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Evidence insufficient on suicide risk screening

Thursday April 25, 2013
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The U.S. Preventive Services Task Force has posted a draft recommendation statement on screening for suicide risk in adolescents, adults and older adults.

The task force considered whether screening all adolescents, adults and older adults for risk factors for suicide is effective. After completing a systematic review of the evidence, the task force concluded that the current evidence is insufficient. Therefore, the task force has issued a draft I statement, which means there is not enough evidence to make a definitive recommendation for or against screening.

Suicide is a major public health issue in America. The lives of more than 37,000 people, both young and old, including those who have served in the military, are cut short each year by suicide, according to a task force news release.

"We all would like to find ways to prevent the suffering of those who commit or attempt suicide, as well as the families and communities they may leave behind," David Grossman, MD, MPH, a task force member, said in the news release. "Unfortunately, at this time we donít know if asking everyone who visits their doctor or nurse about their risk factors for suicide leads to fewer suicides and suicide attempts."

The draft recommendation statement applies to adolescents, adults and older adults without a current mental health disorder or history of mental illness. In the absence of clear evidence, a healthcare professional should consider a number of factors when providing guidance to patients, including current scientific research, expert opinion, professional knowledge and experience, as well as the health histories, values and preferences of patients and their families.

The task force also continues to recommend that adults and adolescents be screened for depression. Evidence has shown that screening for depression coupled with available treatments is effective.

"It is important to note that we are not addressing the needs of people who show symptoms of depression or certain other mental health conditions and may be at higher risk," Grossman said. "For these individuals, having clinicians ask about suicidal thoughts should be part of managing their disease."

Suicide risk varies by gender, age and ethnicity, with higher risk found among men and older adults of most ethnicities, according to the news release. Among adolescents, Hispanic girls and American Indian/Alaskan Natives are known to commit suicide at higher rates.

"The task force calls on the research communities to prioritize studies to develop screening tools that can better identify people without symptoms who are at risk for suicide and to create effective support and treatment programs for people with risk factors for suicide," Grossman said.

"We know that many people who attempt suicide have visited a healthcare professional within a month before their attempt. This means that we have a real opportunity to help if we find better tools."

The task forceís draft recommendation is open for comment until May 20. Comments on the draft recommendation will be considered as the task force develops its final recommendation.

Find links to the draft recommendation on suicide risk screening and other draft recommendations that are open for comment at www.uspreventiveservicestaskforce.org/tfcomment.htm.


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