Identifying Suicide Risk in Adolescents and Young Adults With Type 1 Diabetes: Are Depression Screeners Sufficient?

Abstract

OBJECTIVE Examine the utility of suicide-risk items embedded within depression screeners for identifying the presence of suicide risk in adolescents and young adults (AYA) with type 1 diabetes. RESEARCH DESIGN AND METHODS Sensitivity, specificity, and predictive value of self-report of suicide risk on the Patient Health Questionniaire-9 (PHQ-9) were compared with the pediatric psy-chologist–administered Columbia-Suicide Severity Rating Scale (C-SSRS) as the reference standard for AYA with type 1 diabetes seen in a multidisciplinary AYA Diabetes Program clinic. RESULTS Of 133 participants, 9.8% and 11.3% reported suicide risk on the PHQ-9 and C-SSRS, respectively. Sensitivity of the PHQ-9 risk item was 53.3% (95% CI 27.4%–77.7%), specificity was 95.7% (95% CI 89.9%–98.4%), positive predictive value was 61.5% (95% CI 32.3%–84.9%), and negative predictive value was 94.2% (95% CI 87.9–97.4%). CONCLUSIONS Depression screeners appear to under-identify AYA with type 1 diabetes who may otherwise be at risk for suicide.