title: Prevalence of suicidal ideation and other suicide warning signs in veterans attending an urgent care psychiatric clinic.
abstract: BACKGROUND
  Suicide prevention in the clinical setting is focused on evaluating risk in the coming hours to days, yet little is known about which factors increase acute risk.
  
  
  OBJECTIVE
  To determine the prevalence of factors that may serve as warnings of heightened acute risk.
  
  
  METHODS
  Veterans attending an urgent care psychiatric clinic (n=473) completed a survey on suicidal ideation and other acute risk warning signs.
  
  
  RESULTS
  More than half the sample (52%) reported suicidal ideation during the prior week. Of these, more than one-third (37%) had active ideation which included participants with a current suicide plan (27%) and those who had made preparations to carry out their plan (12%). Other warning signs were also highly prevalent, with the most common being: sleep disturbances (89%), intense anxiety (76%), intense agitation (75%), hopelessness (70%), and desperation (70%). Almost all participants (97%) endorsed at least one warning sign. Participants with depressive syndrome and/or who screened positive for post-traumatic stress disorder endorsed the largest number of warning signs. Those with both depressive syndrome and post-traumatic stress disorder were more likely to endorse intense affective states than those with either disorder alone. All p-values for group comparisons are <.008.
  
  
  CONCLUSIONS
  Our major findings are the strikingly high prevalence of past suicidal ideation, suicide attempts, current suicidal ideation and intense affective states in veterans attending an urgent care psychiatric clinic; and the strong associations between co-occurring post-traumatic stress disorder and depressive syndrome with intense affective states.
authors: Department of Research, VA San Diego Healthcare System, San Diego, CA, USA. Electronic address: mcclure.jan@gmail.com.
authors: Janet R
authors: JR
authors: McClure
authors: Department of Family and Preventive Medicine, University of California, San Diego, CA, USA; Department of Medicine, University of California, San Diego, CA, USA. Electronic address: mcriqui@ucsd.edu.
authors: Michael H
authors: MH
authors: Criqui
authors: School of Public Health, San Diego State University, San Diego, CA, USA. Electronic address: cmacera@mail.sdsu.edu.
authors: Caroline A
authors: CA
authors: Macera
authors: College of Nursing, University of Southern Florida, Tampa, FL, USA. Electronic address: mji@health.usf.edu.
authors: Ming
authors: M
authors: Ji
authors: Department of Psychiatry, University of California, San Diego, CA, USA. Electronic address: cnievergelt@ucsd.edu.
authors: Caroline M
authors: CM
authors: Nievergelt
authors: Department of Psychiatry, University of California, San Diego, CA, USA; Department of Psychiatry, VA San Diego Healthcare System, San Diego, CA, USA; Department of Research, VA San Diego Healthcare System, San Diego, CA, USA. Electronic address: szisook@ucsd.edu.
authors: Sidney
authors: S
authors: Zisook
mesh_terms: D000328:Adult; D000428:Alcohol Drinking / Q000523:psychology*; D000553:Ambulatory Care; D000554:Ambulatory Care Facilities; D002140:California / Q000453:epidemiology; D003866:Depressive Disorder / Q000523:psychology*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D015995:Prevalence; D012306:Risk; D013313:Stress Disorders, Post-Traumatic / Q000523:psychology; D059020:Suicidal Ideation; D013405:Suicide / Q000523:psychology* / Q000706:statistics & numerical data; D013406:Suicide, Attempted / Q000523:psychology; D011795:Surveys and Questionnaires; D014728:Veterans / Q000523:psychology* / Q000706:statistics & numerical data