Suicide Ideation at Its Worst Point: A Predictor of Eventual Suicide in Psychiatric Outpatients

TLDR

Scales for measuring current suicide ideation (SSI‑C), suicide ideation at its worst point in the patient's life (SSI‑W), and hopelessness (BHS) were administered to 3,701 psychiatric outpatients. In a cohort of 3,701 psychiatric outpatients, the SSI‑W scale predicted eventual suicide with an odds ratio of 13.84, outperforming SSI‑C (5.42) and BHS (6.43), and identified a high‑risk subgroup, prompting recommendations for robust interventions and regular monitoring.

Abstract

Scales for measuring current suicide ideation (SSI‐C), suicide ideation at its worst point in the patient's life (SSI‐W), and hopelessness (BHS) were administered to 3,701 outpatients seeking psychiatric treatment. Thirty patients from this sample eventually committed suicide, within a mean of 4 years from the initial assessment. Based on cut‐off scores derived from receiver operating characteristic (ROC) analyses, the SSI‐W had an odds ratio of 13.84 for predicting suicide, whereas the SSI‐C and the BHS had odds ratios of 5.42 and 6.43, respectively. The assessment of suicide ideation at its worst point identifies a subgroup of patients at relatively high risk for eventual suicide. Robust interventions and periodic monitoring for suicide ideation and hopelessness are recommended to reduce long‐term suicide risk.