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Predicting Planned Suicide Attempts With the Columbia-Suicide Severity Rating Scale

A Subanalysis of the 2013 Korea National Suicide Survey on Emergency Department Visitors

Park, C. Hyung Keun, MD*†; Kim, Hyeyoung, MD†‡; Kim, Bora, MD, MAS§; Kim, Eun Young, MD, PhD*∥; Lee, Hyun Jeong, MD¶#; Kim, Daewook, MD**; Ahn, Yong Min, MD, PhD*†

The Journal of Nervous and Mental Disease: February 2019 - Volume 207 - Issue 2 - p 59–68
doi: 10.1097/NMD.0000000000000921
Original Articles
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Identifying predictors of planned suicide attempts (PSA) is critical because these are associated with grave consequences. Using data of suicide attempters visiting emergency departments, we investigated whether the Columbia-Suicide Severity Rating Scale (C-SSRS) subscales, by retrospectively evaluating ideation before an attempt, could predict the occurrence of PSA versus unplanned suicide attempts using logistic regression analyses. The severity subscale was used as a continuous (model A) and a categorical (model B) variable. In model A, higher scores on each subscale were associated with increased risk of PSA. In model B, the highest score on the severity subscale and a higher intensity subscale score predicted PSA. The severity and intensity subscales had areas under receiver operating curves of 0.712 and 0.688 with optimum cutoff points of 4/5 and 15/16, respectively. In addition, being aged 30 to 49 and 50 to 69 years, being male, interpersonal stress, and depressive and adjustment disorders increased PSA risk. The C-SSRS subscales, along with sociodemographic and clinical risk factors, can predict PSA.

*Department of Neuropsychiatry, Seoul National University Hospital;

Department of Psychiatry and Behavioral Science, Seoul National University College of Medicine, Seoul;

Department of Psychiatry, Inha University Hospital, Incheon, Republic of Korea;

§Department of Psychiatry, UCSF Weill Institute for Neurosciences, University of California, San Francisco, San Francisco, California;

Mental Health Center, Seoul National University Health Care Center, Seoul;

Cancer Survivorship Branch, National Cancer Control Institute;

#Mental Health Clinic, National Cancer Center, Goyang-si, Gyeonggi-do; and

**Department of Psychiatry, Pusan National University Yangsan Hospital, Yangsan-si, Gyeongsangnam-do, Republic of Korea.

Send reprint requests to Yong Min Ahn, MD, PhD, Department of Neuropsychiatry, Seoul National University Hospital, 101 Daehak-ro, Jongno-gu, Seoul 03080, Republic of Korea. E-mail: aym@snu.ac.kr.

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