Predicting Suicide with the SAD PERSONS Scale

A study of two widely used assessment tools for suicidal behavior, the SAD PERSONS scale and the Modified SAD PERSONS Scale (MSPS), found that neither accurately assesses or predicts suicide attempts. In fact, SAD PERSONS did not predict suicide better than a system based on chance. The authors concluded that these instruments “should not be used in isolation to inform clinical decisions regarding patient safety.”

A study of two widely used assessment tools for suicidal behavior, the SAD PERSONS scale and the Modified SAD PERSONS Scale (MSPS), found that neither accurately assesses or predicts suicide attempts. In fact, SAD PERSONS did not predict suicide better than a system based on chance. Only 5.3 percent of persons identified as being at high risk by SAD PERSONS and only 7.4 percent of the people identified as being at high risk by MSPS were treated for a suicide attempt within the next six months.

The authors concluded that “in their current form, SAD PERSONS and MSPS do not accurately predict future suicide attempts.” SAD PERSONS was also lacking in its ability to assess current suicide risk. The researchers found that “half of the individuals presenting with a suicide attempt [at the two hospital emergency departments where this study took place] were categorized as low risk by the SAD PERSONS scale” and a quarter of the persons identified as high risk by SAD PERSONS “had no suicidal behavior.” The authors concluded that these instruments “should not be used in isolation to inform clinical decisions regarding patient safety.” The sample was drawn from patients presenting at the emergency department of two large hospitals in Manitoba.

Bolton, J. M., Spiwak, R., & Sareen, J. (2012). Predicting suicide attempts with the SAD PERSONS Scale: A longitudinal analysis. Journal of Clinical Psychiatry, 73(6), e735-e741.