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比较西班牙语儿科患者的自杀风险筛查策略。

Comparing suicide risk screening strategies in Spanish-speaking pediatric patients.

作者信息

Papávero Eliana Belén, Rodante Demian Emanuel, Ingratta Adriana Virginia, Gorrini Antonio, Ralli Eugenia, Rodante Eliana, Arismendi Mariana, Lowry Nathan J, Ryan Patrick, Bridge Jeffrey A, Horowitz Lisa, Daray Federico Manuel

机构信息

Universidad de Buenos Aires. Facultad de Medicina. Instituto de Farmacología; Hospital General de Niños Pedro de Elizalde, Ciudad de Buenos Aires, Argentina.

Universidad de Buenos Aires. Facultad de Medicina. Instituto de Farmacología; Hospital Neuropsiquiátrico Braulio A. Moyano, Ciudad de Buenos Aires, Argentina.

出版信息

Gen Hosp Psychiatry. 2024 Nov-Dec;91:18-24. doi: 10.1016/j.genhosppsych.2024.08.008. Epub 2024 Aug 17.

Abstract

BACKGROUND

Suicide and suicidal behaviors pose significant global public health challenges, especially among young individuals. Effective screening strategies are crucial for addressing this crisis, with depression screening and suicide-specific tools being common approaches. This study compares their effectiveness by evaluating the Ask Suicide-Screening Questions (ASQ) against item 9 of the Patient Health Questionnaire-A (PHQ-A).

METHODS

This study is a secondary analysis of the Argentinean-Spanish version of the ASQ validation study, an observational, cross-sectional, and multicenter study conducted in medical settings in Buenos Aires, Argentina. A convenience sample of pediatric outpatients/inpatients aged 10 to 18 years completed the ASQ, PHQ-A, and Suicide Ideation Questionnaire (SIQ) along with clinical and sociodemographic questions.

RESULTS

A sample of 267 children and adolescents were included in this secondary analysis. Results show that the ASQ exhibited higher sensitivity (95.1%; 95% CI: 83% - 99%) compared to PHQ-A item 9 (73.1%; 95% CI: 57% - 85%), and superior performance in identifying suicide risk in youth.

LIMITATIONS

The study included a convenience sampling and was geographically restricted to Buenos Aires, Argentina. The study also lacked longitudinal follow-up to assess the predictive validity of these screening tools for suicide risk.

CONCLUSION

The study highlights the ASQ's effectiveness in identifying suicide risk among youth, emphasizing the importance of specialized screening tools over depression screening tools alone for accurate risk assessment in this population.

摘要

背景

自杀及自杀行为给全球公共卫生带来了重大挑战,在年轻人中尤为如此。有效的筛查策略对于应对这一危机至关重要,抑郁症筛查和自杀专项工具是常用方法。本研究通过将自杀筛查问题(ASQ)与患者健康问卷A版(PHQ-A)的第9项进行评估,比较了它们的有效性。

方法

本研究是对ASQ验证研究的阿根廷-西班牙语版本进行的二次分析,这是一项在阿根廷布宜诺斯艾利斯的医疗机构中开展的观察性、横断面多中心研究。一个由10至18岁儿科门诊/住院患者组成的便利样本完成了ASQ、PHQ-A和自杀意念问卷(SIQ),以及临床和社会人口统计学问题。

结果

267名儿童和青少年样本被纳入此次二次分析。结果显示,与PHQ-A第9项(73.1%;95%CI:57%-85%)相比,ASQ表现出更高的敏感性(95.1%;95%CI:83%-99%),并且在识别青少年自杀风险方面表现更优。

局限性

该研究采用便利抽样,且地域上仅限于阿根廷布宜诺斯艾利斯。该研究还缺乏纵向随访以评估这些筛查工具对自杀风险的预测效度。

结论

该研究突出了ASQ在识别青少年自杀风险方面的有效性,强调了对于该人群进行准确风险评估而言,专门的筛查工具比单纯的抑郁症筛查工具更为重要。

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本文引用的文献

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JAMA Netw Open. 2024 Jul 1;7(7):e2423996. doi: 10.1001/jamanetworkopen.2024.23996.
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Validation of the Spanish ASQ translation: Screening pediatric patients for suicide-risk in Argentina.
Gen Hosp Psychiatry. 2023 Nov-Dec;85:191-198. doi: 10.1016/j.genhosppsych.2023.11.001. Epub 2023 Nov 4.
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Validation of the ask suicide-screening questions (ASQ) with youth in outpatient specialty and primary care clinics.
Gen Hosp Psychiatry. 2021 Jan-Feb;68:52-58. doi: 10.1016/j.genhosppsych.2020.11.006. Epub 2020 Nov 13.
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Validation and Feasibility of the ASQ Among Pediatric Medical and Surgical Inpatients.
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