Past Suicide Attempts in Depressed Inpatients: Clinical versus Research Assessment

Abstract

The objective of this study was to compare structured clinical assessment versus research measurement of suicidal risk among inpatients with major depression. Fifty depressed inpatients underwent a structured clinical and an independent research assessment of suicidal risk. Agreement between both assessments and its impact upon time to first readmission was tested. A false negative rate of 25% in the clinical screening of past suicide attempts was associated with older age, concealment, and reported lower frequency of suicidal thoughts. Mean times to first readmission (2.5 years follow-up) were 74 weeks (discordant responders) and 118 weeks (concordant responders). A failure to detect 25% of patients with past suicide attempt history in the clinical assessment was associated with older age and concealment of suicidal thoughts.

Keywords:

• assessment
• attempted
• bipolar disorder
• depression
• diagnostic errors
• inpatients
• risk
• suicide

Notes

Note.

^a 2-tailed Fisher's Exact Test.

Additional information

Notes on contributors

Patricio Molero

Patricio Molero, Department of Psychiatry, Division of Molecular Imaging and Neuropathology, Columbia University and New York State Psychiatric Institute, New York, New York, USA.

Michael F. Grunebaum

Michael F. Grunebaum, Department of Psychiatry, Division of Molecular Imaging and Neuropathology, Columbia University and New York State Psychiatric Institute, New York, New York, USA.

Hanga C. Galfalvy

Hanga C. Galfalvy, Department of Psychiatry, Division of Molecular Imaging and Neuropathology, Columbia University and New York State Psychiatric Institute, New York, New York, USA.

Mary A. Bongiovi

Mary A. Bongiovi, Department of Psychiatry, Division of Molecular Imaging and Neuropathology, Columbia University and New York State Psychiatric Institute, New York, New York, USA.

David Lowenthal

David Lowenthal, Department of Psychiatry, Division of Molecular Imaging and Neuropathology, Columbia University and New York State Psychiatric Institute, New York, New York, USA.

M. Goretti Almeida

M. Goretti Almeida, Department of Psychiatry, Division of Molecular Imaging and Neuropathology, Columbia University and New York State Psychiatric Institute, New York, New York, USA.

Ainsley K. Burke

Ainsley K. Burke, Department of Psychiatry, Division of Molecular Imaging and Neuropathology, Columbia University and New York State Psychiatric Institute, New York, New York, USA.

Ellen Stevenson

Ellen Stevenson, Department of Psychiatry, Division of Molecular Imaging and Neuropathology, Columbia University and New York State Psychiatric Institute, New York, New York, USA.

J. John Mann

J. John Mann, Department of Psychiatry, Division of Molecular Imaging and Neuropathology, Columbia University and New York State Psychiatric Institute, New York, New York, USA.

Maria A. Oquendo

Maria A. Oquendo, Department of Psychiatry, Division of Molecular Imaging and Neuropathology, Columbia University and New York State Psychiatric Institute, New York, New York, USA.