https://orcid.org/0000-0003-1394-9904
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Abstract
Objective
Discrepancies between patient reports during clinical evaluations and self-reported suicide ideation are of vital importance. We study the agreement in passive suicidal ideation between reports made by clinicians and patients’ self-reports.
Method
Wish of death in 648 outpatients was assessed by attending clinicians. Within 24 h after clinical evaluation, patients completed a self-report questionnaire in which they were asked whether they had no desire to live. We used cluster analysis to determine the clinical profile of a population of patients according to the concordance between reports made by clinicians and self-reported information.
Results
A low level of agreement (kappa = 0.072) was found between clinicians and patients, as 56.4% (n = 366) of clinician reports classified as containing no death-related ideas although on self-report the patient did state that they had no desire to live. In this group containing discrepancies between the two reports, two clusters were found to have shared characteristics: female sex, middle age, cohabitation, active employment, no history of suicidal behavior, and diagnosis of neurotic, stress-related, and somatoform disorders. In a third, more severe cluster, patients self-reported sleep disturbances, less appetite, poor treatment adherence, and aggressiveness.
Conclusions
We found low agreement between self-reports and clinician assessments regarding the death wish. Self-reporting may be useful in assessing suicide risk.
Low agreement was found between self-reports and clinician assessments regarding passive suicidal ideation.
Most patients in whom the clinician underestimated the risk of suicide were women.
Our results suggest that clinicians require adequate documentation of suicidal risk assessment to identify the high-risk population.
HIGHLIGHTS
ETHICAL APPROVAL
The study was carried out in compliance with the Declaration of Helsinki and approved by the local ethics committee. All participants gave written informed consent after receiving a complete description of the study. Data protection was guaranteed according to legal standards as in previous work by our group.
ACKNOWLEDGMENTS
The authors acknowledge Oliver Shaw, who helped in editing this article.
DISCLOSURE STATEMENT
No potential conflict of interest was reported by the author(s).
AUTHOR CONTRIBUTIONS
Enrique Baca-García designed the MEmind application. Constanza Vera-Varela & Paulo César Manrique Mirón contributed equally to study conception and design, writing original draft, and analyzing the results. María Luisa Barrigón performed writing original draft and analyzing the results. Raquel Álvarez-García performed supervision, Pablo Portillo performed an interpretation of the findings and critical revision of the manuscript. Jaime Chamorro performed visualization and editing. MEmind Study Group contributed collecting data. Enrique Baca-García contributed with definitions of the study design, interpretation of results, and in the final version of the manuscript. All authors contributed to the article, revised and approved the final manuscript.
AUTHOR NOTES
Constanza Vera-Varela, Centro San Juan de Dios, Ciempozuelos, Madrid, Spain.
Paulo César Manrique Mirón, Cátedra-Conacyt. Unidad Cuernava Instituto de Matemáticas, UNAM, Cuernavaca, México.
María Luisa Barrigón, Department of Psychiatry, Jimenez Diaz Foundation. Madrid, Spain; Department of Psychiatry, Autónoma University, Madrid, Spain.
Raquel Álvarez-García and Pablo Portillo, Department of Psychiatry, Rey Juan Carlos University Hospital, Móstoles, Spain.
Jaime Chamorro, Department of Psychiatry, Jimenez Diaz Foundation. Madrid, Spain.
Enrique Baca-García, Department of Psychiatry, Fundación Jiménez Díaz Hospital, Madrid, Spain; Department of Psychiatry, Autónoma University, Madrid, Spain; Department of Psychiatry, Rey Juan Carlos University Hospital, Móstoles, Spain; Department of Psychiatry, General Hospital of Villalba, Madrid, Spain; Department of Psychiatry, Infanta Elena University Hospital, Valdemoro, Spain; Universidad Católica del Maule, Talca, Chile; Department of psychiatry, Centre Hospitalier Universitaire de Nîmes.
DATA AVAILABILITY STATEMENT
Data that support the findings of this study are available on request from the corresponding author. The data are not publicly available due to privacy or ethical restrictions.