that any instrument had sufficient accuracy to predict future suicide with 80% sensitivity and 50% specificity.
  • There is strong evidence to support that the SAD PERSONS Scale has very low sensitivity. Most persons who make future suicidal acts are not identified.
  • Research is needed to clarify if assessment of suicide risk is enhanced when an instrument is used as a complement to the global clinical assessment. To date such research is lacking.
  • More research is needed to clarify the reliabil­ity of the commonly used instruments SUAS and C-SSRS.
  • As of yet there are no studies that assess whether the suicide item of the Montgomery Åsberg Depression Rating Scale (MADRS) can predict suicidal acts.

How to cite this report: SBU. Instruments for Suicide risk assessment. Stockholm: Swedish Agency for Health Technology Assessment and Assessment of Social Services (SBU); 2015. SBU report no 242 (in Swedish).

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SBU Assessment presents a comprehensive, systematic assessment of available scientific evidence. The certainty of the evidence for each finding is systematically reviewed and graded. Full assessments include economic, social, and ethical impact analyses.

SBU assessments are performed by a team of leading professional practitioners and academics, patient/user representatives and SBU staff. Prior to approval and publication, assessments are reviewed by independent experts, SBU’s Scientific Advisory Committees and Board of Directors.

Published: 9/23/2015
Contact SBU: registrator@sbu.se
Report no: 242
https://www.sbu.se/242e

Project group

Experts

  • Bo Runesson (Chair)
  • Ingalill Jildevik Adamsson
  • Tobias Edbom
  • Anna Lindblad
  • Margda Waern

SBU

  • Jenny Odeberg (Project Director)
  • Elisabeth Gustafsson (Project Administrator)
  • Harald Gyllensvärd (Health Economist)
  • Hanna Olofsson (Information Specialist)
  • Agneta Pettersson (Assistant Project Director)

Tre frågor till Bo Runeson, ordförande för rapporten

Bo Runeson
Bo Runeson, professor i psykiatri 

Vilken är den viktigaste slutsatsen i rapporten?

Det saknas evidens för att de granskade intervjuinstrumenten för bedömning av suicidrisk på ett tillförlitligt sätt kan förutsäga suicidrisk.

Vad hoppas du ska hända i vården?

Det är mycket svårt att bedöma suicidrisk, det finns en medvetenhet om detta inom vården. Det behövs förtroendefulla grundliga samtal för att försöka bedöma risken för en suicidhandling.  Instrumenten kan ändå vara användbara för ny och oerfaren personal för att inhämta relevant och enhetlig information.

Var det något resultat du själv blev överraskad av i rapporten?

Att det trots att det gjorts flera stora studier av instrument för suicidriskbedömning finns mycket få studier med kort uppföljningstid, det är viktigt för att man ska kunna identifiera risk den närmaste tiden efter bedömningen.

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