Guidelines from the Brazilian Psychiatric Association for the management of suicidal behavior: screening and assessment
revised and expanded translation of: https://doi.org/10.1590/1516-4446-2020-0994 and https://doi.org/10.1590/1516-4446-2020-1108
DOI:
https://doi.org/10.25118/2763-9037.2024.v14.1260Keywords:
suicide, completed suicide, suicide attempt, mental disorders, guidelinesAbstract
This article details the guidelines for the screening and assessment of suicidal behavior. Screening involves the use of instruments or protocols to identify individuals with suicidal behaviors, which can be applied independently or as part of a broader health assessment. This can be done manually or electronically and can be applied selectively or universally to the entire target population. The assessment of suicide risk should be conducted by a physician and include structured questionnaires and open-ended conversations with the patient, family, and friends to obtain a comprehensive view of behavior, risk and protective factors, and mental health care history. The effectiveness of screening and assessment is enhanced when combined with intervention strategies, such as the Safety Plan, which integrates risk assessment and the creation of an individualized therapeutic plan.
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Baldaçara L, Meleiro A, Quevedo J, Vallada H, Silva AG. Epidemiology of suicides in Brazil: a systematic review. Glob Psychiatry Arch. 2022;5(1):10-25. https://doi.org/10.52095/gp.2022.4377.1035
Baldaçara L, Rocha GA, Leite VS, Porto DM, Grudtner RR, Diaz AP, Meleiro A, Correa H, Tung TC, Quevedo J, Silva AG. Brazilian Psychiatric Association guidelines for the management of suicidal behavior. Part 1. Risk factors, protective factors, and assessment. Braz J Psychiatry. 2021;43(5):525-37. https://doi.org/10.1590/1516-4446-2020-0994 PMID:33111773 - PMCID:PMC8555650
Baldaçara L, Silva AG. Suporte em emergências psiquiátricas (SEP). Belo Horizonte: Editora Ampla; 2021.
Baldaçara L, Cordeiro DC, Calfat EB, Cordeiro Q, Tung TC. Emergências psiquiátricas. 2. ed. Rio de Janeiro: GEN Guanabara Koogan; 2018.
Baldaçara L, Grudtner RR, Leite VS, Porto DM, Robis KP, Fidalgo TM, Rocha GA, Diaz AP, Meleiro A, Correa H, Tung TC, Malloy-Diniz L, Quevedo J, Silva AG. Brazilian Psychiatric Association guidelines for the management of suicidal behavior. Part 2. Screening, intervention, and prevention. Braz J Psychiatry. 2021;43(5):538-49. https://doi.org/10.1590/1516-4446-2020-1108 PMID:33331533 - PMCID:PMC8555636
Baldaçara L, Weber CAT, Gorender M, Grudtner RR, Peu S, Teles ALS, Passos IC, Quevedo J, da Silva AG. Brazilian Psychiatric Association guidelines for the management of suicidal behavior. Part 3. Suicide prevention hotlines. Braz J Psychiatry. 2023;45(1):54-61. https://doi.org/10.47626/1516-4446-2022-2536 PMID:35809251 - PMCID:PMC9976911
Suicide Prevention Resource Center. Suicide screening and assessment. Norman: Suicide Prevention Resource Center; 2014. https://sprc.org/wp-content/uploads/2023/01/RS_suicide-screening_91814-final.pdf
Lindh AU, Dahlin M, Beckman K, Stromsten L, Jokinen J, Wiktorsson S, Renberg ES, Waern M, Runeson B. A comparison of suicide risk scales in predicting repeat suicide attempt and suicide: a clinical cohort study. J Clin Psychiatry. 2019;80(6):18m12707. https://doi.org/10.4088/jcp.18m12707 PMID:31747488
Pompili M, Belvederi Murri M, Patti S, Innamorati M, Lester D, Girardi P, Amore M. The communication of suicidal intentions: a meta-analysis. Psychol Med. 2016;46(11):2239-53. https://doi.org/10.1017/s0033291716000696 PMID:27239944
Boudreaux ED, Miller I, Goldstein AB, Sullivan AF, Allen MH, Manton AP, Arias SA, Camargo CA Jr. The emergency department safety assessment and follow-up evaluation (ED-SAFE): method and design considerations. Contemp Clin Trials. 2013;36(1):14-24. https://doi.org/10.1016/j.cct.2013.05.008 PMID:23707435 PMCID:PMC3979300
Dunlap LJ, Orme S, Zarkin GA, Arias SA, Miller IW, Camargo CA Jr, Sullivan AF, Allen MH, Goldstein AB, Manton AP, Clark R, Boudreaux ED. Screening and intervention for suicide prevention: a cost-effectiveness analysis of the ED-SAFE interventions. Psychiatr Serv. 2019;70(12):1082-7. https://doi.org/10.1176/appi.ps.201800445 PMID:31451063
Stanley B, Brown GK, Currier GW, Lyons C, Chesin M, Knox KL. Brief intervention and follow-up for suicidal patients with repeat emergency department visits enhances treatment engagement. Am J Public Health. 2015;105(8):1570-2. https://doi.org/10.2105/ajph.2015.302656 PMID:26066951 PMCID:PMC4504270
Practice guideline for the assessment and treatment of patients with suicidal behaviors. Am J Psychiatry. 2003;160(11 Suppl):1-60. PMID:14649920
Maino MP, Morales S, Echávarri O, Barros J, García A, Moya C, Szmulewicz T, Fischman R, Núnez C, Tomicic A. Suicide risk configuration system in a clustered clinical sample: a generalized linear model obtained through the LASSO technique. Braz J Psychiatry. 2019;41(2):112-21. https://doi.org/10.1590/1516-4446-2017-0028 PMID:30328960 - PMCID:PMC6781676
D'Onofrio G, Pantalon MV, Degutis LC, Fiellin DA, O'connor PG. Development and implementation of an emergency practitioner-performed brief intervention for hazardous and harmful drinkers in the emergency department. Acad Emerg Med. 2005;12(3):249-56. https://doi.org/10.1197/j.aem.2004.10.021 PMID:15741590 PMCID:PMC1414059
Runeson B, Odeberg J, Pettersson A, Edbom T, Jildevik Adamsson I, Waern M. Instruments for the assessment of suicide risk: a systematic review evaluating the certainty of the evidence.
PLoS One. 2017;12(7):e0180292. https://doi.org/10.1371/journal.pone.0180292 PMID:28723978 PMCID:PMC5517300

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Copyright (c) 2024 Leonardo Baldaçara, Elie Leal de Barros Calfat, Cintia de Azevedo-Marques Périco, Flavia Ismael Pinto, Gislene Alves da Rocha, Verônica da Silveira Leite , Deisy Mendes Porto, Roberta Rossi Grudtner, Alexandre Paim Diaz, Alexandrina Maria Augusto da Silva Meleiro, Humberto Corrêa da Silva Filho, Teng Chei Tung, João Quevedo, Antônio Geraldo da Silva

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