Application of a 5-item brief symptom rating scale to evaluate suicide risk in elderly inpatients

Abstract

Background: Suicide rates among hospital inpatients increase with age. Choosing a simple and appropriate suicide risk assessment tool can assist medical staff to identify high-risk individuals in time, and reduce the inpatient suicide rates. Methods: A total of 1,841 elderly inpatients in the Renji Hospital South Campus, Shanghai Jiaotong University of Medicine from April to August 2020 were randomly selected as the participants for a cross-sectional study. Their conditions were assessed by BSRS-5, Barthel index (BI), and numeric rating scale (NRS). Then, the software SPSS 23.0 (IBM Corp., Armonk, NY, USA) was applied to create a database and statistically analyze the results. Results: According to the BSRS-5 score, 1,825 participants (99.1%) had no suicide risk (0–3 points) and 16 participants (0.9%) had suicide risk (4–24 points). Subsequently, univariate analysis was performed with the BSRS-5 score as the dependent variable and participant gender, age, self-care ability, and pain intensity as independent variables. The results showed that self-care ability (F=3.195, P=0.000) and pain intensity (F=3.247, P=0.001) were the main risk factors for suicide. Finally, to investigate the relationship of suicide risk with self-care ability and pain intensity, the scores of the 3 scales (BSRS-5, BI, NRS) were assigned, and then the data were analyzed by logistic regression. The results showed that self-care ability assignment was statistically significant (P=0.009<0.05, B=−0.657), suggesting that self-care ability score affected the suicide risk in elderly inpatients. Specifically, the weaker their self-care ability, the higher the suicide risk. Conclusions: Suicide prevention strategies should take self-care ability into account, which is a crucial influencing factor of suicide risk in elderly inpatients. The BSRS-5 assessment tool is recommended to assess suicide risk in elderly inpatients, which can then contribute to the establishment of a 3-level safety system for suicide prevention in elderly inpatients.