<div class="section">
<a class="named-anchor" id="S1">
<!--
named anchor
-->
</a>
<h5 class="section-title" id="d831289e130">Objective:</h5>
<p id="P1">To explore what percentage of suicide decedents (SDs) vs controls were
assessed for
suicidality at medical appointments in the year before death.
</p>
</div><div class="section">
<a class="named-anchor" id="S2">
<!--
named anchor
-->
</a>
<h5 class="section-title" id="d831289e135">Patients and Methods:</h5>
<p id="P2">Using the Rochester Epidemiology Project, 66 SDs dying in Olmsted County,
Minnesota,
between January 1, 2000, and December 31, 2009, were identified and matched with 141
age- and sex-matched controls. Blinded chart review determined how often providers
screened and subjects endorsed suicidal ideation (SI). Positive indicators included
chart notes recording SI and/or Patient Health Questionnaire-9 scored more than 0
on question 9.
</p>
</div><div class="section">
<a class="named-anchor" id="S3">
<!--
named anchor
-->
</a>
<h5 class="section-title" id="d831289e140">Results:</h5>
<p id="P3">We found that only 29 of 66 (43.9%) SDs and 14 of 141 (9.9%) controls had
been screened
at any point by any means (
<i>P</i> < .001). Only 25.8% (17 of 66) of SDs expressed SI, whereas 58.6% of screened
SDs
(17 of 29) did so, though none at final appointments before death. No control ever
expressed SI. While the majority of both cases and controls went unscreened, providers
were more likely to screen SDs (
<i>P</i> < .001; odds ratio [OR], 9.0; 95% CI, 3.6-22.0), even with controlling
for mental
health diagnoses (
<i>P</i> = .02; OR, 3.6; 95% CI, 1.2-10.6).
</p>
</div><div class="section">
<a class="named-anchor" id="S4">
<!--
named anchor
-->
</a>
<h5 class="section-title" id="d831289e154">Conclusions:</h5>
<p id="P4">With providers screening less than half of SDs at any point in the year
before death,
and less than 60% of SDs ever endorsing SI, including none at final appointments,
the findings of this naturalistic study bring into question both current screening
practices and screening effectiveness. Nonetheless, when SDs were screened, they were
significantly more likely to endorse SI than were controls, not 1 of whom ever expressed
SI. Taken together, these data suggest that patients expressing SI at any point are
at elevated risk for eventual suicide.
</p>
</div>