Poster Index

Novel monitoring strategies for detecting changes in risk over time

Clinical and neurocognitive studies of suicidal behavior (17)  |  Clinical phenotyping of suicidal individuals (23)
Culture, ethnicity and spiritual approaches. New paradigms in suicidology (11)  |  Ethical and methodological challenges and solutions in suicide research (5)
Genetic, epigenetic and gene expression contributors to suicide risk (2)  |  Intervention research for prevention of suicidal behavior (30)
Lifespan differential aspects (from infancy to elderly) (7)  |  Miscellany (assisted suicide, minorities, legal aspects, etc.) (9)
Neurobiological underpinnings of suicidal behavior (3)  |  Novel monitoring strategies for detecting changes in risk over time (4)
Psychosocial variables: protective and risk factors. Resilience & vulnerability (38)  |  Testing the effectiveness of prevention strategies (6)




Novel monitoring strategies for detecting changes in risk over time


(306) PO-306. In search of the internal structure of the Columbia-Suicide Severity Rating Scale (C-SSRS): A confirmatory factor analysis approach

Day: 09 | Time: 10:30 | Room: Poster Hall

Topic: Novel monitoring strategies for detecting changes in risk over time

Authors:Susana Al-Halabi . Centro de Investigación Biomédica en Salud Mental, CIBERSAM. Psiquiatría - Universidad de Oviedo, Oviedo - Spain
- Abel D. Fernández-Peláez - Patricia Burón - Elena Riesco - Julia Rodríguez-Revuelta - Kelly Posner - María Oquendo - M. Paz García-Portilla - Pilar A. Saiz - Julio Bobes -

 Introduction:
Suicide is a major public health issue, and reduction or prevention depends on accurate identification of at-risk patients. The Columbia-Suicide Severity Rating Scale (C-SSRS) is a semi-structured interview that captures the severity of ideation (with a subscale that reflects five types of ideation), the intensity of ideation (with a subscale comprising five items), the suicidal behaviour and the suicidal behaviour lethality1. The C-SSRS has been validated in Spanish (Sp-C-SSRS)2.
 Goals:
To perform a replication study to identify the underlying internal structure of both Sp-C-SSRS Severity and Intensity subscales.
 Methodology:
The sample comprised a total of 150 outpatients (35.33% with a history of suicide attempt) with unipolar or bipolar depression according to ICD-10 criteria [34% males; mean age (SD)=53.90 years (9.78)]. Data Analysis: For analysing the dimensional structure of the Sp-C-SSRS Severity and Intensity subscales, we used the principal component analysis (PCA) with Varimax rotation. The criteria employed to determine the number of components to extract were the Kaiser rule, the screen plot, and the interpretation of the components.
 Results:
The KMO’s measure of sampling adequacy was 0.763 (Severity subscale) and 0.874 (Intensity subscale), indicating that the data was suitable for factor analysis. The Bartlett´s Test of Sphericity was significant (p < 0.000) in both analyses, confirming that the variables were inert-correlated and therefore suitable for factoring. In both Severity and Intensity subscales, the principal component analysis identified two components that explain 87.98% (Severity) and 86.15% (Intensity) of the total variance. In both subscales, the first component included the first three items and explained 44.04% (Severity) and 64.24% (Intensity) of the total variance. In both subscales, the second component included items number 4 and 5 and explained 43.93% (Severity) and 21.91% (Intensity) of the total variance.
 Conclusions:
The principal component analysis performed in this sample confirms the existence of two components in both Sp-C-SSRS Severity and Intensity subscales. These results suggest the need for further research on the structure of the C-CCSR subscales.
 References:
1. Posner K, Brown GK, Stanley B et al. The Columbia-suicide severity rating scale: initial validity and internal consistency findings from three multisite studies with adolescents and adults. Am J Psychiatry. 2011;168:1266-77.
2. Al-Halabí S, Sáiz PA, Burón P, Garrido M, Benabarre A, Jiménez E, Cervilla J, Navarrete MI, Díaz-Mesa EM, García-Álvarez L, Muñiz J, Posner K, Oquendo MA, García-Portilla MP, Bobes J. Validation of a Spanish version of the Columbia-Suicide Severity Rating Scale (C-SSRS). Revista de Psiquiatría y Salud Mental (2016, in press).


(371) PO-371. Monitoring of treatment of patients at risk of achieving a suicidal attempt

Day: 09 | Time: 10:30 | Room: Poster Hall

Topic: Novel monitoring strategies for detecting changes in risk over time

Authors:Laura Montes Reula . Servicio Navarro de salud- Osasunbidea, Pamplona, Spain
- Rebeca Elorza Pardo - Patricia Macaya Aranguren - Lucía Janda Galán - Almudena Portilla Fernández - Leyre Azcárate Jiménez -

 Introduction:
For years suicide is considered a major public health problem worldwide. It is in our interest to analyze what factors surrounding this event, to identify populations at risk and intervene to achieve a reduction.
 Goals:
Determine whether patients treated at a psychiatric emergency department were previously treated and if subsequently were derived to network of Mental Health.
 Methodology:
A total of 440 patients were included in the study, they were recruited in the emergency department of the Hospital of Navarra and the Hospital Reina Sofia of Tudela. They are about of 207 cases (attempted suicide) and 233 controls (attention for a different reason of an attempt autolytic) in the period between January and October 2015. Of all patients is being carried out follow-up six months after the first emergency care. It has chosen a monitoring group until January 31, 2016 with a sample size of 295 patients with 150 cases and 145 controls.
 Results:
It is observed in the beginning sample (N = 295) to 38.6% of patients were not receiving care at a mental health center, being slightly higher in cases compared to controls. Half of the patients had specialized follow-up, but was higher in controls (60%) to cases (42.8%). These differences are statistically significant. In follow-up after six months, there was a loss of 27 patients. Five of them (1.7%) died by suicide, two controls, and three cases. A number of seven patients were discharged of therapeutic cause.
 Conclusions:
The results in the beginning seem contrary to what is expected, so we should ask ourselves whether we are doing a good screening from primary care services. We need to devise new strategies for the management of suicidal patients. Also it appears that less serious diseases are the most frequent users of mental health centers. Draws attention to the number of autolytic fait events that have occurred in six month follow-up sample.
 References:
Patients hospitalized for suicidal ideation and suicide attempt in a Mental Health Hospital: Clinicodemographical features and 6-month follow-up. Teti GL, Rebok F, Grendas LN, Rodante D, Fógola A, Daray FM. Vertex. 2014 May-Jun;25(115):203-12.


(389) PO-389. Improved risk assessment after suicide attempts in the emergency departments of general hospitals with psychiatric unit in the Region of Murcia.

Day: 09 | Time: 13:30 | Room: Poster Hall

Topic: Novel monitoring strategies for detecting changes in risk over time

Authors:María Loreto Medina Garrido . Servicio Murciano de Salud. Subdirección de Salud Mental, Spain
- Jose Martínez Serrano - Laura Belinchon - Francisco Sánchez Yago - Mª Angeles De Haro - Juan Francisco Martínez Inglés - Miguel Santiuste -

 Introduction:
Throughout the year 2014, and within the Mental Health Strategy of the National Health System, a series of projects that seek to identify concrete actions and interventions that can help the Autonomous Communities (CCAA) to implement will be performed some of the priority objectives of the national Strategy. Specifically in the project in which we find it is called "EARLY DETECTION, TREATMENT AND PREVENTION OF RECURRENCE SUICIDE ATTEMPTS".
 Goals:
Improved risk assessment after attempts at emergency departments of general hospitals with psychiatric unit of the reference areas of our community. • On the one hand with a brief clinical interview which includes the most important risk factors for suicide, • Furthermore, the introduction of a scale of assessment of suicide risk. • Incorporation into the computer systems of the community (SELENE) Improved continuity of care between the emergency services and outpatient mental health services. Suicide risk assessment and incorporation of a scale of assessment of suicide risk in mental health centers.
 Methodology:
As a working group working on the realization of a basic protocol assessment of suicidal behavior in emergencies and that it be recorded in computer-readable format. This protocol is not intended to carry out an investigation but based clinical practices and good performances determine our further action.
 Results:
The protocol where appropriate psychopathological and social assessment is carried out and will be discussed include: 1) the evaluation of psychological and contextual factors that explain the suicidal behavior. 2) the characteristics of suicidal behavior with which seeks to identify the elements that could predict recurrence.
 Conclusions:
Model unified action protocol to suicidal patients. minimum quality rating recorded in reports. Interview training in clinical suicide risk, criteria for admission / discharge unified in the region. Scale standardized assessment.
 References:
1. Working Group of the Clinical Practice Guidelines for the Prevention and Treatment of Suicidal Behavior. Guide to Clinical Practice Prevention and Treatment of Suicidal Behavior. Quality plan for the National Health System of the Ministry of Health, Social Policy and Equality. Technology Assessment Agency Health of Galicia (Avalia-t); 2012. Clinical Practice Guidelines in the NHS: Avalia-t 2010/02 2. Pilar A. Sáiz ∗ y Julio Bobes. Suicide prevention in Spain: An uncovered clinical need. Rev Psiquiatr Salud Ment (Barc.). 2014;7(1):1---4


(424) PO-424. Assessing suicide risk: The Firestone Assessment of Self-Destructive Thoughts (FAST)

Day: 09 | Time: 13:30 | Room: Poster Hall

Topic: Novel monitoring strategies for detecting changes in risk over time

Authors:Marjan Ghahramanlou-Holloway . Uniformed Services University of the Health Sciences, Bethesda, Maryland
- Lisa Firestone -

 Introduction:
The Firestone Assessment of Self-Destructive Thoughts (FAST) is based on Separation Theory and Voice Therapy methodology, a comprehensive approach to psychopathology and the corresponding model of mental health. The theoretical approach, as it relates to suicide, focuses on internalized negative thought processes. The FAST was derived from 20 years of clinical research into self-attacking attitudes, or introjects, that restrict or impair an individual’s psychological development. The authors of the scale believed that it was logical to use these negative thought patterns to predict increasingly aggressive cognition and affect toward the self that are closely related to self-destructive behavior and actual suicide. The FAST covers a wide range of self-destructive behaviors- from self-denial, to extreme self-hate, addictions, self-mutilation, and, at the very end, to suicide. The FAST can be used for risk assessment, treatment planning, targeting intervention and outcome evaluation. , will present data from both inpatient and outpatients samples of individuals diagnosed with psychiatric disorders most associated with suicide risk. In addition, data from a high risk military sample will be presented and explained.