Major depression presents with sadness or loss of interest, and thoughts about death or suicide sometimes occur in severe cases. This symptom may present with favorable thoughts about death and suicide, known as "suicidal ideation," or, more seriously, specific plans to commit suicide, according to the American Psychiatric Association. Specific plans warrant immediate clinical attention.
Many validated suicide symptom questionnaires must be purchased, but some useful questionnaires are available on the internet, including the Suicide Behavior Questionnaire, Modified Scale for Suicidal Ideation and the Suicide Risk Questionnaire.
Suicide Behavior Questionnaire
The Suicide Behavior Questionnaire, developed by Osman and colleagues, contains just four questions assessing suicidal risk. The first question inquires about past suicide thoughts or attempts, as the existence of past attempts proves highly predictive of a future attempt, according to Holma and colleagues in a 2010 issue of the American Journal of Psychiatry. The questionnaire also inquires as to whether the person has thought about suicide in the past year, told someone he was going to commit suicide, and his perception of likelihood that he will attempt suicide at some point. Scores on each question are added together to calculate overall risk.
The National Council website provides this questionnaire along with technical scoring criteria.
Modified Scale for Suicidal Ideation
The Modified Scale for Suicidal Ideation, developed by Ivan Miller and colleagues at Brown University, contains 18 questions that assess suicidal thoughts and behaviors over the previous 48 hours. Questions inquire about the wish to die, wish to live, desire to commit suicide, reasons for committing suicide, whether any deterrents to following through with the wish exist and whether the individual talks about death, among others. Each question is scored on a zero to three scale, and the scores for each question added to a total risk score.
The General Practice South website provides a copy of this scale with administration and scoring details.
Suicide Risk Questionnaire
Not every severely depressed individual may be willing or motivated to self-administer scales like those above, so the Suicide Risk Questionnaire was developed for friends and loved ones of those who may be suicidal. This questionnaire includes questions about the observable behaviors of depressed individuals that may indicate a disposition towards suicide. Questions inquire about the statements made by the individual, such as "life is not worth living," and "I see there is no way out."
Although the occurrence of such behaviors may indicate risk for suicide, some individuals may make such statements as a method to get attention. A second question inquires about depression symptoms, and a person is deemed at highest risk for carrying out a suicide attempt if they show behaviors indicating both suicidal thoughts and depression.
The questionnaire is available at mentalhealthscreening.org.
References
- "American Journal of Psychiatry"; Incidence and Predictors of Suicide Attempts in DSM--IV Major Depressive Disorder: A Five-Year Prospective Study; K.M. Holma and colleagues; May 17, 2010
- The National Council: Suicide Behavior Questionnaire
- General Practice South: Modified Scale for Suicidal Ideation
- Mental Health Screening: Suicide Risk Questionnaire
- "Diagnostic and Statistical Manual of Mental Disorders"; American Psychiatric Association; 2000.
