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ItwasoriginallydescribedbyPattersonetal (1)andhasbeenreviewedbyJuhnke(2).Juhnkealsoadaptedthescaleforkids(3). S:Sex.Menaremorelikelytocommitsuicidethanwomen.Maleskillthemselvesabout fourtimesmoreoften,althoughfemalesmakefarmoreattempts. A:Age.Theageswhicharemostdangerousforsuicidevaryovertime.Youshould consultcurrentstatistics.Asthisisbeingwrittenin2006individuals1524havean elevatedrisk.Suicideisthethirdleadingcauseofdeathinthisagegroup.However, estimatesexistwhichsuggestthatpeoplethisagemakingattemptsoutnumberactual suicidesbyaratioof100400times. Malesoverage75arealsoknowntobeathighrisk.Currentdemographicssuggest thatwomeninthe4554agegrouparehighest,butfemalesinolderoryoungerage rangesarenotthatdifferent.Afterage65individualsasawholehaveanattemptto completedsuiciderateofabout2:1.Uptoage65,itisabouta7:1ratio. D:Depression.Thesuiciderateforthosewhoareclinicallydepressedisabout20times greaterthanforthegeneralpopulation.Hopelessnessisoneaspectofdepressionthat hasaclosetietosuicide.Thesetwoissues,depression andhopelessness,arethe strongestpredictorsofwishesforahasteneddeath.
P:PriorHistory.Roughly80%ofcompletedsuicideswereprecededbyapriorattempt. E:Ethanolabuse.Alcoholand/ordrugabuseincreaserisk. R:Rationalthinkingloss. Psychosis(IheardavoicesayingIshouldkillmyself) increasesrisk.Someestimatessuggestthat2040%ofschizophrenicsmakean attemptatsomepoint,andtheriskishighestearlyonintheillness. S:SupportSystemLoss. Lossofsupportcanvarytremendously.Withkidsand adolescentsitcanbethebreakupoftheirfirstpuppylovewhichtheycantake veryseriouslyeventhoughotherslikeparentsmayviewitasatrivialevent. Otherlost relationshipsforadolescentscanincludeparentsdivorcingandremarryingsomeone else.Evenaparentwhoisdivorcedorseparatedandlivingwithanewpersoncanbea triggerforadolescentsuicide.Thedeathofarelative,suchasgrandparents,canbe anothertriggerforkids.
Lossofaspousecanbedevastatingtosome.Lossofaparentwithinthepast35years increasesriskofsuicide.Amongolderindividuals,menwhoarewidowed,and womenwhoaredivorcedorseparatedareatincreasedrisk O:OrganizedPlan. Thisspeaksforitself.Havingamethodinmindcreatesmorerisk. N:NoSignificantOther. SeeSabove. S:Sickness.Terminalillness,suchascancerandAIDS,alsocarrieswithita20fold increaseinriskofsuicidecomparedtothegeneralpopulation. ScoringSystem 1pointforeachpositiveanswerontheabove. Score 02 34 56 710 Risk Norealproblems,keepwatch Sendhome,butcheckfrequently Consider hospitalization involuntary or voluntary, depending on your level of assurancepatientwithreturnforanothersession definitelyhospitalizeinvoluntarilyorvoluntarily
References 1) Patterson,W,Dohn,H,Bird,J,Patterson,G. Psychsomatics,1983,24,343349 2) Juhnke, G.E. SAD PERSONS scale review. Measurement & Evaluation in Counseling&Development,1994, 27,325328 3) Juhnke, G.E. (The adapted SAD PERSONS: As assessment scale designed for use withchildrenElementarySchoolGuidance&Counesling,1996,252258