SAD PERSONS score

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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.