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Recent research suggests that standardized rating scales are superior to less quantifiable clinician judgment for assessing outcomes over time in patients with depression and anxiety. Now, two reports show that rating scales do not improve assessment of suicide.
Quinlivan and colleagues used six different scales as well as clinician assessment to evaluate the risk for repeat self-harm within 6 months of such an episode in 464 adults. Clinician assessments measured risk in a qualitative manner by cataloguing known risk factors. Repeat self-harm at 6 months occurred in 30% of patients. Positive predictive values (PPVs) for the various scales were poor to modest at best (range, 13%–47%). No scale outperformed global clinician assessment, and ma…