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Screening for adolescent suicidality in primary care: the bullying–insomnia–tobacco–stress test. A population‐based pilot study
Author(s) -
Binder Philippe,
Heintz AnneLaure,
Servant Coralie,
Roux MarieThérèse,
Robin Stéphane,
Gicquel Ludovic,
Ingrand Pierre
Publication year - 2018
Publication title -
early intervention in psychiatry
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.087
H-Index - 45
eISSN - 1751-7893
pISSN - 1751-7885
DOI - 10.1111/eip.12352
Subject(s) - test (biology) , suicidal ideation , conversation , population , insomnia , psychology , psychiatry , medicine , clinical psychology , suicide prevention , poison control , medical emergency , environmental health , paleontology , communication , biology
Aim Adolescents at risk for suicide often see their general practitioner solely for somatic or administrative reasons. A simple screening test given during a conversation would be of substantial help to send a signal and tackle the problem. We propose to update a screening test previously validated in France – the TSTS‐Cafard – because of significant changes in the lives of adolescents with the growth of the cyber world since 2000. Methods The design and setting was a cross‐sectional study involving 912 15‐year‐old adolescents in 90 French schools. They completed a questionnaire that included the TSTS‐Cafard and risk factors extracted from the Health Behaviour in School‐Aged Children survey. To improve the test, we selected questions drawn from the recent literature. Answers were analysed according to ‘suicidality’ = at least one suicide attempt in life or suicidal ideation often over the past 12 months. Results Suicidality rates were 9.6% for boys and 23.1% for girls. Although the TSTS‐Cafard test was generally effective, one question was no longer discriminating. A new test, entitled ‘BITS’, included only four questions on bullying, insomnia, tobacco and stress, with three levels of response and scores ranging from 0 to 8. Improvement was achieved without loss of performance. Using a cut‐off score of 3, we achieved 78% accuracy (area under the curve), 75% sensitivity and 70% specificity. Conclusion The BITS test could allow the question of suicide risk to be addressed during a routine check‐up in primary care but the results need to be validated with 13 to 18‐year olds.