Validity of the Nepali Ask Suicide Screening Questions tool for medical inpatients
Abstract Background Nepal has one of the highest youth suicide rates in the world. Suicide screening is rarely performed during hospitalization, partly due to the lack of validated tools in the local language. We evaluated the validity of the Nepali version of the Ask Suicide-Screening Questions (AS...
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BMC
2025-07-01
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| Series: | BMC Psychiatry |
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| Online Access: | https://doi.org/10.1186/s12888-025-07148-w |
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| author | Daman R Poudel Arun K Sharma Ram H Chapagain Manisha Chapagai Nathan J. Lowry Mahesh R Sigdel Krishna P Bista Rahul Pathak Arun Kunwar Janna Patterson Terrell Carter Lisa M. Horowitz |
| author_facet | Daman R Poudel Arun K Sharma Ram H Chapagain Manisha Chapagai Nathan J. Lowry Mahesh R Sigdel Krishna P Bista Rahul Pathak Arun Kunwar Janna Patterson Terrell Carter Lisa M. Horowitz |
| author_sort | Daman R Poudel |
| collection | DOAJ |
| description | Abstract Background Nepal has one of the highest youth suicide rates in the world. Suicide screening is rarely performed during hospitalization, partly due to the lack of validated tools in the local language. We evaluated the validity of the Nepali version of the Ask Suicide-Screening Questions (ASQ) tool in youth population in medical inpatient settings. Methods We conducted a cross-sectional validation study at two urban hospitals in Nepal between January and July 2022. Patients aged 10 to 24 years admitted to medical wards were recruited through convenience sampling. Patients with significant cognitive impairment, non-fluent in Nepali, or planned early discharge limiting participation were excluded. Trained nurses administered the ASQ followed by the adolescent version of Patient Health Questionnaire (PHQ − 9) and completed a demographic survey. Thereafter a separate team of psychologists, blind to ASQ results, conducted a brief suicide safety assessment (BSSA) as the gold standard for suicide risk screening. Results All study procedures were completed by 309 [54.0% male, mean age = 15.79(± 4.2) years] participants and were included in analysis. In our sample, 15.9% (49/309) screened positive with ASQ; 8.4% (26/309) had elevated suicide risk on the BSSA. The ASQ demonstrated good sensitivity (77%; 95% CI: 56–91), specificity (90%; 95% CI: 86–93), positive predictive value (41%; 95% CI: 27–56) and negative predictive value (98%; 95% CI: 95–99) against BSSA. Conclusion The Nepali version of ASQ is a good, brief screening tool for identifying suicidal risk. Further validation in wider populations including outpatient setting and routine implementation in clinical practice should be considered. |
| format | Article |
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| institution | Kabale University |
| issn | 1471-244X |
| language | English |
| publishDate | 2025-07-01 |
| publisher | BMC |
| record_format | Article |
| series | BMC Psychiatry |
| spelling | doaj-art-c0c06d3cd47f4fbabbd1da62538a709e2025-08-20T03:42:56ZengBMCBMC Psychiatry1471-244X2025-07-012511910.1186/s12888-025-07148-wValidity of the Nepali Ask Suicide Screening Questions tool for medical inpatientsDaman R Poudel0Arun K Sharma1Ram H Chapagain2Manisha Chapagai3Nathan J. Lowry4Mahesh R Sigdel5Krishna P Bista6Rahul Pathak7Arun Kunwar8Janna Patterson9Terrell Carter10Lisa M. Horowitz11Tribhuvan University Teaching Hospital, Institute of MedicineTribhuvan University Teaching Hospital, Institute of MedicineKanti Children’s HospitalTribhuvan University Teaching Hospital, Institute of MedicineNational Institute of Mental HealthTribhuvan University Teaching Hospital, Institute of MedicineNepal Paediatrics SocietyTribhuvan University Teaching Hospital, Institute of MedicineKanti Children’s HospitalAmerican Academy of PediatricsAmerican Academy of PediatricsNational Institute of Mental HealthAbstract Background Nepal has one of the highest youth suicide rates in the world. Suicide screening is rarely performed during hospitalization, partly due to the lack of validated tools in the local language. We evaluated the validity of the Nepali version of the Ask Suicide-Screening Questions (ASQ) tool in youth population in medical inpatient settings. Methods We conducted a cross-sectional validation study at two urban hospitals in Nepal between January and July 2022. Patients aged 10 to 24 years admitted to medical wards were recruited through convenience sampling. Patients with significant cognitive impairment, non-fluent in Nepali, or planned early discharge limiting participation were excluded. Trained nurses administered the ASQ followed by the adolescent version of Patient Health Questionnaire (PHQ − 9) and completed a demographic survey. Thereafter a separate team of psychologists, blind to ASQ results, conducted a brief suicide safety assessment (BSSA) as the gold standard for suicide risk screening. Results All study procedures were completed by 309 [54.0% male, mean age = 15.79(± 4.2) years] participants and were included in analysis. In our sample, 15.9% (49/309) screened positive with ASQ; 8.4% (26/309) had elevated suicide risk on the BSSA. The ASQ demonstrated good sensitivity (77%; 95% CI: 56–91), specificity (90%; 95% CI: 86–93), positive predictive value (41%; 95% CI: 27–56) and negative predictive value (98%; 95% CI: 95–99) against BSSA. Conclusion The Nepali version of ASQ is a good, brief screening tool for identifying suicidal risk. Further validation in wider populations including outpatient setting and routine implementation in clinical practice should be considered.https://doi.org/10.1186/s12888-025-07148-wValidationAsk Suicide-Screening questionsSuicideNepalYouthMental health |
| spellingShingle | Daman R Poudel Arun K Sharma Ram H Chapagain Manisha Chapagai Nathan J. Lowry Mahesh R Sigdel Krishna P Bista Rahul Pathak Arun Kunwar Janna Patterson Terrell Carter Lisa M. Horowitz Validity of the Nepali Ask Suicide Screening Questions tool for medical inpatients BMC Psychiatry Validation Ask Suicide-Screening questions Suicide Nepal Youth Mental health |
| title | Validity of the Nepali Ask Suicide Screening Questions tool for medical inpatients |
| title_full | Validity of the Nepali Ask Suicide Screening Questions tool for medical inpatients |
| title_fullStr | Validity of the Nepali Ask Suicide Screening Questions tool for medical inpatients |
| title_full_unstemmed | Validity of the Nepali Ask Suicide Screening Questions tool for medical inpatients |
| title_short | Validity of the Nepali Ask Suicide Screening Questions tool for medical inpatients |
| title_sort | validity of the nepali ask suicide screening questions tool for medical inpatients |
| topic | Validation Ask Suicide-Screening questions Suicide Nepal Youth Mental health |
| url | https://doi.org/10.1186/s12888-025-07148-w |
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