Predictive Validity of Proposed Diagnostic Criteria for the Suicide Crisis Syndrome: An Acute Presuicidal State

Zimri S. Yaseen, Mariah Hawes, Shira Barzilay, Igor Galynker

Research output: Contribution to journalArticlepeer-review


Background: Determining imminent risk of suicide continues to challenge psychiatrists. To this end, we test the clinical utility of a proposed set of diagnostic criteria for the suicide crisis syndrome (SCS) for prediction of imminent suicidal thoughts and behaviors prospectively. Method: One hundred and seventy individuals hospitalized for suicidal thoughts and behaviors (STB) were evaluated within 72 hr of admission with measures assessing symptoms of the proposed SCS, history of STB, current ideation, and depression severity. Four-eight weeks following discharge, STB were reassessed. Associations between SCS and postdischarge attempts were examined using chi-square and logistic regression analyses. The receiver operator characteristic analysis was used to test the optimal number of symptoms required to meet proposed SCS criteria. Results: The syndrome was maximally informative about short-term risk of postdischarge suicide behavior when all criteria were met. The syndrome conferred a sevenfold increase in risk of postdischarge suicide attempt, and significantly improved prediction by standard risk factors, which was null to limited. Conclusions: The SCS diagnostic criteria are supported and appear to describe a clinically meaningful syndrome in a high-risk population. Assessment of SCS may meaningfully improve clinical assessment of imminent suicide risk. Further study is needed to better understand the syndrome and its applicability in low-risk populations.

Original languageEnglish
Pages (from-to)1124-1135
Number of pages12
JournalSuicide and Life-Threatening Behavior
Issue number4
StatePublished - 2019
Externally publishedYes

Bibliographical note

Publisher Copyright:
© 2018 The American Association of Suicidology

ASJC Scopus subject areas

  • Clinical Psychology
  • Public Health, Environmental and Occupational Health
  • Psychiatry and Mental health


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