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EMBARGOED UNTIL: November 8, 2011 at 12:01 am EST
Landmark Study Finds Columbia Suicide Severity Rating Scale Predicts Suicide Attempt
Rating scale opens the door for precision in intervention and prevention of suicide among wide spectrum of populations
(New York, NY) – A landmark study led by Columbia Psychiatry researchers has shown that the Columbia Suicide Rating Scale (C-SSRS) is not only valuable in assessing suicidal behavior, but is significantly valuable in predicting an attempt. The paper is scheduled for release at AJP in Advance, the advance edition of The American Journal of Psychiatry, on November 8, 2011.
The Institute of Medicine noted in 2002 the lack of definitions and standardization as one of the major impediments to suicide prevention. Subsequently, the FDA requested a standardized assessment tool for suicidal behavior and selected Columbia Psychiatry researchers to lead that initiative. The study, which builds upon that work, was carried out at three sites with adolescent suicide attempters and adults presenting to the emergency room with psychiatric problems.
Lead author and C-SSRS developer Kelly Posner, PhD, noted, “The results are likely to have tremendous impact both nationally and internationally. Now clinicians have a real scientific footing on which to base treatment interventions.” Before the C-SSRS, researchers and clinicians had no clear way in which to define risk. “Prevention depends upon appropriate screening and identification,” noted Dr. Posner. “In a seminal article in JAMA, Dr. John Mann and colleagues identified this as one of the two most important obstacles to suicide prevention."
“Treatment was initiated at great cost for patients who didn’t need it and increased the burden for clinicians with unnecessary referrals,” she added. “What our study shows is that using the C-SSRS helps to identify patients that would have fallen through the cracks. It’s about saving lives and directing limited resources to the people who actually need them.”
Furthermore, “Fifty percent of suicides see their primary care doctor the month before they die; we should be asking questions about suicide the way we monitor for blood pressure.”
“At a time when multiple populations exhibit high rates of suicidality,” said Jeffrey Lieberman, MD, Chairman of the Department of Psychiatry at Columbia University and Director of the New York State Psychiatric Institute, “it gives us a great deal of hope that those individuals at greatest risk can be identified and treated. The public health benefits in terms of lives saved could be enormous.”
He added, “The benefit of this is that -- in emergency rooms, in clinical settings, in schools, in primary care offices -- this can be used by doctors and medical professionals or people who are trained in it who didn’t have any medical training at all previously, but are trained in the use of the instrument. This can be used to screen individuals and then, if they reach this threshold level of concern, to refer them for further evaluation and possible intervention.”
“Having a proven method to assess suicide risk is a huge step forward in our efforts to save lives,” said Office of Mental Health Commissioner Michael Hogan. “Dr. Posner and her colleagues have established the validity of The Columbia–Suicide Severity Rating Scale (C-SSRS). This is a critical step in putting this tool in the hands of health care providers and others in a position to take steps for safety. We congratulate them on their efforts."
Posner and colleagues’ work over the last 20 years has established the C-SSRS as the definitive assessment tool for suicidal thoughts and behaviors. It is used world-wide in intervention studies and clinical trials across a broad range of disorders and diseases, and by institutions from the US Military to the World Health Organization to local fire departments. Reading Hospital and Medical Center successfully implemented an abbreviated CSSRS into its “clinical suicide screening protocol that is a component of assessment for all patients admitted to the acute care hospital setting.”
Funding for the study was provided by the National Institutes of Health and the American Foundation for Suicide Prevention.
Editor’s note: Broadcast quality video is available.
Columbia University Department of Psychiatry & NYS Psychiatric Institute
Columbia Psychiatry is ranked among the best departments and psychiatric research facilities in the nation and has contributed greatly to the understanding and treatment of psychiatric disorders. Located at the New York State Psychiatric Institute on the NewYork-Presbyterian Hospital/Columbia University Medical Center campus in northern Manhattan, the department enjoys a rich and productive collaborative relationship with physicians in various disciplines at Columbia University’s College of Physician’s and Surgeons. Columbia Psychiatry is home to distinguished clinicians and researchers noted for their clinical and research advances in the diagnosis and treatment of depression, suicide, schizophrenia, bipolar and anxiety disorders, eating disorders, and childhood psychiatric disorders. The 2000 Nobel Laureate Eric Kandel was recognized for research that helped elucidate the cellular processes that underlie learning and memory — contributions that have implications for treating conditions such as Alzheimer’s and age-related memory loss. Columbia Psychiatry’s extraordinary scientific base is supported by more federal grants than any other psychiatry department in the nation.
Visit http://columbiapsychiatry.org/ for more information.