Innovations In Clinical Neuroscience

SEP-OCT 2014

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

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[ 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 ] Innovations in CLINICAL NEUROSCIENCE 93 ABSTRACT There is a need for a choice of scales to evaluate the full range of suicidal phenomena. Such scales must be capable of use as both safety and efficacy outcome measures in research and in clinical settings. Central to the success in finding and developing effective anti-suicidal medications is having a sensitive suicidality scale that can detect an efficacy signal in conventional sample sizes used in clinical trials. The Sheehan-Suicidality Tracking Scale was developed for these purposes. This article provides a 2014 status update on the scale's progress, its use, and its properties. The authors review why and how the scale was developed; the scale structure, versions, and properties; the trials in which it was used; the time frames accommodated; its validation and reliability studies; its utility in screening and assessment; its utility in assessing treatment-emergent suicidal adverse events; its use as an efficacy outcome measure; its availability in self-rated and clinician-rated forms; the availability and linguistic validation of pediatric versions; linguistic validation in other languages; how it compares with global ratings of suicidality; and its possible utility and applications. INTRODUCTION There is a need for a choice of scales to evaluate the full range of suicidal phenomena. Such scales must be capable of use as both safety and efficacy outcome measures in research and in clinical settings. Sensitivity to anti-suicidal effects in modest sample sizes is particularly important in the context of efforts to find and develop anti-suicidal medications. The Sheehan-Suicidality Tracking Scale (S- STS) was developed to provide a brief but efficient assessment instrument for use in assessing change in suicidal ideation and behavior while providing a comprehensive description of suicidal ideation and behavior. The primary goals in the design of the S-STS were for the scale to be as follows: 1. Short and inexpensive 2. Simple, clear, and easy to administer or self-rate 3. Highly sensitive (i.e., able to detect a high proportion of patients who are suicidal) 4. Specific (i.e., able to screen out those who are not suicidal) by DAVID V. SHEEHAN, MD, MBA; JENNIFER M. GIDDENS; and IVAN SASCHA SHEEHAN, PhD Dr. D. Sheehan is Distinguished University Health Professor Emeritus at the University of South Florida College of Medicine, Tampa, Florida; J. Giddens is the Co-founder of the Tampa Center for Research on Suicidality, Tampa, Florida; and Dr. I. S. Sheehan is Assistant Professor and Graduate Program Director, School of Public and International Affairs, University of Baltimore, Baltimore, Maryland. Innov Clin Neurosci. 2014;11(9–10):93–140 FUNDING: There was no funding for the development and writing of this article. FINANCIAL DISCLOSURES: Dr. D. Sheehan is the author and copyright holder of the Sheehan-Suicidality Tracking Scale (S-STS), the Sheehan-Suicidality Tracking Scale Clinically Meaningful Change Measure Version (S-STS CMCM), the Pediatric versions of the S-STS, the Sheehan Disability Scale (SDS), and the Suicidality Modifiers Scale; is a co-author of the Suicide Plan Tracking Scale (SPTS), Sheehan- Homicidality Tracking Scale, and the Mini International Neuropsychiatric Interview (MINI); and owns stock in Medical Outcomes Systems, which has computerized the S-STS and the MINI. J. Giddens is the author and copyright holder of the SPTS and is a named consultant on the S-STS, the S-STS CMCM, the Pediatric versions of the S-STS, and the Suicidality Modifiers Scale. Dr. I. S. Sheehan is the co-author of the Sheehan-Homicidality Tracking Scale. He is also the son of Dr. D. Sheehan, who is the author and copyright holder of the S-STS, the S-STS CMCM, the Pediatric versions of the S-STS, the SDS, and the Suicidality Modifiers Scale; a co-author of the SPTS, the Sheehan-Homicidality Tracking Scale, and the MINI; and owns stock in Medical Outcomes Systems, which has computerized the S-STS and the MINI. ADDRESS CORRESPONDENCE TO: David V. Sheehan, MD, MBA; E-mail: dsheehan@health.usf.edu KEY WORDS: Suicide scale, suicide assessment, suicide risk, suicide, suicidality, suicidality scale, patient-rated suicide assessment, pediatric suicide, suicide in children, pediatric suicide scale, adolescent suicide scale, S-STS, homicide assessment, homicidality, homicide, S-HTS [ R E V I E W ] Status Update on the Sheehan-Suicidality Tracking Scale (S-STS) 2014

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