University of Massachusetts Medical School Faculty Publications

Title

C-SSRS performance in emergency department patients at high risk for suicide

UMMS Affiliation

Department of Emergency Medicine

Publication Date

2020-07-24

Document Type

Article

Disciplines

Emergency Medicine | Health Services Administration | Mental and Social Health | Mental Disorders | Psychiatry and Psychology

Abstract

OBJECTIVE: To evaluate the psychometric and predictive performance of the Columbia-Suicide Severity Rating Scale (C-SSRS) in emergency department (ED) patients with suicidal ideation or attempts (SI/SA).

METHODS: Participants (n = 1,376, mean age 36.8, 55% female, 76.8% white) completed the C-SSRS during the ED visit and were followed for one year. Reliability analyses, exploratory structural equation modeling, and prediction of future SA were explored.

RESULTS: Reliability of the Suicidal Ideation subscale was adequate, but was poor for the Intensity of Ideation and Suicidal Behavior subscales. Three empirically derived factors characterized the C-SSRS. Only Factor 1 (Suicidal Ideation and Attempts) was a reliable predictor of subsequent SA, though odds ratios were small (ORs: 1.09-1.10, CI95% : 1.04, 1.15). The original C-SSRS Suicidal Ideation and Suicidal Behavior subscales and the C-SSRS ED screen predicted subsequent SA, again with small odds ratios (ORs: 1.07-1.19, CI95% : 1.01, 1.29). In participants without a SA history, no C-SSRS subscale predicted subsequent SA. History of any SA (OR: 1.98, CI95% : 1.43, 2.75) was the strongest predictor of subsequent SA.

CONCLUSIONS: The psychometric evidence for the C-SSRS was mixed. History of a prior SA, as measured by the C-SSRS, provided the most parsimonious and powerful assessment for predicting future SA.

DOI of Published Version

10.1111/sltb.12657

Source

Brown LA, Boudreaux ED, Arias SA, Miller IW, May AM, Camargo CA Jr, Bryan CJ, Armey MF. C-SSRS performance in emergency department patients at high risk for suicide. Suicide Life Threat Behav. 2020 Jul 24. doi: 10.1111/sltb.12657. Epub ahead of print. PMID: 32706437. Link to article on publisher's site

Related Resources

Link to Article in PubMed

Journal/Book/Conference Title

Suicide and life-threatening behavior

PubMed ID

32706437

Share

COinS