title: Validation of a Spanish version of the Columbia-Suicide Severity Rating Scale (C-SSRS).
abstract: OBJECTIVE
  To examine the psychometric properties of a Spanish version of the C-SSRS (Sp-CSSRS).
  
  
  METHODS
  Data are from a naturalistic, cross-sectional, multicentre, validation study, including 467 psychiatric outpatients, 242 of whom had a history of suicide attempt. The study measures were: C-SSRS; the Hamilton Depression Rating Scale (HDRS); the Beck Suicide Intent Scale; the Medical Damage Scale.
  
  
  RESULTS
  Construct validity: Pearson coefficient between the C-SSRS severity (C-Sev) and intensity (C-Int) of ideation subscale scores was 0.44 (P<.000) for the total sample. Likewise, Pearson coefficient between C-Sev score and HDRS item 3 was 0.56 (P<.000). For the sub-sample of patients with suicide attempt, significant Pearson correlations were found between the C-Sev and the Beck Suicide Intent Scale scores (r=0.22; P=.001). Discriminant validity: Significant differences were found in C-Sev and C-Int scores between patients with and without suicide attempt (P<.000). The C-Sev score discriminated between patients based on HDRS item 3 (P<.009). Sensitivity to change: Linear regression showed that a one-unit decrease in HDRS item 3 corresponded to a decrease of 5.08 units in the C-Sev score (P=.141). A one-unit change in HDRS item 3 corresponded to a change of 13.51 on the C-Int assessments (P=.007). Cronbach's alpha was 0.53 for C-Int. The principal component analysis identified 2 components that explain 55.66% of the total variance (C-Int).
  
  
  CONCLUSIONS
  The data support that the Sp-C-SSRS is a reliable and valid instrument for assessing suicidal ideation and behaviour in daily clinical practice and research settings.
authors.affiliation: Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Oviedo, España; Instituto Universitario de Neurociencias del Principado de Asturias (INEUROPA), Oviedo, España.
authors.forename: Susana
authors.initials: S
authors.lastname: Al-Halabí
authors.affiliation: Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Oviedo, España; Instituto Universitario de Neurociencias del Principado de Asturias (INEUROPA), Oviedo, España; Departamento de Psiquiatría, Universidad de Oviedo, Oviedo, España.
authors.forename: Pilar A
authors.initials: PA
authors.lastname: Sáiz
authors.affiliation: Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Oviedo, España; Instituto Universitario de Neurociencias del Principado de Asturias (INEUROPA), Oviedo, España.
authors.forename: Patricia
authors.initials: P
authors.lastname: Burón
authors.affiliation: Instituto Universitario de Neurociencias del Principado de Asturias (INEUROPA), Oviedo, España.
authors.forename: Marlén
authors.initials: M
authors.lastname: Garrido
authors.affiliation: Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Oviedo, España; Unitat de Trastorn Bipolar, Hospital Clínic, Universitat de Barcelona, Institut d'Investigaciones Biomèdiques August Pi i Sunyer (IDIBAPS), Barcelona, España.
authors.forename: Antoni
authors.initials: A
authors.lastname: Benabarre
authors.affiliation: Unitat de Trastorn Bipolar, Hospital Clínic, Universitat de Barcelona, Institut d'Investigaciones Biomèdiques August Pi i Sunyer (IDIBAPS), Barcelona, España.
authors.forename: Esther
authors.initials: E
authors.lastname: Jiménez
authors.affiliation: Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Oviedo, España; Unidad de Salud Mental, Hospital Universitario San Cecilio, Departamento de Psiquiatría, Universidad de Granada, Granada, España.
authors.forename: Jorge
authors.initials: J
authors.lastname: Cervilla
authors.affiliation: Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Oviedo, España; Unidad de Salud Mental, Hospital Universitario San Cecilio, Departamento de Psiquiatría, Universidad de Granada, Granada, España.
authors.forename: María Isabel
authors.initials: MI
authors.lastname: Navarrete
authors.affiliation: Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Oviedo, España; Departamento de Psiquiatría, Universidad de Oviedo, Oviedo, España.
authors.forename: Eva M
authors.initials: EM
authors.lastname: Díaz-Mesa
authors.affiliation: Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Oviedo, España; Departamento de Psiquiatría, Universidad de Oviedo, Oviedo, España.
authors.forename: Leticia
authors.initials: L
authors.lastname: García-Álvarez
authors.affiliation: Instituto Universitario de Neurociencias del Principado de Asturias (INEUROPA), Oviedo, España; Departamento de Psicología, Universidad de Oviedo, Oviedo, España.
authors.forename: José
authors.initials: J
authors.lastname: Muñiz
authors.affiliation: Departamento de Psiquiatría, New York State Psychiatric Institute, Columbia University, Nueva York, NY, Estados Unidos.
authors.forename: Kelly
authors.initials: K
authors.lastname: Posner
authors.affiliation: Departamento de Psiquiatría, New York State Psychiatric Institute, Columbia University, Nueva York, NY, Estados Unidos.
authors.forename: María A
authors.initials: MA
authors.lastname: Oquendo
authors.affiliation: Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Oviedo, España; Instituto Universitario de Neurociencias del Principado de Asturias (INEUROPA), Oviedo, España; Departamento de Psiquiatría, Universidad de Oviedo, Oviedo, España. Electronic address: albert@uniovi.es.
authors.forename: María Paz
authors.initials: MP
authors.lastname: García-Portilla
authors.affiliation: Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Oviedo, España; Instituto Universitario de Neurociencias del Principado de Asturias (INEUROPA), Oviedo, España; Departamento de Psiquiatría, Universidad de Oviedo, Oviedo, España.
authors.forename: Julio
authors.initials: J
authors.lastname: Bobes
mesh_terms: D000328:Adult; D003430:Cross-Sectional Studies; D005260:Female; D006801:Humans; D016014:Linear Models; D008297:Male; D008875:Middle Aged; D025341:Principal Component Analysis; D011569:Psychiatric Status Rating Scales; D011594:Psychometrics; D015203:Reproducibility of Results; D013030:Spain; D059020:Suicidal Ideation; D013406:Suicide, Attempted / Q000523:psychology*; D014177:Translations
keywords: Assessment; Columbia-Suicide Severity Rating Scale; Conducta suicida; Evaluación; Ideación suicida; Propiedades psicométricas; Psychometric properties; Suicidal behaviour; Suicidal ideation