The p4 screener: evaluation of a brief measure for assessing potential suicide risk in 2 randomized effectiveness trials of primary care and oncology patients.
The p4 screener: evaluation of a brief measure for assessing potential suicide risk in 2 randomized effectiveness trials of primary care and oncology patients.
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DOI：
10.4088/pcc.10m00978blu
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发表时间：
2010-01-01
期刊：
影响因子：
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通讯作者：
Williams, Linda S
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文献类型：
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作者：
Dube, Priyanka;Kurt, Kroenke;Williams, Linda S
背景：抑郁症是最常见的精神障碍，自杀是其最严重的后果。本研究的主要目的是评估 P4 筛选器的初步证据，作为评估潜在自杀风险的简单措施。 方法：在初级保健（2005 年 1 月至 2008 年 6 月；N = 250）和肿瘤患者（2006 年 3 月至 2009 年 8 月；N = 309）的 2 项随机有效性试验中对 P4 筛选器进行了前瞻性评估。两项试验均在 5 个时间点评估潜在自杀意念：基线以及 1、3、6 和 12 个月。 P4筛查人员询问“4P”：过去的自杀企图、自杀计划、完成自杀的可能性和预防因素。根据对这 4 个项目的反应，将患者分为最低风险、较低风险和较高风险。 结果：在试验的某个时刻，17.6%（250 名中的 44 名）的情感障碍和肌肉骨骼疼痛分级护理 (SCAMP) 参与者和 16.5%（309 名中的 51 名印第安纳癌症疼痛和抑郁症 (INCPAD) 参与者）触发了 1 次或多次自杀评估。在触发自杀评估的患者中，大多数（SCAMP 中的 44 名患者中的 29 名和 INCPAD 中的 51 名患者中的 27 名）被算法归类为最低风险。只有 1 名 SCAMP 参与者（0.4%）和 5 名 INCPAD 参与者（1.6%）被归类为较高风险。其中，阻止患者尝试自杀的最常见因素是“4 F”：信仰、家庭、未来希望和对尝试失败的恐惧。结论：初步研究结果表明，P4 筛查仪可能有助于评估抑郁症患者临床护理和临床研究中的潜在自杀风险。试验注册：clinicaltrials.gov 标识符：NCT00118430 (SCAMP) 和NCT00313573（INCPAD）。
BACKGROUND: Depression is the most common mental disorder, and suicide is its most serious consequence. The primary objective of this study was to evaluate preliminary evidence for the P4 screener as a brief measure to assess potential suicide risk.METHOD: The P4 screener was prospectively evaluated in 2 randomized effectiveness trials of primary care (January 2005-June 2008; N = 250) and oncology patients (March 2006-August 2009; N = 309). Potential suicide ideation was assessed at 5 time points in both trials: baseline and 1, 3, 6, and 12 months. The P4 screener asks about the "4 P's": past suicide attempts, suicide plan, probability of completing suicide, and preventive factors. Patients were classified as minimal, lower, and higher risk based upon responses to these 4 items.RESULTS: A suicide assessment was triggered 1 or more times by 17.6% (44 of 250) of Stepped Care for Affective Disorders and Musculoskeletal Pain (SCAMP) participants and 16.5% (51 of 309) of Indiana Cancer Pain and Depression (INCPAD) participants at some point in the trial. Of the patients who triggered a suicide assessment, the majority (29 of 44 in SCAMP and 27 of 51 in INCPAD) were classified as minimal risk by the algorithm. Only 1 (0.4%) of the SCAMP participants and 5 (1.6%) of the INCPAD participants were classified as higher risk. Among the latter, the most common factors preventing patients from attempting suicide were the "4 F's": faith, family, future hope, and fear of failing in their attempt.CONCLUSIONS: Preliminary findings suggest that the P4 screener may be useful in assessing potential suicide risk in the clinical care of depressed patients as well as in clinical research.TRIAL REGISTRATION: clinicaltrials.gov Identifier: NCT00118430 (SCAMP) and NCT00313573 (INCPAD).