title: Impact of screening for risk of suicide: randomised controlled trial.
abstract: BACKGROUND
  Concerns have been expressed about the impact that screening for risk of suicide may have on a person's mental health.
  
  
  OBJECTIVE
  To examine whether screening for suicidal ideation among people who attend primary care services and have signs of depression increases the short-term incidence of feeling that life is not worth living.
  
  
  METHODS
  In a multicentre, single-blind, randomised controlled trial, 443 patients in four general practices were randomised to screening for suicidal ideation or control questions on health and lifestyle (trial registration: ISRCTN84692657). The primary outcome was thinking that life is not worth living measured 10-14 days after randomisation. Secondary outcome measures comprised other aspects of suicidal ideation and behaviour.
  
  
  RESULTS
  A total of 443 participants were randomised to early (n = 230) or delayed screening (n = 213). Their mean age was 48.5 years (s.d. = 18.4, range 16-92) and 137 (30.9%) were male. The adjusted odds of experiencing thoughts that life was not worth living at follow-up among those randomised to early compared with delayed screening was 0.88 (95% CI 0.66-1.18). Differences in secondary outcomes between the two groups were not seen. Among those randomised to early screening, 37 people (22.3%) reported thinking about taking their life at baseline and 24 (14.6%) that they had this thought 2 weeks later.
  
  
  CONCLUSIONS
  Screening for suicidal ideation in primary care among people who have signs of depression does not appear to induce feelings that life is not worth living.
authors.affiliation: Reader in Mental Health Services Research, Centre for Mental Health, Faculty of Medicine, Imperial College London, Claybrook Centre, 37 Claybrook Road, London W6 8LN, UK. m.crawford@imperial.ac.uk
authors.forename: Mike J
authors.initials: MJ
authors.lastname: Crawford
authors.forename: Lavanya
authors.initials: L
authors.lastname: Thana
authors.forename: Caroline
authors.initials: C
authors.lastname: Methuen
authors.forename: Pradip
authors.initials: P
authors.lastname: Ghosh
authors.forename: Sian V
authors.initials: SV
authors.lastname: Stanley
authors.forename: Juliette
authors.initials: J
authors.lastname: Ross
authors.forename: Fabiana
authors.initials: F
authors.lastname: Gordon
authors.forename: Grant
authors.initials: G
authors.lastname: Blair
authors.forename: Priya
authors.initials: P
authors.lastname: Bajaj
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D003863:Depression / Q000453:epidemiology* / Q000523:psychology; D005194:Family Practice; D005260:Female; D006801:Humans; D057194:Intention to Treat Analysis; D008131:London / Q000453:epidemiology; D008297:Male; D008403:Mass Screening / Q000009:adverse effects / Q000523:psychology*; D008875:Middle Aged; D017063:Outcome Assessment, Health Care / Q000706:statistics & numerical data; D012307:Risk Factors; D016037:Single-Blind Method; D059020:Suicidal Ideation; D013405:Suicide / Q000523:psychology / Q000706:statistics & numerical data*; D014504:Urban Health; D055815:Young Adult