Magazine article Clinical Psychiatry News

Suicide Risk Significant among Screened Nonresponders

Magazine article Clinical Psychiatry News

Suicide Risk Significant among Screened Nonresponders

Article excerpt


SAN FRANCISCO -- Teens who answered "no response" for one or more questions during a standard suicide screening in the ED typically have a risk of suicide nearly on par with those who answered "yes" to at least one question, results of a study showed.

"Risk for suicidality was substantial among both groups," Tricia Hengehold of the University of Cincinnati reported at the Pediatric Academic Societies meeting. 'About half of each group fit the medium-risk category, although the yes group had more teens in the high-risk category comparatively."

Although suicide is the second leading cause of teen death in the United States and those at risk for suicide present to the ED more often than those who aren't at risk, most EDs do not routinely screen adolescents for suicide, Ms. Hengehold said.

In their study, she and her coinvestigators compared all teens who answered yes or no response (NR) to any question on the Ask Suicide-Screening Questions (ASQ). A total of 3,386 adolescents, aged 12-17 years, were screened when each presented to the ED with a complaint other than a psychiatric one. The data came from a preexisting study not initially designed for studying nonresponders.

The majority of teens (93%) answered no to all ASQ questions: 5% answered yes to at least one ASQ question, regardless of other answers, and 2% answered no response on at least one of the ASQ questions, but did not answer yes to any of them.

The average age of participants was 14 years among all response groups, but females were overrepresented in the yes and NR groups: 74% of females answered yes to one of the ASQ questions, compared with just 26% of males. Similarly, 79% of females were classified as nonresponders, vs. 21% of males. In the negative screen group, however, females (54%) and males (46%) were much more evenly represented.

Patients who answered yes or NR also were more likely to have Medicaid or Medicare than commercial insurance or a self-pay arrangement. Within the yes group, 56% had public insurance, and 39% had private insurance. In the NR group, 43% had public insurance, and 53% had private insurance.

Any teens who answered yes or NR should have undergone evaluation by a mental health professional, but those answering yes were more likely to get this evaluation than nonresponders. Nearly all (93%) of those answering yes received the evaluation, compared with 79% of nonresponders. …

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