Whether Called Acute Suicidal Affective Disturbance or Suicide Crisis Syndrome, a Suicide-specific Diagnosis Would Enhance Clinical Care, Increase Patient Safety, and Mitigate Clinician Liability

Joiner, Thomas E.; Simpson, Skip; Rogers, Megan L.; Stanley, Ian H.; Galynker, Igor

doi:10.1097/pra.0000000000000315

Cited by 34 publications

(38 citation statements)

References 6 publications

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“…Although an argument can be made for legal responsibility of clinicians should they employ such a diagnosis, the opposite may in fact be true (Joiner, Simpson, Rogers, Stanley, & Galynker, ). When a patient dies by suicide, a lawsuit arguing for medical malpractice would include determining if proper steps have been taken for the mitigation of his/her suicide risk.…”

Section: Discussionmentioning

confidence: 99%

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Suicide Crisis Syndrome: A review of supporting evidence for a new suicide‐specific diagnosis

Schuck

Calati

Barzilay

et al. 2019

Behavioral Sci & The Law

105

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Suicide is a major public health problem, and suicide rates are still on the rise. Current strategies for identifying individuals at risk for suicide, such as the use of a patient's self‐reported suicidal ideation or evidence of past suicide attempts, have not been sufficient in reducing suicide rates. Recently, research groups have been focused on determining the acute mental state preceding a suicide attempt. The development of an acute suicidal diagnosis, the Suicide Crisis Syndrome (SCS), is aimed at capturing this state to better treat individuals. The SCS has five main evidence‐based components—entrapment, affective disturbance, loss of cognitive control, hyperarousal, and social withdrawal. The SCS may provide clinicians with the ability to identify individuals who are experiencing an acute pre‐suicidal mental state, regardless of their self‐reported suicidal ideation. Future research leading to the incorporation of this diagnosis into clinical practice could improve the quality of care and reduce the personal, societal, and legal burden of suicide.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Suicide Crisis Syndrome: A review of supporting evidence for a new suicide‐specific diagnosis

Schuck

Calati

Barzilay

et al. 2019

Behavioral Sci & The Law

105

View full text Add to dashboard Cite

show abstract

“…This concept emphasizes that symptoms develop very quickly. Its main components are: drastic increase in suicidal intents over the course of hours or days; marked social alienation (e.g., social withdrawal, disgust with others, perceived burdensomeness) and/or self-alienation (self-hatred, perceptions that one's psychological pain is a burden); the above mentioned are hopelessly unchangeable; and over-arousal (agitation, irritability, insomnia, nightmares) (12). A 28-item clinical scale (ASADI-L) was also developed to assess lifetime ASAD symptoms (17).…”

Section: Acute Suicidal Affective Disturbance and Suicidal Crisis Synmentioning

confidence: 99%

“…While these are clinically important features, they alone provide little useful information on the background of suicidal behavior (e.g., mental disorder, crisis situation, etc.) and do not help to identify warning signs or acute risk and to predict future suicidal behavior (12,13). Because acute suicide risk usually develops rapidly (up to some days or hours) (14), it would be necessary to introduce a category that emphasizes the characteristics of this life-threatening pre-suicidal state of mind requiring urgent intervention (15,16).…”

Section: Introductionmentioning

confidence: 99%

Crisis Concept Re-loaded?—The Recently Described Suicide-Specific Syndromes May Help to Better Understand Suicidal Behavior and Assess Imminent Suicide Risk More Effectively

et al. 2021

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Background: Despite of the decreasing suicide rates in many countries, suicide is still a major public health concern worldwide. Traditional suicide risk factors have limited clinical predictive value, as they provide little reliable information on the acute psychological processes leading to suicide.Aims: The aim of this analysis is to describe and compare the recently introduced two suicide-specific syndromes [Acute Suicidal Affective Disturbance (ASAD) and Suicidal Crisis Syndrome (SCS)] with the classic psychological features of pre-suicidal crisis and also to assess the clinical utility of the new suicide prediction scales in contrast to classical risk factors.Method: Conceptual analysis.Results: Suicide-specific syndromes are not novel in terms of symptomatology or dynamics of symptom onset, but in their use of well-defined diagnostic criteria. In addition to symptomatic classification, they also provide an opportunity to objectively measure the current pre-suicidal emotional and mental state by validated tools.Limitations: Future studies need to be completed to prove the reliability and predictive validity of suicide-specific diagnostic categories and the related suicide risk assessment tools.Conclusion: Clinical use of suicide-specific syndromes is suggested. This transdiagnostic approach not only enables a more accurate and objective assessment of imminent suicide risk, but also facilitates research in neuroscience, which represent a major step forward in managing and complex understanding of suicidal behavior.

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“…Further, conditions that result in death but lack a diagnostic label may lead to misclassification of cause of death in registries. Finally, despite concerns that a suicide‐specific diagnosis may facilitate lawsuits, it may actually enhance patient care and mitigate clinician liability (Joiner, Simpson, Rogers, Stanley, & Galynker, ).…”

Section: Conceptual Clinical and Practical Rationale For A New Diagmentioning

confidence: 99%

The necessity, validity, and clinical utility of a new diagnostic entity: Acute suicidal affective disturbance

2019

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Objective: Here we argue for the necessity, validity, and clinical utility of a new diagnostic entity, acute suicidal affective disturbance (ASAD).Method: We expand on the conceptual, clinical, and practical rationale for ASAD, propose its defining features, describe research results to date, and suggest avenues for future research.Results: There is accruing evidence for the existence of a previously unclassified, rapid-onset mood disturbance that geometrically escalates and regularly results in life-threatening behavior.Conclusions: ASAD research may not only improve the field's understanding of suicidal behavior but also enhance clinical effectiveness and save lives.The first step in wisdom is to know the things themselves… objects are distinguished and known by classifying them methodically and giving them appropriate names. (Carolius Linnaeus).Consider the following scenario, based on actual cases encountered by the senior author: an individual is diagnosed with a nonmood disorder psychiatric condition (e.g., schizophrenia) and admitted to inpatient psychiatry. During hospitalization, mood disorder symptoms and suicide risk are regularly assessed and viewed as minimal. The patient's chart indicated the occurrence of a suicide attempt approximately 4 years before. However, the circumstances surrounding this attempt were not documented, and unbeknownst to unit clinicians and unreported by the patient, a past history of rapidonset, intense suicidal crises occurred about 5 years previously. The condition is aggressively treated and clear improvement is observed. The individual is, thus, discharged; approximately 18 hr postdischarge, suicidality again intensifies dramatically, culminating in the individual's death by suicide. The primary condition had not worsened.

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Whether Called Acute Suicidal Affective Disturbance or Suicide Crisis Syndrome, a Suicide-specific Diagnosis Would Enhance Clinical Care, Increase Patient Safety, and Mitigate Clinician Liability

Cited by 34 publications

References 6 publications

Suicide Crisis Syndrome: A review of supporting evidence for a new suicide‐specific diagnosis

Suicide Crisis Syndrome: A review of supporting evidence for a new suicide‐specific diagnosis

Crisis Concept Re-loaded?—The Recently Described Suicide-Specific Syndromes May Help to Better Understand Suicidal Behavior and Assess Imminent Suicide Risk More Effectively

The necessity, validity, and clinical utility of a new diagnostic entity: Acute suicidal affective disturbance

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