Innovations In Clinical Neuroscience

SEP-OCT 2014

A peer-reviewed, evidence-based journal for clinicians in the field of neuroscience

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Innovations in CLINICAL NEUROSCIENCE [ V O L U M E 1 1 , N U M B E R 9 – 1 0 , S E P T E M B E R – O C T O B E R 2 0 1 4 ] 30 assessment. In addition, the analyses conducted simply evaluated the presence or absence of reported SIB at any time during study participation report, and did not evaluate the extent to which SIB may have escalated or diminished from one follow-up visit to the next. Finally, the data extracted for these analyses cannot address potential differences between specific medications or treatment conditions, since no treatment blind information is stored in the anonymized dataset. Accurate assessment of SIB is essential in clinical trials and clinical practice. The eC-SSRS improves upon previous SIB assessment methods by directly capturing patient reports of thoughts and behaviors through a computer interview. This approach avoids error and bias that may be present when clinicians interview patients. Additionally, the electronic nature of the assessment allows for efficient, standardized collection and processing of information. Any assessment developed to measure SIB must demonstrate adequate psychometric characteristics. The current study adds to a growing evidence base supporting the reliability and validity of the eC-SSRS across patient populations and clinical contexts. These results reinforce prior findings that lifetime SIB risk predicts future suicidal behavior, and that the eC-SSRS is a TABLE 4. Negative and positive prospective reports of SIB during study participation based on study type and number of lifetime suicidal behaviors reported at baseline. BASELINE REPORTED LIFETIME SIB PSYCHIATRIC STUDY PARTICIPANTS NONPSYCHIATRIC STUDY PARTICIPANTS Prospective Behavior Prospective Behavior Negative Positive OR (95% CI)* Negative Positive OR (95% CI)* No suicidal behaviors 5,006 117 -- 1,988 7 -- One lifetime behavior 600 57 4.07 (2.9–5.6) **** 41 1 6.93 (0.8–57.6) ns Two lifetime behaviors 401 72 7.68 (5.6–10.5) **** 24 1 11.83 (1.4–99.9) ** Three lifetime behaviors 311 64 8.81 (6.4–12.2) **** 10 1 28.40 (3.2–252.6) *** Four lifetime behaviors 105 27 11.00 (6.9–17.4) **** 3 1 94.67 (8.7–1024.6)**** BASELINE REPORTED LIFETIME SIB Prospective Ideation Prospective Ideation Negative Positive OR (95% CI)* Negative Positive OR (95% CI)* No suicidal behaviors 5,074 49 -- 1,995 0 -- One lifetime behavior 638 19 3.08 (1.8–5.3)**** 42 0 -- Two lifetime behaviors 458 15 3.39 (1.9–6.1)**** 25 0 -- Three lifetime behaviors 353 22 6.45 (3.9–10.8)**** 11 0 -- Four lifetime behaviors 122 10 8.49 (4.2–17.2)**** 4 0 -- * Common odds ratios were computed using patients reporting no prior suicidal behaviors served as the reference group. ns p>0.05 ** p <0.05 *** p<0.01 **** p<0.001 SIB: suicidal ideation and behavior

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