Symptoms of the suicide crisis syndrome and associated risk factors in an acute psychiatric population, a cross-sectional study

Abstract Background The focus of suicide research changes from traditional risk factors to acute warning signs. Patient self-reported suicidal ideation (SI) is not a reliable measure of acute suicide risk. Presuicidal syndromes such as suicide crisis syndrome (SCS) attempt to describe measurable syn...

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Main Authors: Linde Melby, Karina Høyen, Astrid Prestmo, Arne Vaaler, Tuva Kvithyld, Igor Galynker, Fredrik Walby, Mette Langaas, Terje Torgersen
Format: Article
Language:English
Published: Cambridge University Press 2025-01-01
Series:European Psychiatry
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Online Access:https://www.cambridge.org/core/product/identifier/S0924933825100308/type/journal_article
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author Linde Melby
Karina Høyen
Astrid Prestmo
Arne Vaaler
Tuva Kvithyld
Igor Galynker
Fredrik Walby
Mette Langaas
Terje Torgersen
author_facet Linde Melby
Karina Høyen
Astrid Prestmo
Arne Vaaler
Tuva Kvithyld
Igor Galynker
Fredrik Walby
Mette Langaas
Terje Torgersen
author_sort Linde Melby
collection DOAJ
description Abstract Background The focus of suicide research changes from traditional risk factors to acute warning signs. Patient self-reported suicidal ideation (SI) is not a reliable measure of acute suicide risk. Presuicidal syndromes such as suicide crisis syndrome (SCS) attempt to describe measurable syndromes based on warning signs other than SI. Methods Seven hundred and ten acutely admitted patients were included in the study. Identification of symptoms describing the five components of SCS was done by performing a retrospective text analysis of the patient records (electronic medical records). Patients were grouped according to high or low level of SCS symptoms. We performed statistical tests for group differences in demographics, traditional risk factors, and clinical variables, including agitation assessed by the Positive and Negative Symptom Scale-Excited Component (PANSS-EC). Results Seventy-two patients had high levels of SCS symptoms. They reported less SI the last month before admission; suicidality was less relevant for referral, the intake suicide assessment more often concluded with high suicide risk, they were more often referred and admitted involuntarily, and they had higher total scores on PANSS-EC. Conclusion The individual SCS symptoms may provide useful information in the evaluation of acute suicide risk at intake. A high level of SCS symptoms suggests more severe conditions. The lower reports among high-level than low-level SCS patients of self-reported SI last month before admission, shows the limitation of using SI as a warning sign. The association between the level of SCS symptoms and PANSS-EC total score suggests that agitation could give valuable additional information for suicide risk assessments.
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spelling doaj-art-cc997d23b965474dbe033cfd042094dc2025-08-20T03:16:01ZengCambridge University PressEuropean Psychiatry0924-93381778-35852025-01-016810.1192/j.eurpsy.2025.10030Symptoms of the suicide crisis syndrome and associated risk factors in an acute psychiatric population, a cross-sectional studyLinde Melby0https://orcid.org/0000-0003-2560-9421Karina Høyen1Astrid Prestmo2Arne Vaaler3https://orcid.org/0000-0002-4630-1517Tuva Kvithyld4Igor Galynker5https://orcid.org/0009-0001-4122-1470Fredrik Walby6https://orcid.org/0000-0001-5154-7397Mette Langaas7https://orcid.org/0000-0002-5714-0288Terje Torgersen8https://orcid.org/0000-0001-8813-0990Department of Mental Healthcare, https://ror.org/01a4hbq44 St. Olav’s Hospital, Trondheim University Hospital , Trondheim, Norway Department of Mental Health, https://ror.org/05xg72x27 Norwegian University of Science and Technology , Trondheim, NorwayDepartment of Mental Healthcare, https://ror.org/01a4hbq44 St. Olav’s Hospital, Trondheim University Hospital , Trondheim, Norway Department of Mental Health, https://ror.org/05xg72x27 Norwegian University of Science and Technology , Trondheim, NorwayDepartment of Mental Healthcare, https://ror.org/01a4hbq44 St. Olav’s Hospital, Trondheim University Hospital , Trondheim, NorwayDepartment of Mental Healthcare, https://ror.org/01a4hbq44 St. Olav’s Hospital, Trondheim University Hospital , Trondheim, Norway Department of Mental Health, https://ror.org/05xg72x27 Norwegian University of Science and Technology , Trondheim, NorwayDepartment of Mental Healthcare, https://ror.org/01a4hbq44 St. Olav’s Hospital, Trondheim University Hospital , Trondheim, NorwayDepartment of Psychiatry, Mount Sinai Beth Israel, New York, NY, USANational Centre for Suicide Research and Prevention (NSSF), https://ror.org/01a4hbq44 Oslo University Hospital , Oslo, NorwayDepartment of Mathematical Sciences, Norwegian University of Science and Technology (NTNU), Trondheim, NorwayDepartment of Mental Healthcare, https://ror.org/01a4hbq44 St. Olav’s Hospital, Trondheim University Hospital , Trondheim, Norway Department of Mental Health, https://ror.org/05xg72x27 Norwegian University of Science and Technology , Trondheim, NorwayAbstract Background The focus of suicide research changes from traditional risk factors to acute warning signs. Patient self-reported suicidal ideation (SI) is not a reliable measure of acute suicide risk. Presuicidal syndromes such as suicide crisis syndrome (SCS) attempt to describe measurable syndromes based on warning signs other than SI. Methods Seven hundred and ten acutely admitted patients were included in the study. Identification of symptoms describing the five components of SCS was done by performing a retrospective text analysis of the patient records (electronic medical records). Patients were grouped according to high or low level of SCS symptoms. We performed statistical tests for group differences in demographics, traditional risk factors, and clinical variables, including agitation assessed by the Positive and Negative Symptom Scale-Excited Component (PANSS-EC). Results Seventy-two patients had high levels of SCS symptoms. They reported less SI the last month before admission; suicidality was less relevant for referral, the intake suicide assessment more often concluded with high suicide risk, they were more often referred and admitted involuntarily, and they had higher total scores on PANSS-EC. Conclusion The individual SCS symptoms may provide useful information in the evaluation of acute suicide risk at intake. A high level of SCS symptoms suggests more severe conditions. The lower reports among high-level than low-level SCS patients of self-reported SI last month before admission, shows the limitation of using SI as a warning sign. The association between the level of SCS symptoms and PANSS-EC total score suggests that agitation could give valuable additional information for suicide risk assessments. https://www.cambridge.org/core/product/identifier/S0924933825100308/type/journal_articleagitationrisk factorssuicidal behaviorsuicide crisis syndromewarning signs
spellingShingle Linde Melby
Karina Høyen
Astrid Prestmo
Arne Vaaler
Tuva Kvithyld
Igor Galynker
Fredrik Walby
Mette Langaas
Terje Torgersen
Symptoms of the suicide crisis syndrome and associated risk factors in an acute psychiatric population, a cross-sectional study
European Psychiatry
agitation
risk factors
suicidal behavior
suicide crisis syndrome
warning signs
title Symptoms of the suicide crisis syndrome and associated risk factors in an acute psychiatric population, a cross-sectional study
title_full Symptoms of the suicide crisis syndrome and associated risk factors in an acute psychiatric population, a cross-sectional study
title_fullStr Symptoms of the suicide crisis syndrome and associated risk factors in an acute psychiatric population, a cross-sectional study
title_full_unstemmed Symptoms of the suicide crisis syndrome and associated risk factors in an acute psychiatric population, a cross-sectional study
title_short Symptoms of the suicide crisis syndrome and associated risk factors in an acute psychiatric population, a cross-sectional study
title_sort symptoms of the suicide crisis syndrome and associated risk factors in an acute psychiatric population a cross sectional study
topic agitation
risk factors
suicidal behavior
suicide crisis syndrome
warning signs
url https://www.cambridge.org/core/product/identifier/S0924933825100308/type/journal_article
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