TY  - JOUR
PY  - 2018//
TI  - Agreement between self and psychiatrist reporting of suicidal ideation at a Veterans Administration psychiatric emergency clinic
JO  - Depression and anxiety
A1  - McClure, Janet R.
A1  - Tal, Ilanit
A1  - Macera, Caroline A.
A1  - Ji, Ming
A1  - Nievergelt, Caroline M.
A1  - Lee, Soo Yong
A1  - Kayman, Josh
A1  - Zisook, Sidney
SP  - 1114
EP  - 1121
VL  - 35
IS  - 11
N2  - BACKGROUND: With suicide rising in the United States, identifying and preventing suicides is increasingly important. To provide a valuable step toward achieving effective suicide risk assessment, this study examines the agreement between self-report measures and psychiatrist documentation of suicidal ideation and behaviors (SI) at a Veterans Administration (VA) psychiatric emergency clinic. <br><br>METHODS: A total of 377 veterans presenting at a VA psychiatric emergency clinic completed a self-report survey on SI and other acute risk factors for suicidal behavior. We examined agreement between veterans' self-reported SI and psychiatrists' clinical notes regarding SI. <br><br>RESULTS: A total of 199 veterans (53%) self-reported SI; 80 psychiatrist notes (21%) indicated SI. Psychiatrists and veterans differed in 44% (164/377) of cases. Among the discordant cases, the veterans' self-report was more severe than the psychiatrists' in 97% of cases. Of the 120 veterans with SI and documented as having no SI by psychiatrists, 31 (26%) reported having a suicide plan and 18 (15%) plan preparations. <br><br>FINDINGS were similar when controlling for presenting problem, current depression, presence of a standardized suicide risk assessment, psychiatrist training level, past suicide attempt, homelessness, diagnosis of personality, or substance use disorder. <br><br>CONCLUSIONS: Agreement between veterans' self-reports and psychiatrists' documentation of SI was generally low, with veterans self-reporting SI significantly more often than psychiatrists documented SI in their clinical notes. This suggests that inclusion of a self-report questionnaire provides an additional source of data to complement information gleaned from the clinical interview for a more comprehensive risk assessment, but only if actually examined by the clinician.<br><br>© 2018 Wiley Periodicals, Inc.<p />  <p>Language: en</p>
LA  - en
SN  - 1091-4269
UR  - http://dx.doi.org/10.1002/da.22813
ID  - ref1
ER  -