Magazine article Clinical Psychiatry News

Automated Screenings Might Detect Suicidality

Magazine article Clinical Psychiatry News

Automated Screenings Might Detect Suicidality

Article excerpt


LOS ANGELES -- About half of trauma patients report suicidal ideation within a year of their injury, and about 20% do so at any given time during that year, according to an investigation of 206 patients at Harborview Medical Center, the University of Washington's Level I trauma center in Seattle.

A patient's ties to assault and some of the other risk factors identified in the study could be spotted automatically by electronic medical records (EMR) systems.

With a few programming tweaks, records systems can alert clinicians to those most likely to be considering suicide so preventive steps can be taken, said lead investigator Stephen S. O'Connor, Ph.D., formerly of the University of Washington, and now with the department of psychological sciences at Western Kentucky University, in Bowling Green.

"We feel that this is a really pressing need. Suicidality is endemic within the trauma population, and a lot of it is under the radar." An automated screening system might prevent suicidal people from falling through the cracks amid the tumult of trauma and follow-up care, he said at the annual conference of the American Association of Suicidology.

At some point during the 12-month investigation, 101 (49%) patients acknowledged that they had thought they'd be better off dead or had thought about hurting themselves, as assessed by the Patient Health Questionnaire-9.

About 26% admitted to those feelings while in the hospital, and the number dipped only moderately during regular, semimonthly reassessments, with 18% of the sample acknowledging suicidal thoughts at month 12.

While in the hospital, suicidal ideation was predicted by a previous mental health visit (relative risk, 1.89; 95% confidence interval, 1.02-3.5; P = .04); total score on the Personal Health Questionnaire Depression Scale-8 (RR ,1.12; 95% CI 1.07-1.19; P less than .001); and general mental health function on the Short Form Health Survey-12 (RR, 0.98; 95% CI 0.97-1.00; P = .04).

There was also a nonsignificant trend for injury severity.

Having children was protective (RR, 0.55; 95% CI 0.35-0.85; P = .01).

After discharge, patients who had been assaulted were most likely to be considering suicide (RR 2.03; 95% CI 1.28-3.20; P less than 0. …

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