Comparative clinical utility of screening for Suicide Crisis Syndrome versus suicidal ideation in relation to suicidal ideation and attempts at one‐month follow‐up

Abstract

Introduction: Suicidal ideation (SI) has numerous limitations in predicting suicidal behavior. The Suicide Crisis Syndrome (SCS) is proposed as an alternative method of detecting risk. This study compares the relative utility of SI and SCS in statistically predicting SI and behaviors at one-month follow-up. Methods: 382 psychiatric patients (98 inpatients, 284 outpatients) completed baseline measures and provided information about suicide-related outcomes one month later. Participants were grouped based on responses to measures assessing SCS and SI.Results: Rates of follow-up suicidal behavior were significantly higher among those reporting both SCS and SI (22.2%) than those reporting SI alone (6.0%) or neither SCS nor SI (0.9%). SCS alone (8.3%) had descriptively, but not statistically, higher rates of suicidal behavior than those with neither SCS nor SI, and did not differ from SI alone and the combination of SCS and SI. Those reporting SI-with and without SCS-had higher levels of follow-up suicidal thoughts than those without SI. Conclusion:The SCS was equivalent to SI, and incrementally informative alongside SI, in detecting individuals at risk of future suicidal behavior, whereas SI was more strongly related to future SI than SCS. The combination of SCS and SI may be clinically useful in detecting individuals who are at risk for suicide.

Machine learning approach for the development of a crucial tool in suicide prevention: The Suicide Crisis Inventory-2 (SCI-2) Short Form

“…Responses are rated on a 5-point Likert scale, ranging from 0 (Not at all) to 4 (Extremely), with selected items recorded such that higher scores are indicative of more severe SCS symptoms. The SCI-2 has demonstrated excellent internal consistency as well as convergent, discriminant, criterion, and predictive validity in past research [21,52]. Internal consistency in the present study was excellent (α = .98).…”

Suicide Crisis Syndrome: A systematic review

“…(2017), and two referring to the sample used by Calati et al. (2020); and in five studies, samples were taken from a larger, prospective study, as such there might be some overlap of the included samples (Bafna et al., 2022; Flint et al., 2021; Pia et al., 2020; Rogers, Bafna, & Galynker, 2022; see Table 3).…”

A Suicide-Specific Diagnosis – The Case For

“…Suicidal ideation has various limitations when it comes to predicting suicidal behavior, and the SCS may be a more effective method at detecting risk. In a sample of psychiatric patients, suicidal behavior (Rogers et al, 2022) and suicide attempts (Bloch-Elkouby et al, 2021), were more frequent in patients reporting both suicidal ideation and SCS versus suicidal ideation alone when assessed at 1-month follow-up. Thus, many individuals hospitalized with suicidal ideation will likely not attempt suicide (especially in a short timeframe), and therefore may be exposed to excessive and unnecessary treatment, often for medical–legal reasons, which can be traumatic and harmful for the patient (Hall & Hall, 2013), particularly when the treatments are delivered with coercive modalities (Paksarian et al, 2014).…”

“…Additionally, the SCS is predictive of 1-month postdischarge suicidal thoughts and behaviors (Bloch-Elkouby et al, 2021; Cohen et al, 2022) and suicide attempts (Barzilay et al, 2020; Yaseen et al, 2019). Further, the SCS demonstrated incremental predictive validity over suicidal ideation regarding suicidal attempts (Rogers et al, 2022). The SCS has been employed in numerous research and clinical settings, both in the United States and internationally (c.f., Høyen et al, 2022; Menon et al, 2022; Otte et al, 2020; Wu et al, 2022).…”