SAD PERSONS score: Difference between revisions
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==Background== | ==Background== | ||
*Score intended to evaluate patients presenting with [[depression]] and/or suicidal ideation and determine need for admission | *Score intended to evaluate patients presenting with [[depression]] and/or suicidal ideation and determine need for admission | ||
*However, while scale has good specificity (>90%), sensitivity is only 2%<ref>Saunders K, Brand F, Lascelles K, et al. The sad truth about the SADPERSONS Scale: an evaluation of its clinical utility in self-harm patients. Emerg Med J 2014;31:796-798.</ref> | *However, while scale has good specificity (>90%), sensitivity is only 2%.<ref>Saunders K, Brand F, Lascelles K, et al. The sad truth about the SADPERSONS Scale: an evaluation of its clinical utility in self-harm patients. Emerg Med J 2014;31:796-798.</ref> Neither the original nor modified score is useful for predicting need for admission.<ref>Bolton, James M.; Spiwak, Rae; Sareen, Jitender (15 June 2012). "Predicting Suicide Attempts With the SAD PERSONS Scale". The Journal of Clinical Psychiatry. 73 (06): e735–e741.</ref> | ||
**Therefore, this score likely '''should not''' be utilized in the ED setting to make admission decisions. | **Therefore, this score likely '''should not''' be utilized in the ED setting to make admission decisions. | ||
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*'''A'''ge <19 or >45 '''(1)''' | *'''A'''ge <19 or >45 '''(1)''' | ||
*'''D'''epressed symptoms '''(2)''' | *'''D'''epressed symptoms '''(2)''' | ||
*'''P'''ast | *'''P'''ast psychiatric history or suicide attempts '''(1)''' | ||
*[[ETOH|'''E'''TOH]]/drug use history '''(1)''' | *[[ETOH|'''E'''TOH]]/drug use history '''(1)''' | ||
*'''R'''ational thought loss '''(2)''' | *'''R'''ational thought loss '''(2)''' | ||
*'''S'''eparated/divorced/widowed '''(1)''' | *'''S'''eparated/divorced/widowed or sickness with 3 or more prescription medications'''(1)''' | ||
*'''O'''rganized | *'''O'''rganized plan or serious attempt '''(2)''' | ||
*'''N'''o social support '''(1)''' | *'''N'''o social support '''(1)''' | ||
*'''S'''tated intent (or ambivalence) '''(2)''' | *'''S'''tated intent (or ambivalence) '''(2)''' | ||
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==Disposition== | ==Disposition== | ||
*By point total: | *By point total: | ||
**<6: May discharge home if have someone to care for them, follow | **<6: May discharge home if have someone to care for them, follow-up within 1 day, call follow up MD, and create safety plan (contracting for safety is not helpful, but creating a crisis plan may be) | ||
**6-8: 50% admission rate (consult | **6-8: 50% admission rate (consult psychiatry for further risk assessment) | ||
**>8: Admit | **>8: Admit | ||
Latest revision as of 14:51, 25 March 2019
Background
- Score intended to evaluate patients presenting with depression and/or suicidal ideation and determine need for admission
- However, while scale has good specificity (>90%), sensitivity is only 2%.[1] Neither the original nor modified score is useful for predicting need for admission.[2]
- Therefore, this score likely should not be utilized in the ED setting to make admission decisions.
Score
- Sex = male (1)
- Age <19 or >45 (1)
- Depressed symptoms (2)
- Past psychiatric history or suicide attempts (1)
- ETOH/drug use history (1)
- Rational thought loss (2)
- Separated/divorced/widowed or sickness with 3 or more prescription medications(1)
- Organized plan or serious attempt (2)
- No social support (1)
- Stated intent (or ambivalence) (2)
- Assessment must be without ETOH/drugs on board (wait for person to sober)
Disposition
- By point total:
- <6: May discharge home if have someone to care for them, follow-up within 1 day, call follow up MD, and create safety plan (contracting for safety is not helpful, but creating a crisis plan may be)
- 6-8: 50% admission rate (consult psychiatry for further risk assessment)
- >8: Admit
See Also
References
- ↑ Saunders K, Brand F, Lascelles K, et al. The sad truth about the SADPERSONS Scale: an evaluation of its clinical utility in self-harm patients. Emerg Med J 2014;31:796-798.
- ↑ Bolton, James M.; Spiwak, Rae; Sareen, Jitender (15 June 2012). "Predicting Suicide Attempts With the SAD PERSONS Scale". The Journal of Clinical Psychiatry. 73 (06): e735–e741.