@article{ref1,
title="The sad truth about the SADPERSONS Scale: An evaluation of its clinical utility in self-harm patients",
journal="Emergency medicine journal",
year="2014",
author="Saunders, Kate and Brand, Fiona and Lascelles, Karen and Hawton, Keith E.",
volume="31",
number="10",
pages="796-798",
abstract="BACKGROUND: The SADPERSONS Scale is commonly used as a screening tool for suicide risk in those who have self-harmed. It is also used to determine psychiatric treatment needs in those presenting to emergency departments. To date, there have been relatively few studies exploring the utility of SADPERSONS in this context. OBJECTIVES: To determine whether the SADPERSONS Scale accurately predicts psychiatric hospital admission, psychiatric aftercare and repetition of self-harm at presentation to the emergency department following self-harm. METHODS: SADPERSONS scores were recorded for 126 consecutive admissions to a general hospital emergency department. Clinical management outcomes following assessment were recorded, including psychiatric hospital admission, community psychiatric aftercare and repetition of self-harm in the following 6 months. RESULTS: Psychiatric hospital admission was required in five cases (4.0%) and community psychiatric aftercare in 70 (55.5%). 31 patients (24.6%) repeated self-harm. While the specificity of the SADPERSONS scores was greater than 90% for all outcomes, sensitivity for admission was only 2.0%, for community aftercare was 5.8% and for repetition of self-harm in the following 6 months was just 6.6%. CONCLUSIONS: For the purposes of suicide prevention, a low false negative rate is essential. SADPERSONS failed to identify the majority of those either requiring psychiatric admission or community psychiatric aftercare, or to predict repetition of self-harm. The scale should not be used to screen self-harm patients presenting to general hospitals. Greater emphasis should be placed on clinical assessment which takes account of the individual and dynamic nature of risk assessment.<p /> <p>Language: en</p>",
language="en",
issn="1472-0205",
doi="10.1136/emermed-2013-202781",
url="http://dx.doi.org/10.1136/emermed-2013-202781"
}