title: [Suicide risk assessment tools for adults in general medical practice].
abstract: BACKGROUND
  It is estimated that almost half of suicide victims have consulted a general practitioner during the month preceding their act. The implementation of a suicide risk assessment tool validated in primary care is therefore needed in general medical practice.
  
  
  OBJECTIVE
  To review the suicide risk assessment tools for adults, to discuss their validity, and to suggest a pertinent tool which could be used in primary care.
  
  
  METHODS
  Research into scientific databases (keywords: psychiatric status rating scales; tools; questionnaires; risk assessment; suicide; attempted suicide; suicidal ideation; primary care; family practice; general practice) and into French and English language primary care journals. Review of publications and recommendations from health promotion and suicide prevention organizations, and from general practice and psychiatry learned societies.
  
  
  RESULTS
  Two categories of suicide risk assessment tools have been found. On one hand, questionnaires aim at predicting suicidal behaviours (or their recurrence) using a risk score. They are interesting in research but of limited value in clinical practice because of their low specificity and individual predictive power. On the other hand, semi-directive interviews unable clinicians to explore the three dimensions of suicidality (levels of risk, urgency and danger), thus knowing to what extent the patient is suicidal and to adopt the appropriate preventive care strategy. Their use in clinical routine is highly recommended. The Grille d'estimation de la dangerosité d'un passage à l'acte suicidaire is the only interview to have been validated in primary care so far. It could be a pertinent tool in general practice.
  
  
  CONCLUSIONS
  Preventing suicide in primary care requires the assessment of suicide risk using a semi-directive interview. We suggest a qualitative study to be carried out in general practice on the Grille d'estimation de la dangerosité d'un passage à l'acte suicidaire.
authors.affiliation: CHU Lapeyronie, département de médecine légale, avenue du Doyen Gaston Giraud, 34295 Montpellier cedex 5, France. Electronic address: pa-peyron@chu-montpellier.fr.
authors.forename: Pierre-Antoine
authors.initials: PA
authors.lastname: Peyron
authors.affiliation: Faculté de médecine, département de médecine générale, CS 59001, 2 rue de l'École de médecine, 34060 Montpellier cedex 2, France.
authors.forename: Michel
authors.initials: M
authors.lastname: David
mesh_terms: D000328:Adult; D058006:General Practice; D006801:Humans; D018570:Risk Assessment; D013405:Suicide / Q000706:statistics & numerical data*; D011795:Surveys and Questionnaires