Abstract
Background. Suicidal ideation is an important risk factor for suicide attempts and completions, and early identification of the likely presence of self-harm cognitions would benefit clients and clinicians alike. This study examined the clinical utility of the Kessler K10 psychological distress score as an indicator of suicidal ideation. Methods. Suicidal ideation was assessed on the basis of four relevant questions contained in the General Health Questionnaire (GHQ-28), and these were subsequently analyzed against the K10 scores. The data were collected using a monthly risk-factor surveillance system where each month a representative random sample of South Australians over the age of 16 years is interviewed. The cumulative data covered the period 2002 to 2007 (n = 12,884). Results. Psychological distress and suicidal ideation were reported by 9.9% and 5.1% of the participants, respectively. Univariate analysis demonstrated a positive linear relationship between the K10 score and suicidal ideation. Participants scoring in the very high range of the K10 were more likely to report suicidal ideation and this was experienced with greater frequency than by those who were less distressed. A logistic regression analysis revealed that even those in the moderate category were four times more likely to experience suicidal ideation than those in the low category, and those in the high and very high categories were 21 and 77 times more likely, respectively. Separate models based on sex and using odds-ratios based on very high vs. low K10 scores showed that males were 104 times more likely to report suicidal ideation compared to a 63 times higher rate for females. Both sexes had a 52% probability of experiencing suicidal ideation if they fell into the very high distress group. Conclusions. The K10 score is a clinically useful indicator of the presence of suicidal ideation.
References
2001). Interpreting scores on the Kessler Distress Scale (K10). Australian and New Zealand Journal of Public Health, 25, 494–497.
(2005). Suicide attempts, plans, and ideation in culturally diverse sites: The WHO SUPRE-NISS community survey. Psychological Medicine, 35, 1457–1465.
(2006). Evaluation of two measures of psychological distress as screeners for depression in the general population. Canadian Journal of Psychiatry, 52, 111–120.
(2006). Treating trauma and traumatic grief in children and adolescents. New York: Guilford.
(2002). Stratum-specific likelihood ratios of the General Health Questionnaire in the community: Help-seeking and physical comorbidity affect the test characteristics. Psychological Medicine, 32, 519–529.
(2003). The performance of the K6 and K10 screening scales for psychological distress in the Australian National Survey of Mental Health and Well-Being. Psychological Medicine, 33, 357–362.
(2001). Suicidal ideation, psychiatric disorder, and medical illness in a community epidemiological study. Suicide and Live-Threatening Behavior, 31, 207–213.
(1989). Suicidal ideation in a young population. Acta Psychiatrica Scandinavica, 79, 481–489.
(1979). A scaled version of the General Health Questionnaire. Psychological Medicine, 9, 139–145.
(1994). Final versions of our nonspecific psychological distress scale. Ann Arbor: University of Michigan Press.
(2007). Detecting determinants of suicidal ideation: South Australian surveillance system results. International Journal of Public Health, 52, 142–152.
(1998). Differences in health estimates using telephone and door-to-door survey methods – A hypothetical exercise. Australian and New Zealand Journal of Public Health, 22, 223–226.
(2007). Understanding suicidal behavior. Chichester: Wiley.
(2001). The measurement of suicidal ideation. Crisis, 22, 12–14.
(1999). Prevalence of suicide ideation and suicide attempts in nine countries. Psychological Medicine, 29, 9–17.
(