Prevalence of suicidality in asymptomatic adolescents in the paediatric emergency department and utility of a screening tool.

OBJECTIVE

Many authorities recommend screening adolescents for risk of suicide. The ED is a potential setting for such screening. The aim of this study is to explore the use of the Risk of Suicide Questionnaire (RSQ) as a screening tool for suicidality in patients who come to the ED without mental health concerns and without recent mental health history. The Suicide Ideation Questionnaire (SIQ) was the comparison standard.

METHODS

A cross-sectional convenience sample of overtly psychiatrically asymptomatic adolescents presenting to a large paediatric ED underwent both the RSQ and SIQ. Adolescents with positive screens underwent formal assessment by mental health practitioners.

RESULTS

Two hundred and one patients were identified and 110 consented to participate. One hundred participants completed both questionnaires. Twenty-two per cent of participants had positive RSQ (95% CI 14-31%). No adolescent yielded a positive SIQ: prevalence of suicidality was 0.0% (95% CI 0.0-3.6%). No participant showed suicidal ideation on formal review. One question in the RSQ - 'Has something very stressful happened to you in the past few weeks?' - accounted for the majority of false positive screens.

CONCLUSION

The prevalence of suicidal ideation in asymptomatic patients presenting to this paediatric ED is very low. Using this selection method, the RSQ could not be validated, but would be unlikely to be suitable for screening this low-risk population with a high false positive rate.