Suicidal intent in deliberate self-harm and the risk of suicide: the predictive power of the Suicide Intent Scale.
BACKGROUND
Suicidal intent at the time of deliberate self-harm (DSH) is known to be associated with risk of future suicide in DSH patients. The predictive power of suicidal intent to identify particular individuals who are at high risk of suicide is unclear.


METHODS
Clinical and demographic data on 4156 DSH patients presenting to hospital 1993 and 1997 were analysed. Follow-up information on eventual suicide was available for 2489 patients (mean follow-up 5.2 years). The predictive value of the Beck Suicidal Intent Scale (SIS) was examined using Receiver Operating Characteristic (ROC) plots.


RESULTS
Thirty males (2.9%) and 24 females (1.7%) died by suicide. Despite a robust association between suicidal intent and eventual suicide, the positive predictive value (PPV) of the SIS was low (4%). Predicted probabilities of suicide assigned to individual patients were also low, even for those who eventually died by suicide.


CONCLUSIONS
Assessment and follow-up information was not available for all patients.


CONCLUSIONS
The SIS cannot predict which individual patients will ultimately die by suicide. Nonetheless, information regarding suicidal intent is valuable in the clinical risk assessment and management of DSH patients.
Harriss
Louise
L
Centre for Suicide Research, Department of Psychiatry, University of Oxford, Warneford Hospital, Oxford OX3 7JX, UK.
Hawton
Keith
K
D006801:Humans; D033182:Intention; D011237:Predictive Value of Tests; D011569:Psychiatric Status Rating Scales / Q000706:statistics & numerical data*; D011594:Psychometrics; D012307:Risk Factors; D016728:Self-Injurious Behavior / Q000453:epidemiology / Q000523:psychology; D013405:Suicide / Q000523:psychology* / Q000706:statistics & numerical data