title: Combining the Suicide Intent Scale and the Karolinska Interpersonal Violence Scale in suicide risk assessments.
abstract: BACKGROUND
  High suicide intent, childhood trauma, and violent behavior are risk factors for suicide in suicide attempters. The aim of this study was to investigate whether the combined assessment of suicide intent and interpersonal violence would provide a better prediction of suicide risk than an assessment of only suicide intent or interpersonal violence.
  
  
  METHODS
  This is a cohort study involving 81 suicide attempters included in the study between 1993 and 1998. Patients were assessed with both the Suicide Intent Scale (SIS) and the Karolinska Interpersonal Violence Scale (KIVS). Through the unique personal identification number in Sweden, patients were linked to the Cause of Death Register maintained by the Swedish National Board of Health and Welfare. Suicides were ascertained from the death certificates.
  
  
  RESULTS
  Seven of 14 patients who had died before April 2013 had committed suicide. The positive predictive value for the Suicide Intent Scale alone was 16.7 %, with a specificity of 52 % and an area under the curve of 0.74. A combined assessment with the KIVS gave higher specificity (63 %) and a positive predictive value of 18.8 % with an AUC of 0.83. Combined use of SIS and KIVS expressed interpersonal violence as an adult subscale gave a sensitivity of 83.3 %, a specificity of 80.3 %, and a positive predictive value of 26 % with an AUC of 0.85. The correlation between KIVS and SIS scores was not significant.
  
  
  CONCLUSIONS
  Using both the the SIS and the KIVS combined may be better for predicting completed suicide than using them separately. The nonsignificant correlation between the scales indicates that they measure different components of suicide risk.
authors.affiliation: Department of Clinical Neuroscience, Psychiatry Section, Karolinska Institutet, Karolinska University Hospital, Building R5, Solna, SE-171 76, Stockholm, Sweden. jon.stefansson@ki.se.
authors.forename: J
authors.initials: J
authors.lastname: Stefansson
authors.affiliation: Department of Clinical Neuroscience, Psychiatry Section, Karolinska Institutet, Karolinska University Hospital, Building R5, Solna, SE-171 76, Stockholm, Sweden. peter.nordstrom@ki.se.
authors.forename: P
authors.initials: P
authors.lastname: Nordström
authors.affiliation: Department of Clinical Neuroscience, Psychiatry Section, Karolinska Institutet, Karolinska University Hospital, Building R5, Solna, SE-171 76, Stockholm, Sweden. bo.runeson@ki.se.
authors.forename: B
authors.initials: B
authors.lastname: Runeson
authors.affiliation: Department of Clinical Sciences, Karolinska Institutet, Danderyd Hospital, Stockholm, Sweden. marie.asberg@ki.se.
authors.forename: M
authors.initials: M
authors.lastname: Åsberg
authors.affiliation: Department of Clinical Neuroscience, Psychiatry Section, Karolinska Institutet, Karolinska University Hospital, Building R5, Solna, SE-171 76, Stockholm, Sweden. jussi.jokinen@ki.se.|Department of Clinical Sciences, Umeå University, Umeå, Sweden. jussi.jokinen@ki.se.
authors.forename: J
authors.initials: J
authors.lastname: Jokinen
mesh_terms: D000328:Adult; D000374:Aggression / Q000523:psychology; D015331:Cohort Studies; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D011569:Psychiatric Status Rating Scales; D018570:Risk Assessment / Q000379:methods; D012307:Risk Factors; D059020:Suicidal Ideation; D013405:Suicide / Q000523:psychology; D013406:Suicide, Attempted / Q000523:psychology; D013548:Sweden; D014754:Violence / Q000523:psychology*; D000092864:Suicide Prevention