Screening for adolescent suicidality in primary care: the bullying–insomnia–tobacco–stress test. A population‐based pilot study

Binder, Philippe; Heintz, Anne-Laure; Servant, Coralie; Roux, Marie-Thérèse; Robin, Stéphane; Gicquel, Ludovic; Ingrand, Pierre

doi:10.1111/eip.12352

Cited by 10 publications

(12 citation statements)

References 34 publications

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“…These findings confirm and even improve the results of our previous work: in the initial BITS study using a self‐completed questionnaire among 15‐year‐old school students, sensitivity was 75% and specificity 70% (AUC = 0.78) (Binder et al, ). In the TSTScafard detection utility study, sensitivity was 79%, and specificity 55% (Binder et al, ; Binder & Chabaud, ). Our data are in line with those of questionnaires investigating suicidality (even though these questionnaires are designed to assess suicide risk per se, not to alert GPs about the need to ask about suicidality).…”

Section: Discussionsupporting

confidence: 90%

“…As a means of alerting about a history of suicidality, the performance of the BITS‐test in a primary care population of 13‐to‐18‐year‐olds consulting a GP was similar to that of a self‐administered questionnaire completed by 15‐year‐olds in a school setting (Binder et al, ). The ROC curve indicated that a score equal or above 3 on the BITS test showed good sensitivity (66%) and high specificity (83%) for the identification of suicidality in this population.…”

Section: Discussionmentioning

confidence: 82%

“…The primary endpoint was the proportion of suicidality revealed using the BITS test (suicidality: at least one suicidal attempt during lifetime or any SI over the past 12 months). The parameters were: bilateral alpha risk 5%; primary endpoint frequency of 3% to 5% of suicidality discovered by the TSTScafard (Binder et al, ) intraclass correlation coefficient 0.05 corresponding to a variance inflation factor of 1.2 for a population of five adolescents/GP cluster. Minimum sample size was 460 adolescents and 100 GPs.…”

Section: Methodsmentioning

confidence: 99%

“…Moreover, TSTScafard memorization stood in need of improvement; we consequently proceeded to its updating and simplification by elaborating the BITS test (Binder & Chabaud, ), which is limited to 4 questions with 2 levels of severity in the responses (Figure ). To develop the BITS test, we reviewed the literature in order to identify adolescent behaviours known to be associated with suicidality (Binder et al, ). We then conducted a school‐based study involving 15‐year‐old students, and four of these behaviours were shown to be both highly associated with suicidality and easy to discuss with adolescents: Bullying (van Geel, Vedder, & Tanilon, ), Insomnia (McCall et al, ), Tobacco (Riala, Taanila, Hakko, & Rasanen, ) and Stress (Stanley et al, ).…”

Section: Introductionmentioning

confidence: 99%

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Detection of adolescent suicidality in primary care: an international utility study of the bullying‐insomnia‐tobacco‐stress test

Binder

Heintz

Haller

et al. 2019

Early Intervention Psych

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Aim: General practitioners (GPs) are ideally placed to identify suicidality in adolescents. However, adolescents are often reluctant to confide in their GPs about these problems, and GPs are not comfortable when questioning them about suicide. We previously proposed the BITS test, a set of four opening and four additional questions, to alert doctors about possible suicidality in an adolescent. We validated its use in the identification of suicidality ("frequent suicidal ideation or suicide attempts at one time or another)" in 15-year-old adolescents in a school setting. The objective of the present study was to assess the detection utility of this method in 13-to-18-year-olds in primary care.Methods: We carried out a screening utility study in general practices in 17 Frenchspeaking sites in four countries and three continents. Each GP was instructed to use the bullying, insomnia, tobacco, stress (BITS) test with five to ten 13-to-18-year-old adolescents, consulting consecutively, for any reason. They subsequently asked them questions about their suicidality. Results:One hundred and two GPs tested a total of 693 adolescents; 13.0% of the adolescents (girls 15.4%, boys 9.9%) reported suicidality (1.6% known, 11.4% previously unknown). A score of at least 3 on the BITS scale was associated with suicidality (sensitivity: 65.9, specificity: 82.5%). Conclusions:The BITS test is a pragmatic instrument, alerting the GP to an adolescent's previously unknown suicidability, whatever the reason for consultation. K E Y W O R D S adolescent, general practice, mass screening, primary health care, suicide attempt

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Section: Discussionsupporting

confidence: 90%

Section: Discussionmentioning

confidence: 82%

Section: Methodsmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Detection of adolescent suicidality in primary care: an international utility study of the bullying‐insomnia‐tobacco‐stress test

Binder

Heintz

Haller

et al. 2019

Early Intervention Psych

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“…Several tools have been validated and recommended in France; some can be memorized, such as the test to screen suicide risks and the HEADSS psychosocial interview guide; [17] others such as the ADRSp are self-administered questionnaires designed to evaluate depressive tendencies. [27][28][29]…”

Section: Comparison To the Literaturementioning

confidence: 99%

What do troubled adolescents expect from their GPs?

Tudrej

Heintz

Ingrand

et al. 2016

European Journal of General Practice

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Background Video gaming is one of the main recreational activities of children and adolescents. The American Psychiatric Association and the World Health Organization recently proposed diagnostic criteria for a pathological use of video games. The objective is to explore the perceptions of adolescents concerning pathological video game use. Methods Qualitative study by semi structured individual interviews in the homes of adolescent gamers and non-gamers living in southwest France. The sampling was theoretical. The analysis was carried out using an inductive approach following the phases of thematic analysis. The researchers used triangulation. Collection was concluded when theoretical saturation had been reached. Results 17 adolescents aged 10-18 were interviewed between April 2018 and March 2019. The adolescents recognised that video games use can be pathological. Deleterious consequences to physical, mental, and social wellbeing associated with gaming were discussed. Mental health, family and social environments, and the type of game seemed to in uence the transition from recreational to pathological video-game use. The adolescents agreed on the need to regulate their gaming, particularly through parental control and self-control. Conclusions Risks and protective factors related to the types of video game, the adolescent, and the environment were identi ed. Parental support would help lower the risk of pathological gaming. Recruitment Sources of recruitment were family physicians, hospital-based doctors, and music teachers. The last source allowed a recruitment of adolescents not necessarily included in care plan and who had hobbies. An informational letter was given to each of these contacts, who forwarded an information sheet to the parents.

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Quelle est la part du tabagisme dans l’augmentation du risque suicidaire chez les jeunes fumeurs ? Revue systématique

Underner¹,

Perriot²,

Chazeron³

et al. 2023

L'Encéphale

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Screening for adolescent suicidality in primary care: the bullying–insomnia–tobacco–stress test. A population‐based pilot study

Abstract: The BITS test could allow the question of suicide risk to be addressed during a routine check-up in primary care but the results need to be validated with 13 to 18-year olds.

Cited by 10 publications

References 34 publications

Detection of adolescent suicidality in primary care: an international utility study of the bullying‐insomnia‐tobacco‐stress test

Detection of adolescent suicidality in primary care: an international utility study of the bullying‐insomnia‐tobacco‐stress test

What do troubled adolescents expect from their GPs?

Quelle est la part du tabagisme dans l’augmentation du risque suicidaire chez les jeunes fumeurs ? Revue systématique

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