The SAD PERSONS scale assesses the risk of suicide in patients, with each risk factor represented by a letter in the mnemonic. The scale is used for both adults and children, and a higher score indicates a higher risk of suicide. Medical students who used the scale showed an increased ability to determine patients’ risk of suicide.
The SAD PERSONS scale is a tool used to assess the risk of patients who may be suicidal. The name is a mnemonic to help practitioners remember each risk factor. One point is awarded for each risk factor present, and there are guidelines for what to do with a patient’s score in each score range. The original scale is for adults, but the scale was later revised to include criteria for children.
In the adult scale, the first S represents sex or gender, A stands for age, and D represents depression. The P indicates a previous suicide attempt, E stands for the use of ethanol (alcohol) or other drugs, while R stands for a loss of rational thinking by the patient. The second S indicates a lack of social support, O stands for organized plan, N indicates the patient has no spouse, and the final S represents a chronic or debilitating illness.
Men are more likely to carry out suicide plans than females, so they are awarded one point for gender, while females score zero. People younger than 20 or older than 75 are at higher risk. Those who have an organized and detailed plan for committing suicide are considered much more likely to follow it.
The scale for children is quite similar, with two exceptions. N stands for neglectful parenting and the final S indicates school problems. For both scales, patients who score zero to two points are sent home and told to follow up with a mental health professional at a later date. A score of three to four requires close follow-up and possible hospitalization, and those with scores of five to six should seriously consider hospitalization. Those that score a seven or more should be hospitalized or checked into a mental health facility.
In an evaluation done by the Academy of Psychosomatic Medicine, medical students using the SAD PERSONS scale showed an increased ability to determine patients’ risk of suicide. The control group, which did not use the SAD PERSONS scale, rated both high- and low-risk patients as high-risk. This could lead to hospitalizations in cases where it is not really necessary.
The SAD PERSONS scale was developed in 1983 and was updated in 1996 to include children. A common place to use the SAD PERSONS scale is in the emergency room. If a patient presents claiming to be suicidal or to have attempted suicide, a quick and easy determination of the seriousness of the situation is often very helpful.
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