SAD PERSONS score

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%. Neither the original nor modified score is useful for predicting need for admission.
  • 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

• General Psych Workup
• Depression