Mayes Taryn L, Killian Michael, Rush A John, Emslie Graham J, Carmody Thomas, Kennard Betsy D, Jha Manish K, King Jessica, Hughes Jennifer L, Trivedi Madhukar H
Department of Psychiatry, UT Southwestern Medical Center, 5323 Harry Hines Boulevard, Dallas, TX, 75390, USA.
College of Social Work, Florida State University 296 Champions Way, Tallahassee, FL, 32304, Children's Medical Center of Dallas, USA.
J Psychiatr Res. 2020 Jul;126:19-25. doi: 10.1016/j.jpsychires.2020.04.008. Epub 2020 May 5.
Several self-report rating scales have been developed to assess suicidal ideation, yet most have limited utility in predicting future suicide attempts. This is particularly critical in adolescence, where suicide is the second leading cause of death. This study evaluated the Concise Health Risk Tracking Self-Report (CHRT-SR) as a prospective predictor of suicide attempts and events in high-risk adolescents enrolled in a suicide-prevention intensive outpatient program (IOP).
Data were collected by retrospective chart review of adolescents treated in IOP for youth with severe suicidality. At baseline, youth completed the 14-item CHRT-SR (CHRT-SR), which assesses suicide risk based on 3 subscales: Propensity, Impulsivity, and Suicidal Thoughts. Two outcomes were assessed: actual suicide attempts and suicidal events (suicide attempt, inpatient hospitalization, or emergency department visit) during the IOP.
Of the 251 adolescents who completed the baseline CHRT-SR, 26 had a suicidal event during IOP (mean time in IOP: 5.4 ± 2.3 weeks), of whom 14 had an actual suicide attempt. Youth with any suicidal event had higher scores than those without an event on the CHRT-SR Total (p = .005), Propensity (p = .008), and Suicidal Thoughts (p = .001) scales at baseline. Youth who made a suicide attempt had significantly higher scores than those without an event for the Total Score, Propensity, and Suicidal Thoughts subscales. CHRT-SR Total Score of 28 had a sensitivity of 85.7% and specificity of 56.5% in predicting suicide attempts. A score of 22 predicted suicidal events, with a sensitivity of 80.8% and specificity of 40.9%. CHRT-SR Total Score of 12 predicted suicide attempts, with a sensitivity of 85.7% and specificity of 53.4%.
The CHRT-SR self-report predicts suicide attempts and events with at least 80% sensitivity and acceptable specificity in adolescents at high-risk for suicide.
已开发出几种自我报告评定量表来评估自杀意念，但大多数在预测未来自杀未遂方面效用有限。这在青少年中尤为关键，因为自杀是青少年第二大死因。本研究评估了简明健康风险追踪自我报告（CHRT-SR）作为参加自杀预防强化门诊项目（IOP）的高危青少年自杀未遂及相关事件的前瞻性预测指标。
通过对在IOP接受治疗的有严重自杀倾向青少年的病历进行回顾性审查来收集数据。在基线时，青少年完成14项CHRT-SR，该量表基于3个分量表评估自杀风险：倾向、冲动性和自杀念头。评估了两个结局：IOP期间的实际自杀未遂和自杀相关事件（自杀未遂、住院或急诊就诊）。
在完成基线CHRT-SR的251名青少年中，26名在IOP期间发生了自杀相关事件（IOP平均时长：5.4±2.3周），其中14名有实际自杀未遂行为。发生任何自杀相关事件的青少年在基线时CHRT-SR总分（p = 0.005）、倾向分量表（p = 0.008）和自杀念头分量表（p = 0.001）上的得分高于未发生事件的青少年。有自杀未遂行为的青少年在总分、倾向分量表和自杀念头分量表上的得分显著高于未发生事件的青少年。CHRT-SR总分28分在预测自杀未遂方面的敏感性为85.7%，特异性为56.5%。22分可预测自杀相关事件，敏感性为80.8%，特异性为40.9%。CHRT-SR总分12分可预测自杀未遂，敏感性为85.7%，特异性为53.4%。
CHRT-SR自我报告在自杀高危青少年中预测自杀未遂及相关事件时敏感性至少为80%，特异性可接受。
