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The Predictive Validity of the Beck Depression Inventory Suicide Item
Abstract
OBJECTIVE: The current study examines the predictive validity of the Beck Depression Inventory (BDI) suicide item for death by suicide and suicide attempts. METHOD: The study included 2 samples: (1) 5,200 psychiatric outpatients who were evaluated between 1975 and 1995 and followed prospectively for up to 20 years (all psychiatric diagnoses based on DSM-III and DSM-III-R), and (2) 119 patients who, between 2000 and 2004, participated in a randomized controlled trial of outpatient Cognitive Therapy for Suicide Prevention after a suicide attempt and were followed for 18 months (all psychiatric diagnoses based on DSM-IV-TR). All patients completed structured diagnostic interviews, as well as the BDI and Scale for Suicide Ideation. RESULTS: Cox regression models demonstrated that the BDI suicide item significantly predicted both deaths by suicide (Wald χ(2)1 = 35.67; P < .001 [N = 5,200]) and repeat suicide attempts (Wald χ(2)1 = 8.82; P < .01 [N = 119]), with each successive rating on the item conferring greater risk. Using receiver operating characteristic (ROC) curves, optimal cutoff scores of 1 and above for suicide and 2 and above for suicide attempts were identified as providing the best balance between sensitivity and specificity. CONCLUSIONS: The BDI suicide item is associated with both risk of repeat suicide attempts and death by suicide. The use of the item as a brief, efficient screen for suicide risk in routine clinical care is recommended. Clinicians would then conduct a comprehensive suicide risk assessment in response to a positive screen. Future research examining the item's performance in other at-risk groups (ie, older adults, adolescents, inpatients, etc) is encouraged.
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“A single item assesses suicide ideation (item no. 9) and has been considered an efficient screening tool for suicide risk in clinical settings [27].”
From High depression symptomatology and mental pain characterize suicidal psychiatric patients (2022) · cites this paper as [27]
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Metadata
- Authors
- Green, K. L., Brown, G. K., Jager-Hyman, S., Cha, J., Steer, R. A., & Beck, A. T.
- Affiliations
- University of Pennsylvania (US)
- Venue
- The Journal of Clinical Psychiatry
- Publisher
- Physicians Postgraduate Press, Inc
- Published
- 2015-12-23
- Volume
- 76
- Issue
- 12
- Pages
- 1683-1686
- ISSN
- 0160-6689 (ISSN-L)
- OpenAlex
- W2230776822
- Cited by
- 162
- References
- 0
- Citations by year
- 2026: 12 · 2025: 17 · 2024: 12 · 2023: 22 · 2022: 25 · 2021: 16 · 2020: 13 · 2019: 15 · 2018: 14 · 2017: 8 · 2016: 5 · 2015: 2
- FWCI
- 12.00
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- The Journal of Clinical Psychiatry (publishedVersion)
- PubMed (publishedVersion)
- Funders
- National Institute of Mental Health (T32 MH083745, R37 MH 47383, R01MH067805, T32MH082745, R37MH047383)
- Topics
- Social Sciences › Psychology › Clinical Psychology › Suicide and Self-Harm Studies
- Social Sciences › Psychology › Experimental and Cognitive Psychology › Anxiety, Depression, Psychometrics, Treatment, Cognitive Processes
- Social Sciences › Psychology › Social Psychology › Mental Health via Writing
- Keywords
- Beck Depression Inventory, predictive validity, suicide risk screening, suicide attempts, suicide risk assessment, psychiatric outpatients, cut-off values
- MeSH terms
- Adult, Female, Follow-Up Studies, Humans, Male, Middle Aged, Mortality, Predictive Value of Tests, Psychiatric Status Rating Scales, Risk, Suicide, Suicide, Attempted, Reproducibility of Results, Proportional Hazards Models, Young Adult
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