Poudel Daman R, Sharma Arun K, Chapagain Ram H, Chapagai Manisha, Lowry Nathan J, Sigdel Mahesh R, Bista Krishna P, Pathak Rahul, Kunwar Arun, Patterson Janna, Carter Terrell, Horowitz Lisa M
Tribhuvan University Teaching Hospital, Institute of Medicine, Kathmandu, Nepal.
Nepal Paediatrics Society, Kathmandu, Nepal.
BMC Psychiatry. 2025 Jul 22;25(1):719. doi: 10.1186/s12888-025-07148-w.
Nepal has one of the highest youth suicide rates in the world. Suicide screening is rarely performed during hospitalization, partly due to the lack of validated tools in the local language. We evaluated the validity of the Nepali version of the Ask Suicide-Screening Questions (ASQ) tool in youth population in medical inpatient settings.
We conducted a cross-sectional validation study at two urban hospitals in Nepal between January and July 2022. Patients aged 10 to 24 years admitted to medical wards were recruited through convenience sampling. Patients with significant cognitive impairment, non-fluent in Nepali, or planned early discharge limiting participation were excluded. Trained nurses administered the ASQ followed by the adolescent version of Patient Health Questionnaire (PHQ - 9) and completed a demographic survey. Thereafter a separate team of psychologists, blind to ASQ results, conducted a brief suicide safety assessment (BSSA) as the gold standard for suicide risk screening.
All study procedures were completed by 309 [54.0% male, mean age = 15.79(± 4.2) years] participants and were included in analysis. In our sample, 15.9% (49/309) screened positive with ASQ; 8.4% (26/309) had elevated suicide risk on the BSSA. The ASQ demonstrated good sensitivity (77%; 95% CI: 56-91), specificity (90%; 95% CI: 86-93), positive predictive value (41%; 95% CI: 27-56) and negative predictive value (98%; 95% CI: 95-99) against BSSA.
The Nepali version of ASQ is a good, brief screening tool for identifying suicidal risk. Further validation in wider populations including outpatient setting and routine implementation in clinical practice should be considered.
尼泊尔是世界上青少年自杀率最高的国家之一。住院期间很少进行自杀筛查，部分原因是缺乏当地语言的有效工具。我们评估了尼泊尔语版的自杀筛查问题（ASQ）工具在医学住院患者中的有效性。
2022年1月至7月，我们在尼泊尔的两家城市医院进行了一项横断面验证研究。通过便利抽样招募入住内科病房的10至24岁患者。排除有严重认知障碍、尼泊尔语不流利或计划提前出院限制参与的患者。经过培训的护士进行ASQ评估，随后进行青少年版患者健康问卷（PHQ - 9）评估，并完成人口统计学调查。此后，一个对ASQ结果不知情的心理学家团队进行了简短的自杀安全评估（BSSA），作为自杀风险筛查的金标准。
309名参与者[54.0%为男性，平均年龄 = 15.79（±4.2）岁]完成了所有研究程序并纳入分析。在我们的样本中，15.9%（49/309）的ASQ筛查呈阳性；8.4%（26/309）在BSSA中自杀风险升高。与BSSA相比，ASQ显示出良好的敏感性（77%；95%CI：56 - 91）、特异性（90%；95%CI：86 - 93）、阳性预测值（41%；95%CI：27 - 56）和阴性预测值（98%；95%CI：95 - 99）。
尼泊尔语版的ASQ是一种用于识别自杀风险的良好的简短筛查工具。应考虑在更广泛的人群中进一步验证包括门诊环境，并在临床实践中进行常规实施。
