SAD PERSONS score: Difference between revisions

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SCORE (points)
==Background==
 
*Score intended to evaluate patients presenting with [[depression]] and/or suicidal ideation and determine need for admission
Sex = male (1)
*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.
Age <19 or >45 (1)
 
Depressed S/S (2)
 
Past psych hx (1)
 
Etoh/drug use hx (1)
 
Rational thought loss (2)
 
Sep/div./wid (1)
 
Organized /serious attempt (2)
 
No social support (1)
 
Stated intent (or ambivilance) (2)
 
 
*assessment must be without ETOH/drugs on board
 
 
DISPOSITION (by point total)
 
<6: May d/c home if have someone to care for them, follow x 1dy, call f/u MD, contract
 
6-8: 50% admission rate (consult psych)
 
>8: Admit


==Score==
*'''S'''ex = male '''(1)'''
*'''A'''ge <19 or >45 '''(1)'''
*'''D'''epressed symptoms '''(2)'''
*'''P'''ast psychiatric history or suicide attempts '''(1)'''
*[[ETOH|'''E'''TOH]]/drug use history '''(1)'''
*'''R'''ational thought loss '''(2)'''
*'''S'''eparated/divorced/widowed or sickness with 3 or more prescription medications'''(1)'''
*'''O'''rganized plan or serious attempt '''(2)'''
*'''N'''o social support '''(1)'''
*'''S'''tated intent (or ambivalence) '''(2)'''
   
   
;Assessment must be without ETOH/drugs on board (wait for person to sober)


2/6/06 DONALDSON (adapted from Lampe, Hockberger)
==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==
*[[General Psych Workup]]
*[[Depression]]


==References==
<references/>


[[Category:Psych]]
[[Category:Psychiatry]]

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

  1. 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.
  2. 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.