Evaluating Suicidality Assessment in Adolescents
Author Information
Author(s): Holi Matti Mikael, Pelkonen Mirjami, Karlsson Linnea, Tuisku Virpi, Kiviruusu Olli, Ruuttu Titta, Marttunen Mauri
Primary Institution: Department of Mental Health and Alcohol Research, National Public Health Institute, Helsinki, Finland
Hypothesis
The clinical evaluation might under-detect suicidality compared with the structured assessment performed by trained raters.
Conclusion
There was only a modest agreement between the trained clinicians' suicidality evaluation and the K-SADS evaluation, especially concerning suicidal or self-harming acts.
Supporting Evidence
- The clinicians' classification to class 1 (no suicidal ideation) was 85%, class 2 (suicidal ideation) 50%, and class 3 (suicidal acts) 10%.
- Weighted kappa for the agreement of the measures was 0.335.
- 70% of the subjects were classified identically by the two assessments.
Takeaway
Doctors sometimes miss signs of serious feelings like wanting to hurt oneself in teenagers, so it's important to use special questions to find out how they really feel.
Methodology
Clinicians classified adolescent psychiatric outpatients into three classes of suicidality, which were then compared with classifications from a structured diagnostic interview (K-SADS-PL).
Potential Biases
The clinicians may have under-recognized self-harming behavior due to its complexity and the way it was classified.
Limitations
The study was cross-sectional and limited to an urban outpatient sample, which may not generalize to other populations.
Participant Demographics
The sample consisted of 218 adolescent psychiatric outpatients aged 13-19, with 18% boys and 82% girls.
Statistical Information
P-Value
0.0001
Confidence Interval
0.198–0.471
Statistical Significance
p<0.0001
Digital Object Identifier (DOI)
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