IDENTIFYING SUICIDAL IDEATION IN GENERAL MEDICAL PATIENTS

  • Cooper-Patrick L
  • CRUM R
  • FORD D
 et al. 
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Abstract

Objectives.-To describe characteristics of general medical patients with
suicidal ideation and to develop an efficient clinical strategy for
identifying these patients.
Design.-Cross-sectional analysis of data without intervention.
Setting.-A representative sample of community respondents interviewed as
part of the National Institute of Mental Health Epidemiologic Catchment
Area surveys. Subjects.-A total of 6041 individuals who reported
receiving care in general medical settings in the 6 months preceding the
baseline interview.
Main Outcome Measure.-Suicidal ideation within the year preceding the
baseline interview.
Results.-A total of 154 patients(2.6%) had experienced suicidal
thoughts within the previous year. In multivariate analyses, the
following sociodemographic factors were significantly associated with
having suicidal ideation: being white (odds ratio {[}OR], 2.8; Prelative to African American, separated or divorced (OR, 1.8; P=.03)
relative to married, and aged 18 to 30 years (OR, 2.3; P=.02) or aged 31
to 50 years (OR, 2.1; P=.03) relative to those older than 65 years.
Gender, educational level, and socioeconomic status were not
statistically associated with suicidal ideation. Psychiatric disorders
significantly associated with suicidal ideation were major depression
(OR, 10.3; P(OR, 2.0; P=.04), and phobic disorder (OR, 1.6; P=.02) within the
previous year. However, only 34% of respondents with suicidal ideation
met criteria for major depression. With the aid of stepwise logistic
regression, a four-item screening questionnaire, the Suicidal Ideation
Screening Questionnaire, was developed to predict patients with suicidal
ideation. Likelihood ratios for suicidal ideation increased from 0.21 to
32.8 with more positive responses to questions concerning symptoms of
hopelessness, guilt, depressed mood, and sleep disturbances.
Conclusions.-If the results from the four-item screen are reproduced in
a clinical setting, general medical patients with a high likelihood for
suicidal ideation may be identified with a brief screening
questionnaire. This screen would have greater sensitivity than would be
achieved by assessing suicidal ideation only in those patients who meet
criteria for a distinct psychiatric disorder.

Author-supplied keywords

  • Adult
  • Aged
  • Cross-Sectional Studies
  • Family Practice/*statistics & numerical data
  • Female
  • Humans
  • Likelihood Functions
  • Logistic Models
  • Male
  • Mental Disorders/*diagnosis
  • Mental Disorders/epidemiology
  • Middle Aged
  • Multivariate Analysis
  • Socioeconomic Factors
  • Suicide/*psychology
  • Suicide/statistics & numerical data

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Authors

  • L Cooper-Patrick

  • R M CRUM

  • D E FORD

  • L COOPERPATRICK

  • R M CRUM

  • D E FORD

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