title: The emergency physician's assessment of suicide risk in intentional self-poisoning using the modified SAD PERSONS scale versus standard psychiatric evaluation in a general hospital in South India: a cross-sectional study.
abstract: BACKGROUND
  The reliable identification, by emergency physicians, of those with intentional self-poisoning at risk of repeating attempts is crucial, particularly in countries with a shortfall of mental health professionals.
  
  
  METHODS
  This cross-sectional study of intentional self-poisoning in India compared an emergency physician's assessment for the need for psychiatric referral, using the modified SAD PERSONS Scale (MSPS) as an interview guide, with a standard psychiatric interview.
  
  
  RESULTS
  In 67 consecutive adults with intentional self-poisoning, MSPS cut-off scores of 5 or more best approximated psychiatric assessments for the need for psychiatric referral (positive likelihood ratio 2.9, 95% confidence interval [CI] 0.8-10.2; negative likelihood ratio 0.5, 95% CI 0.3-0.8).
  
  
  CONCLUSIONS
  MSPS-guided emergency physicians' assessments after self-poisoning showed modest concordance with psychiatric assessments of suicide-risk. Concordance with psychiatric assessments may improve if risk factors prevalent in different settings are identified and incorporated in the MSPS.
authors.affiliation: Assistant Professor, Department of Psychiatry, Christian Medical College, Vellore, Tamil Nadu, India susmit1984@yahoo.co.in.
authors.forename: Susmita
authors.initials: S
authors.lastname: Chandramouleeswaran
authors.affiliation: Assistant Professor, Department of Acute Care Medicine, Christian Medical College, Vellore, Tamil Nadu, India.
authors.forename: Natasha Catherine
authors.initials: NC
authors.lastname: Edwin
authors.affiliation: Professor, Department of Critical Care Medicine, Christian Medical College, Vellore, Tamil Nadu, India.
authors.forename: Peter John
authors.initials: PJ
authors.lastname: Victor
authors.affiliation: Professor, Department of Psychiatry, Prof BV Moses Centre for Evidence-Informed Health Care and Health Policy, Christian Medical College, Vellore, Tamil Nadu, India.
authors.forename: Prathap
authors.initials: P
authors.lastname: Tharyan
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D003430:Cross-Sectional Studies; D004632:Emergency Medical Services; D005260:Female; D006769:Hospitals, General; D006801:Humans; D007194:India; D008297:Male; D008875:Middle Aged; D011041:Poisoning / Q000523:psychology; D011569:Psychiatric Status Rating Scales / Q000592:standards*; D012307:Risk Factors; D012680:Sensitivity and Specificity; D013406:Suicide, Attempted / Q000523:psychology*
keywords: Suicide risk-assessment; diagnostic odds ratio; self-poisoning; sensitivity; specificity