title: The Columbia Suicide Screen: validity and reliability of a screen for youth suicide and depression.
abstract: OBJECTIVE
  This study reports on the psychometric properties of a brief, self-administered screening questionnaire, the Columbia Suicide Screen (CSS), intended to identify high school students at risk for suicide.
  
  
  METHODS
  Seventeen hundred twenty-nine 9th- to 12th-grade students completed the CSS and Beck Depression Inventory during school hours in 1991 to 1994. Three hundred fifty-six students who screened positively and 285, group matched on age, gender, and ethnicity, who screened negatively were examined on the Diagnostic Interview Schedule for Children (DISC), version 2.3, to assess validity. The DISC-based suicide risk criterion was suicidal ideation or prior suicide attempt and a DSM-III-R diagnosis of major depression or dysthymia or substance use. Test-retest reliability was assessed in a subsample of 85.
  
  
  RESULTS
  The most balanced algorithm had a sensitivity of 0.75, specificity 0.83, and positive predictive value 16%. Suicidal ideation and prior attempt item reliabilities (kappa) were 0.48 and 0.58, respectively. Eight-day test-retest reliability for the most balanced scoring algorithm was 0.32.
  
  
  CONCLUSIONS
  The CSS demonstrated good sensitivity and reasonable specificity identifying students at risk for suicide. A second-stage evaluation would be needed to reduce the burden of low specificity.
authors.affiliation: Department of Child Psychiatry, New York State Psychiatric Institute, Columbia University, New York, NY 10032, USA. shafferd@childpsych.columbia.edu
authors.forename: David
authors.initials: D
authors.lastname: Shaffer
authors.forename: Michelle
authors.initials: M
authors.lastname: Scott
authors.forename: Holly
authors.initials: H
authors.lastname: Wilcox
authors.forename: Carey
authors.initials: C
authors.lastname: Maslow
authors.forename: Roger
authors.initials: R
authors.lastname: Hicks
authors.forename: Christopher P
authors.initials: CP
authors.lastname: Lucas
authors.forename: Robin
authors.initials: R
authors.lastname: Garfinkel
authors.forename: Steven
authors.initials: S
authors.lastname: Greenwald
mesh_terms: D000293:Adolescent; D000294:Adolescent Behavior; D003863:Depression / Q000175:diagnosis* / Q000523:psychology; D005260:Female; D006801:Humans; D007406:Interview, Psychological; D008297:Male; D008403:Mass Screening; D000297:Psychology, Adolescent; D011594:Psychometrics; D015203:Reproducibility of Results; D012307:Risk Factors; D013405:Suicide / Q000523:psychology; D011795:Surveys and Questionnaires; D000092864:Suicide Prevention