title: Predictive validity of a five-item symptom checklist to screen psychiatric morbidity and suicide ideation in general population and psychiatric settings.
abstract: OBJECTIVE
  Suicide is a major concern in public health worldwide. Early identification of individuals at risk is critical for suicide prevention. The present study revised the 5-item Brief Symptom Rating Scale (BSRS-5) to a checklist format (BSRS-5R) and validated the BSRS-5R into a screening tool for psychiatric morbidity and suicide ideation in the general public.
  
  
  METHODS
  The study participants consisted of two subsets of sample from community residents and psychiatric patients. The community subjects were recruited from stratified proportional randomization sampling in a nationwide community survey, while the psychiatric patients were from psychiatric outpatient service and psychiatric daycare unit in a teaching hospital in northern Taiwan. All participants responded to the questionnaire investigating the BSRS-5, personal experience with suicide, and demographic information.
  
  
  RESULTS
  In total, 2147 community respondents and 700 respondents from psychiatric settings completed the survey questions. The BSRS-5R was highly correlated to BSRS-5 with good internal consistency in our study sample. For the community subjects, receiver operating characteristic curve analysis revealed an optimal cutoff of 2/3 for BSRS-5R to discriminate psychiatric morbidity or suicide ideation. The BSRS-5R could also identify psychiatric morbidity in psychiatric outpatients and daycare patients. In addition, the cutoff of 4/5 for BSRS-5R to determine suicide ideation yielded moderately good predictive validity in psychiatric outpatients and in daycare patients.
  
  
  CONCLUSIONS
  The BSRS-5R was validated as an efficient checklist to screen for psychiatric morbidity and suicide ideation in the general public. The result is valuable in translating into general medical and community settings for early detection of suicide ideation.
authors.affiliation: School of Nursing, National Taiwan University College of Medicine, Taipei, Taiwan; Taiwan Suicide Prevention Center, Taipei, Taiwan.
authors.forename: Chia-Yi
authors.initials: CY
authors.lastname: Wu
authors.affiliation: Department of Psychiatry, Kaohsiung Medical University Hospital, Kaohsiung Medical University, Kaohsiung, Taiwan.
authors.forename: Jia-In
authors.initials: JI
authors.lastname: Lee
authors.affiliation: Taiwan Suicide Prevention Center, Taipei, Taiwan; Department of Psychiatry, National Taiwan University College of Medicine, Taipei, Taiwan; Department of Psychiatry, National Taiwan University Hospital, Taipei, Taiwan. Electronic address: mingbeen@ntu.edu.tw.
authors.forename: Ming-Been
authors.initials: MB
authors.lastname: Lee
authors.affiliation: Taiwan Suicide Prevention Center, Taipei, Taiwan; Department of Psychiatry, National Taiwan University Hospital, Taipei, Taiwan.
authors.forename: Shih-Cheng
authors.initials: SC
authors.lastname: Liao
authors.affiliation: Taiwan Suicide Prevention Center, Taipei, Taiwan; Department of Psychiatry, Chang-Gung Memorial Hospital and Chang-Gung University, Taoyuan, Taiwan.
authors.forename: Chia-Ming
authors.initials: CM
authors.lastname: Chang
authors.affiliation: Department of Psychiatry, National Taiwan University Hospital, Taipei, Taiwan.
authors.forename: Hsi-Chung
authors.initials: HC
authors.lastname: Chen
authors.affiliation: Taiwan Suicide Prevention Center, Taipei, Taiwan; Division of General Psychiatry, Songde Branch, Taipei City Hospital, Taipei, Taiwan.
authors.forename: For-Wey
authors.initials: FW
authors.lastname: Lung
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D057189:Checklist / Q000592:standards*; D005260:Female; D006801:Humans; D016015:Logistic Models; D008297:Male; D008403:Mass Screening / Q000379:methods*; D001523:Mental Disorders / Q000175:diagnosis / Q000453:epidemiology*; D008875:Middle Aged; D009017:Morbidity; D010045:Outpatients; D011569:Psychiatric Status Rating Scales / Q000592:standards*; D012372:ROC Curve; D012307:Risk Factors; D057566:Self Report; D059020:Suicidal Ideation; D013624:Taiwan / Q000453:epidemiology; D055815:Young Adult
keywords: psychiatric morbidity; psychological distress; self-rating scale; suicide ideation; suicide risk screening