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Journal Article


Hsi-Hong Kuo, Chen-Hsin Chen, Jeng-Tung Chiang, Ming-Been Lee, Shih-Cheng Liao. J. Suicidol. 2022; 17(1): 59-66.


(Copyright © 2022, Taiwanese Society of Suicidology, Publisher Airiti)






PURPOSE: Suicide has been an important public health problem worldwide, and the elderly (age 65 and older) have the highest suicide mortality rate compared to other age groups in Taiwan. The present study aimed to evaluate the reliability of the Five-Item Brief Symptom Rating Scale (BSRS-5) in detecting the psychiatric morbidity and suicide ideation, to identify their associated risk factors, and to assess the effectiveness of intervention with regular home care services for the physically disabled elderly.

METHODS: The study subjects comprised five hundred and sixty elderly subjects who were physically disabled and received regular home care services biweekly. They were visited and assessed using the BSRS-5 by the trained personnel four times during a two-month period. The receiver operating characteristic (ROC) analysis was used to determine the optimal cutoff point of the BSRS-5 score in screening for suicide ideation. In addition, the alternating logistic regression (ALR) method was used to identify the risk factors.

RESULTS: The BSRS-5 was found to be a valid tool for the prediction of suicide ideation for the home-bound elderly. Fitting the longitudinal data with the ALR method showed that females, being under poor health status, and those who had ever consulted a psychiatrist were more likely to have psychiatric morbidity. In addition, the findings indicated that the BSRS-5 score was the only statistically significant predictor for suicide ideation. Furthermore, the results revealed a significant decrease in the level of psychological distress and the proportion of psychiatric morbidity during four times of home interview assessments.

CONCLUSION: The BSRS-5 was a useful tool for screening the elderly at risk of suicide ideation. The results also implied potential effectiveness of home care services for the elderly to reduce psychological distress.

Language: en


psychological distress; BSRS-5; elderly suicide; home care service


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