Identifying Suicide Risk in Adolescents and Young Adults With Type 1 Diabetes: Are Depression Screeners Sufficient?

• Published in: Diabetes care Vol. 45; no. 5; pp. 1288 - 1291
• Main Authors: Moss, Ashley C, Roberts, Alissa J, Yi-Frazier, Joyce P, Read, Kendra L, Taplin, Craig E, Weaver, Kathryn W, Pihoker, Catherine, Hirsch, Irl B, Malik, Faisal S
• Format: Journal Article
• Language: English
• Published: United States American Diabetes Association 01-05-2022
• Subjects: Adolescent; Adolescents; Adults; Child; Child & adolescent psychiatry; Depression - diagnosis; Diabetes; Diabetes mellitus; Diabetes mellitus (insulin dependent); Diabetes Mellitus, Type 1 - complications; Disease Susceptibility; Health risks; Humans; Mental depression; Mental health; Novel Communications in Diabetes; Pediatrics; Predictive Value of Tests; Risk; Sensitivity; Suicide; Suicides & suicide attempts; Surveys and Questionnaires; Teenagers; Young Adult; Young adults
• ISSN: 0149-5992; 1935-5548
• DOI: 10.2337/dc21-1553

Examine the utility of suicide-risk items embedded within depression screeners for identifying the presence of suicide risk in adolescents and young adults (AYA) with type 1 diabetes.
Sensitivity, specificity, and predictive value of self-report of suicide risk on the Patient Health Questionniaire-9 (PHQ-9) were compared with the pediatric psychologist-administered Columbia-Suicide Severity Rating Scale (C-SSRS) as the reference standard for AYA with type 1 diabetes seen in a multidisciplinary AYA Diabetes Program clinic.
Of 133 participants, 9.8% and 11.3% reported suicide risk on the PHQ-9 and C-SSRS, respectively. Sensitivity of the PHQ-9 risk item was 53.3% (95% CI 27.4%-77.7%), specificity was 95.7% (95% CI 89.9%-98.4%), positive predictive value was 61.5% (95% CI 32.3%-84.9%), and negative predictive value was 94.2% (95% CI 87.9-97.4%).
Depression screeners appear to under-identify AYA with type 1 diabetes who may otherwise be at risk for suicide.