title: A clinical measure of suicidal ideation, suicidal behavior, and associated symptoms in bipolar disorder: Psychometric properties of the Concise Health Risk Tracking Self-Report (CHRT-SR).
abstract: OBJECTIVE
  People with bipolar disorder are at high risk of suicide, but no clinically useful scale has been validated in this population. The aim of this study was to evaluate the psychometric properties in bipolar disorder of the 7- and 12-item versions of the Concise Health Risk Tracking Self-Report (CHRT-SR), a scale measuring suicidal ideation, suicidal behavior, and associated symptoms.
  
  
  METHODS
  The CHRT was administered to 283 symptomatic outpatients with bipolar I or II disorder who were randomized to receive lithium plus optimized personalized treatment (OPT), or OPT without lithium in a six month longitudinal comparative effectiveness trial. Participants were assessed using structured diagnostic interviews, clinician-rated assessments, and self-report questionnaires.
  
  
  RESULTS
  The internal consistency (Cronbach α) was 0.80 for the 7-item CHRT-SR and 0.90 for the 12-item CHRT-SR with a consistent factor structure, and three independent factors (current suicidal thoughts and plans, hopelessness, and perceived lack of social support) for the 7-item version. CHRT-SR scores are correlated with measures of depression, functioning, and quality of life, but not with mania scores.
  
  
  CONCLUSIONS
  The 7- and 12-item CHRT-SR both had excellent psychometric properties in a sample of symptomatic subjects with bipolar disorder. The scale is highly correlated with depression, functioning, and quality of life, but not with mania. Future research is needed to determine whether the CHRT-SR will be able to predict suicide attempts in clinical practice.
authors.affiliation: VA Palo Alto Health Care System, Palo Alto, CA, USA; Department of Psychiatry & Behavioral Sciences, Stanford University School of Medicine, Stanford, CA, USA. Electronic address: ostacher@stanford.edu.
authors.forename: Michael J
authors.initials: MJ
authors.lastname: Ostacher
authors.affiliation: Department of Psychiatry, Massachusetts General Hospital, Boston, MA, USA; Harvard Medical School, Boston, MA, USA.
authors.forename: Andrew A
authors.initials: AA
authors.lastname: Nierenberg
authors.affiliation: Biostatistics Center, Massachusetts General Hospital, Boston, MA, USA.
authors.forename: Dustin
authors.initials: D
authors.lastname: Rabideau
authors.affiliation: Department of Psychiatry, Massachusetts General Hospital, Boston, MA, USA; Harvard Medical School, Boston, MA, USA.
authors.forename: Noreen A
authors.initials: NA
authors.lastname: Reilly-Harrington
authors.affiliation: Department of Psychiatry, Massachusetts General Hospital, Boston, MA, USA; Harvard Medical School, Boston, MA, USA.
authors.forename: Louisa G
authors.initials: LG
authors.lastname: Sylvia
authors.affiliation: Department of Psychiatry, Massachusetts General Hospital, Boston, MA, USA.
authors.forename: Alexandra K
authors.initials: AK
authors.lastname: Gold
authors.affiliation: Department of Psychiatry, Massachusetts General Hospital, Boston, MA, USA.
authors.forename: Leah W
authors.initials: LW
authors.lastname: Shesler
authors.affiliation: Department of Psychiatry & Behavioral Sciences, Stanford University School of Medicine, Stanford, CA, USA.
authors.forename: Terence A
authors.initials: TA
authors.lastname: Ketter
authors.affiliation: Department of Psychiatry, University of Texas Health Science Center, San Antonio, TX, USA.
authors.forename: Charles L
authors.initials: CL
authors.lastname: Bowden
authors.affiliation: Bipolar Disorders Research Center, University Hospital's Case Medical Center, Case Western Reserve University, Cleveland, OH, USA.
authors.forename: Joseph R
authors.initials: JR
authors.lastname: Calabrese
authors.affiliation: Department of Psychiatry, University of Pittsburgh School of Medicine, Pittsburgh, PA, USA.
authors.forename: Edward S
authors.initials: ES
authors.lastname: Friedman
authors.affiliation: Department of Psychiatry, Icahn School of medicine at Mount Sinai, New York, NY, USA.
authors.forename: Dan V
authors.initials: DV
authors.lastname: Iosifescu
authors.affiliation: Department of Psychiatry, University of Pennsylvania School of Medicine, USA.
authors.forename: Michael E
authors.initials: ME
authors.lastname: Thase
authors.affiliation: Biostatistics in Psychiatry & Public Health, Weill Cornell Medical College, New York, NY, USA.
authors.forename: Andrew C
authors.initials: AC
authors.lastname: Leon
authors.affiliation: Department of Psychiatry, The University of Texas Southwestern Medical Center, USA.
authors.forename: Madhukar H
authors.initials: MH
authors.lastname: Trivedi
mesh_terms: D000328:Adult; D001714:Bipolar Disorder / Q000175:diagnosis / Q000628:therapy; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D018020:Lithium Compounds / Q000627:therapeutic use; D008137:Longitudinal Studies; D008297:Male; D057285:Precision Medicine; D011594:Psychometrics; D011619:Psychotropic Drugs / Q000627:therapeutic use; D057566:Self Report; D013405:Suicide
chemical_list: D018020:Lithium Compounds; D011619:Psychotropic Drugs
keywords: Bipolar disorder; Evidence-based care; Mood disorders; Psychometrics; Suicide