@article{ref1,
title="Does suicidal ideation as measured by the PHQ-9 predict suicide among VA patients?",
journal="Psychiatric services",
year="2016",
author="Louzon, Samantha A. and Bossarte, Robert M. and McCarthy, John F. and Katz, Ira R.",
volume="67",
number="5",
pages="517-522",
abstract="OBJECTIVE: Frequency of suicidal ideation in the past two weeks, assessed by item 9 of the nine-item Patient Health Questionnaire (PHQ-9), has been positively associated with suicide mortality among patients in a setting other than the Veterans Health Administration (VHA). To inform suicide prevention activities at the VHA, it is important to evaluate whether item 9 is associated with suicide risk among patients in the VHA system. <br><br>METHODS: PHQ-9 assessments (N=447,245) conducted by the VHA between October 1, 2009, and September 30, 2010, were collected. National Death Index data were used to ascertain suicide mortality from the date of PHQ-9 assessment through September 30, 2011. Multivariable proportional hazards regressions were used to evaluate associations between responses to item 9 and suicide mortality. <br><br>RESULTS: After the analyses adjusted for covariates, a response of &quot;several days&quot; for item 9 was associated with a 75% increased risk of suicide (hazard ratio [HR]=1.75, 95% confidence interval [CI]=1.24-2.46), a response of &quot;more than half the days&quot; was associated with a 115% increased risk of suicide (HR=2.15, CI=1.32-3.51), and a response of &quot;nearly every day&quot; was associated with a 185% increased risk of suicide (HR=2.85, CI=1.81-4.47), compared with a response of &quot;not at all.&quot; However, 71.6% of suicides during the study period occurred among patients who responded &quot;not at all&quot; to item 9 from their most recent PHQ-9. <br><br>CONCLUSIONS: Higher levels of suicidal ideation, indicated by item 9 of the PHQ-9, were associated with increased risk of suicide among patients in the VHA system.<p /> <p>Language: en</p>",
language="en",
issn="1075-2730",
doi="10.1176/appi.ps.201500149",
url="http://dx.doi.org/10.1176/appi.ps.201500149"
}