Department of Psychosocial Research, Butler Hospital, Warren Alpert Medical School of Brown University, Providence, Rhode Island, USA.
Department of Emergency Medicine, University of Massachusetts Medical School, Worcester, Massachusetts, USA.
Suicide Life Threat Behav. 2020 Dec;50(6):1097-1104. doi: 10.1111/sltb.12657. Epub 2020 Jul 24.
To evaluate the psychometric and predictive performance of the Columbia-Suicide Severity Rating Scale (C-SSRS) in emergency department (ED) patients with suicidal ideation or attempts (SI/SA).
Participants (n = 1,376, mean age 36.8, 55% female, 76.8% white) completed the C-SSRS during the ED visit and were followed for one year. Reliability analyses, exploratory structural equation modeling, and prediction of future SA were explored.
Reliability of the Suicidal Ideation subscale was adequate, but was poor for the Intensity of Ideation and Suicidal Behavior subscales. Three empirically derived factors characterized the C-SSRS. Only Factor 1 (Suicidal Ideation and Attempts) was a reliable predictor of subsequent SA, though odds ratios were small (ORs: 1.09-1.10, CI : 1.04, 1.15). The original C-SSRS Suicidal Ideation and Suicidal Behavior subscales and the C-SSRS ED screen predicted subsequent SA, again with small odds ratios (ORs: 1.07-1.19, CI : 1.01, 1.29). In participants without a SA history, no C-SSRS subscale predicted subsequent SA. History of any SA (OR: 1.98, CI : 1.43, 2.75) was the strongest predictor of subsequent SA.
The psychometric evidence for the C-SSRS was mixed. History of a prior SA, as measured by the C-SSRS, provided the most parsimonious and powerful assessment for predicting future SA.
评估哥伦比亚-自杀严重程度评定量表（C-SSRS）在有自杀意念或尝试（SI/SA）的急诊科（ED）患者中的心理计量学和预测性能。
参与者（n=1376，平均年龄 36.8，55%为女性，76.8%为白人）在 ED 就诊期间完成了 C-SSRS，并在一年后进行了随访。探索了可靠性分析、探索性结构方程建模和对未来 SA 的预测。
自杀意念子量表的可靠性是足够的，但意念强度和自杀行为子量表的可靠性较差。C-SSRS 有三个经验衍生的因素。只有因子 1（自杀意念和尝试）是未来 SA 的可靠预测因素，尽管优势比很小（ORs：1.09-1.10，CI：1.04，1.15）。原始的 C-SSRS 自杀意念和自杀行为子量表以及 C-SSRS ED 筛查预测了随后的 SA，优势比也很小（ORs：1.07-1.19，CI：1.01，1.29）。在没有 SA 病史的参与者中，没有 C-SSRS 子量表预测随后的 SA。任何 SA 病史（OR：1.98，CI：1.43，2.75）是预测随后 SA 的最强预测因素。
C-SSRS 的心理计量学证据好坏参半。C-SSRS 测量的既往 SA 史提供了预测未来 SA 的最简洁和最有力的评估。
