Predictive Validity of the MINI Suicidal Scale for Self-Harm in Acute Psychiatry: A Prospective Study of the First Year after Discharge

Abstract

The aim of the study was to explore the predictive validity of the Suicidal Scale of the Mini-International Neuropsychiatric Interview as a screen for suicidal behavior and non-suicidal self-injury following discharge from an acute psychiatric ward. Using a prospective, naturalistic design, the patients were screened with the Suicidal Scale when discharged (n = 307). At 12 months post-discharge, the Suicidal Scale was a significant predictor of suicidal behavior (n = 48) and suicidal behavior+non-suicidal self-injury (n = 49) but not for non-suicidal self-injury (n = 15). For patients without any known previous suicide attempts (n = 180), the Suicidal Scale was a significant predictor of suicidal behavior (n = 21) and suicidal behavior+non-suicidal self-injury (n = 11). Further research is needed to determine the overall utility of the routine screening of self-harm.

Keywords:

• extramural follow-up
• mental disorders
• non-suicidal self-injury
• screening
• suicidal

Acknowledgments

We gratefully acknowledge the participation of the staff of the psychiatric ward at the Ålesund Hospital. We also thank Mona Skjønberg of the Centre of Research and Education in Forensic Psychiatry at Oslo University Hospital for valuable support and help. The authors have no conflicts of interest to report in relation to the research presented in this manuscript.

Notes

Note.

^a F34.0 and F38.0 not included.

^b Includes excluded patients (n = 77) and drop-outs (n = 104).

^c Emotionally unstable personality disorder (F60.3x) was found in 75% of the patients with a personality disorder.

Note.

^a Items 1-5 experienced during the last month.

^b The percentage of the patients (n = 307) with “yes” score on that item. *p ≤ 0.05, **p ≤ 0.01, ***p ≤ 0.001.

Note.

^a 180 patients with “no” scores on Items 5 and 6 at discharge.

Note.

^a Numbers of patients with scores at different cut-offs.

^b Patients recorded with either suicidal attempts or NSSI (not threats).

^c,d How many times the odds of self-harm ^c increased with a MINI score equal or above cut-off or ^d decreased with a MINI score below cut-off.