http://archpedi.jamanetwork.com/ en-us Sat, 01 Dec 2012 00:00:00 GMT Tue, 01 Jan 2013 00:50:38 GMT Silverchair editor@archpedi.jamanetwork.com webmaster@archpedi.jamanetwork.com http://archpedi.jamanetwork.com/article.aspx?articleID=1363508 Sat, 01 Dec 2012 00:00:00 GMT Horowitz LM, Bridge JA, Teach SJ, et al. <span class="paragraphSection"><div class="boxTitle">Objective</div>To develop a brief screening instrument to assess the risk for suicide in pediatric emergency department patients.<div class="boxTitle">Design</div>A prospective, cross-sectional instrument-development study evaluated 17 candidate screening questions assessing suicide risk in young patients. The Suicidal Ideation Questionnaire served as the criterion standard.<div class="boxTitle">Setting</div>Three urban, pediatric emergency departments associated with tertiary care teaching hospitals.<div class="boxTitle">Participants</div>A convenience sample of 524 patients aged 10 to 21 years who presented with either medical/surgical or psychiatric chief concerns to the emergency department between September 10, 2008, and January 5, 2011.<div class="boxTitle">Main Exposures</div>Participants answered 17 candidate questions followed by the Suicidal Ideation Questionnaire.<div class="boxTitle">Main Outcome Measures</div>Sensitivity, specificity, predictive values, likelihood ratios, and area under the receiver operating characteristic curves of the best-fitting combinations of screening questions for detecting elevated risk for suicide.<div class="boxTitle">Results</div>A total of 524 patients were screened (344 medical/surgical and 180 psychiatric). Fourteen of the medical/surgical patients (4%) and 84 of the psychiatric patients (47%) were at elevated suicide risk on the Suicidal Ideation Questionnaire. Of the 17 candidate questions, the best-fitting model comprised 4 questions assessing current thoughts of being better off dead, current wish to die, current suicidal ideation, and past suicide attempt. This model had a sensitivity of 96.9% (95% CI, 91.3-99.4), specificity of 87.6% (95% CI, 84.0-90.5), and negative predictive values of 99.7% (95% CI, 98.2-99.9) for medical/surgical patients and 96.9% (95% CI, 89.3-99.6) for psychiatric patients.<div class="boxTitle">Conclusions</div>A 4-question screening instrument, the Ask Suicide-Screening Questions (ASQ), with high sensitivity and negative predictive value, can identify the risk for suicide in patients presenting to pediatric emergency departments.</span> 166 12 1170 1176 10.1001/archpediatrics.2012.1276 http://archpedi.jamanetwork.com/article.aspx?articleID=1363508