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Validation of the Chinese SAD PERSONS Scale to predict repeated self-harm in emergency attendees in Taiwan.
BMC Psychiatry. 2014 Feb 17; 14:44.BP

Abstract

BACKGROUND

Past and repeated self-harm are long-term risks to completed suicide. A brief rating scale to assess repetition risk of self-harm is important for high-risk identification and early interventions in suicide prevention. The study aimed to examine the validity of the Chinese SAD PERSONS Scale (CSPS) and to evaluate its feasibility in clinical settings.

METHODS

One hundred and forty-seven patients with self-harm were recruited from the Emergency Department and assessed at baseline and the sixth month. The controls, 284 people without self-harm from the Family Medicine Department in the same hospital were recruited and assessed concurrently. The psychometric properties of the CSPS were examined using baseline and follow-up measurements that assessed a variety of suicide risk factors. Clinical feasibility and applicability of the CSPS were further evaluated by a group of general nurses who used case vignette approach in CSPS risk assessment in clinical settings. An open-ended question inquiring their opinions of scale adaptation to hospital inpatient assessment for suicide risks were also analyzed using content analysis.

RESULTS

The CSPS was significantly correlated with other scales measuring depression, hopelessness and suicide ideation. A cut-off point of the scale was at 4/5 in predicting 6-month self-harm repetition with the sensitivity and specificity being 65.4% and 58.1%, respectively. Based on the areas under the Receiver Operating Characteristic curves, the predictive validity of the scale showed a better performance than the other scales. Fifty-four nurses, evaluating the scale using case vignette found it a useful tool to raise the awareness of suicide risk and a considerable tool to be adopted into nursing care.

CONCLUSIONS

The Chinese SAD PERSONS Scale is a brief instrument with acceptable psychometric properties for self-harm prediction. However, cautions should be paid to level of therapeutic relationships during assessment, staff workload and adequate training for wider clinical applications.

Authors+Show Affiliations

No affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableDepartment of Medical Research, Mackay Memorial Hospital, Taipei, Taiwan. maryliuyip@gmail.com.

Pub Type(s)

Journal Article
Research Support, Non-U.S. Gov't
Validation Study

Language

eng

PubMed ID

24533537

Citation

Wu, Chia-Yi, et al. "Validation of the Chinese SAD PERSONS Scale to Predict Repeated Self-harm in Emergency Attendees in Taiwan." BMC Psychiatry, vol. 14, 2014, p. 44.
Wu CY, Huang HC, Wu SI, et al. Validation of the Chinese SAD PERSONS Scale to predict repeated self-harm in emergency attendees in Taiwan. BMC Psychiatry. 2014;14:44.
Wu, C. Y., Huang, H. C., Wu, S. I., Sun, F. J., Huang, C. R., & Liu, S. I. (2014). Validation of the Chinese SAD PERSONS Scale to predict repeated self-harm in emergency attendees in Taiwan. BMC Psychiatry, 14, 44. https://doi.org/10.1186/1471-244X-14-44
Wu CY, et al. Validation of the Chinese SAD PERSONS Scale to Predict Repeated Self-harm in Emergency Attendees in Taiwan. BMC Psychiatry. 2014 Feb 17;14:44. PubMed PMID: 24533537.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Validation of the Chinese SAD PERSONS Scale to predict repeated self-harm in emergency attendees in Taiwan. AU - Wu,Chia-Yi, AU - Huang,Hui-Chun, AU - Wu,Shu-I, AU - Sun,Fang-Ju, AU - Huang,Chiu-Ron, AU - Liu,Shen-Ing, Y1 - 2014/02/17/ PY - 2013/10/03/received PY - 2014/02/10/accepted PY - 2014/2/19/entrez PY - 2014/2/19/pubmed PY - 2014/12/15/medline SP - 44 EP - 44 JF - BMC psychiatry JO - BMC Psychiatry VL - 14 N2 - BACKGROUND: Past and repeated self-harm are long-term risks to completed suicide. A brief rating scale to assess repetition risk of self-harm is important for high-risk identification and early interventions in suicide prevention. The study aimed to examine the validity of the Chinese SAD PERSONS Scale (CSPS) and to evaluate its feasibility in clinical settings. METHODS: One hundred and forty-seven patients with self-harm were recruited from the Emergency Department and assessed at baseline and the sixth month. The controls, 284 people without self-harm from the Family Medicine Department in the same hospital were recruited and assessed concurrently. The psychometric properties of the CSPS were examined using baseline and follow-up measurements that assessed a variety of suicide risk factors. Clinical feasibility and applicability of the CSPS were further evaluated by a group of general nurses who used case vignette approach in CSPS risk assessment in clinical settings. An open-ended question inquiring their opinions of scale adaptation to hospital inpatient assessment for suicide risks were also analyzed using content analysis. RESULTS: The CSPS was significantly correlated with other scales measuring depression, hopelessness and suicide ideation. A cut-off point of the scale was at 4/5 in predicting 6-month self-harm repetition with the sensitivity and specificity being 65.4% and 58.1%, respectively. Based on the areas under the Receiver Operating Characteristic curves, the predictive validity of the scale showed a better performance than the other scales. Fifty-four nurses, evaluating the scale using case vignette found it a useful tool to raise the awareness of suicide risk and a considerable tool to be adopted into nursing care. CONCLUSIONS: The Chinese SAD PERSONS Scale is a brief instrument with acceptable psychometric properties for self-harm prediction. However, cautions should be paid to level of therapeutic relationships during assessment, staff workload and adequate training for wider clinical applications. SN - 1471-244X UR - https://www.unboundmedicine.com/medline/citation/24533537/Validation_of_the_Chinese_SAD_PERSONS_Scale_to_predict_repeated_self_harm_in_emergency_attendees_in_Taiwan_ L2 - https://bmcpsychiatry.biomedcentral.com/articles/10.1186/1471-244X-14-44 DB - PRIME DP - Unbound Medicine ER -