SAD PERSONS scale

The SAD PERSONS scale is an acronym utilized as a mnemonic device. It was first developed as a clinical assessment tool for medical professionals to determine suicide risk, by Patterson et al.[1] The Adapted-SAD PERSONS Scale was developed by Gerald A. Juhnke for use with children in 1996.

SAD PERSONS scale
Purposedetermine suicide risk

Recent studies have found although the scale has specificity, its sensitivity is so low it is of no clinical value;[2][3] moreover it may actually be clinically harmful.[4] This measure has also been criticized for being an index of risk factors that may not be applicable to individuals, and that suicide risk be assessed with more valid measures of the individual's current risk level.[5]

Calculation

The score is calculated from ten yes/no questions, with one point for each affirmative answer:

  • S: Male sex
  • A: Age (<19 or >45 years)
  • D: Depression
  • P: Previous attempt
  • E: Excess alcohol or substance use
  • R: Rational thinking loss
  • S: Social supports lacking
  • O: Organized plan
  • N: No spouse
  • S: Sickness

This score is then mapped onto a risk assessment scale as follows:

  • 0–4: Low
  • 5–6: Medium
  • 7–10: High

Modified SAD PERSONS Scale

The score is calculated from ten yes/no questions, with points given for each affirmative answer as follows:[6]

  • S: Male sex → 1
  • A: Age 15–25 or 59+ years → 1
  • D: Depression or hopelessness → 2
  • P: Previous suicidal attempts or psychiatric care → 1
  • E: Excessive ethanol or drug use → 1
  • R: Rational thinking loss (psychotic or organic illness) → 2
  • S: Single, widowed or divorced → 1
  • O: Organized or serious attempt → 2
  • N: No social support → 1
  • S: Stated future intent (determined to repeat or ambivalent) → 2

This score is then mapped onto a risk assessment scale as follows:

  • 0–5: May be safe to discharge (depending upon circumstances)
  • 6–8: Probably requires psychiatric consultation
  • >8: Probably requires hospital admission

See also

References
  1. Patterson, WM; Dohn, HH; Bird, J; Patterson, GA (April 1983). "Evaluation of suicidal patients: the SAD PERSONS scale". Psychosomatics. 24 (4): 343–5, 348–9. doi:10.1016/S0033-3182(83)73213-5. PMID 6867245.
  2. Bolton, James M.; Spiwak, Rae; Sareen, Jitender (15 June 2012). "Predicting Suicide Attempts With the SAD PERSONS Scale". The Journal of Clinical Psychiatry. 73 (6): e735–e741. doi:10.4088/JCP.11m07362. PMID 22795212.
  3. Saunders, K.; Brand, F.; Lascelles, K.; Hawton, K. (29 July 2013). "The sad truth about the SADPERSONS Scale: an evaluation of its clinical utility in self-harm patients". Emergency Medicine Journal. 31 (10): 796–798. doi:10.1136/emermed-2013-202781. PMID 23896589.
  4. M. Birnbaumer, Diane. "A Sad Performance by the SADPERSONS Scale". NEJM Journal Watch. Massachusetts Medical Society. Retrieved 8 August 2013.
  5. Harris, K. M.; Syu, J.-J.; Lello, O. D.; Chew, Y. L. E.; Willcox, C. H.; Ho, R. H. M.; Tran, U. S. (2015). "The ABC's of Suicide Risk Assessment: Applying a Tripartite Approach to Individual Evaluations". PLOS ONE. 10 (6): e0127442. Bibcode:2015PLoSO..1027442H. doi:10.1371/journal.pone.0127442. PMC 4452484. PMID 26030590.
  6. Oxford Handbook of Emergency Medicine. Third Edition. Page 609.
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