Identifying subtypes of suicidality: a second larger consensus study in emergency clinical psychiatric practice

Frontiers in Psychiatry, vol. 17, pp. 1751407

Abstract

Background: A model has been developed to distinguish subtypes of pathways to entrapment leading to suicidality in clinical mental health practice. The (hypothetical) 4-type Model of Entrapment ((h)4ME) delineates four subtypes of suicidality: I) Perceptual Disintegration (PD), II) Primary Depressive Cognition (PDC), III) Psychosocial Turmoil (PT) and IV) Inadequate Coping/Communication (IC). Objective: To examine the model's usability and feasibility in a larger cohort of suicidal patients (n= 75) following a pilot study. Methods: Consultation reports to general practitioners of 75 suicidal emergency patients were independently allocated to subtypes by three psychiatrists and three nurses using the SUICIDI-3 tool. This tool describes the proposed subtypes. Interrater agreement was assessed by calculating Intraclass Correlation Coefficients (ICCs). Absolute and dimensional type agreement was established to assess the model's usability and the SUICIDI-3 tools feasibility. Results: All raters were able to assign cases to subtypes. Excellent absolute Type Agreement (aTA) was observed for PD (0.96) and PDC (0.92), and good aTA for PT (0.83) and IC (0.83). For dimensional Type Agreement (dTA) the ICC was excellent for PD (0.97), PDC (0.95) and IC 0.92), and good for PT (0.88). Conclusions: The (h)4ME demonstrates promising usability and feasibility when tested by staff of psychiatric emergency services. Replication studies of samples of various clinical, demographic or ethnic origin and of diverse professional background and contexts are needed to confirm the consistency of these findings.

Authors 14

1. Remco Fp De Winter Aachen Department Suicide Prevention in Mental Health (SuPreMH) Mental Health Institute Rivierduinen

   Maastricht University · GGZ Rivierduinen

   Affiliation as printed

   Department Suicide Prevention in Mental Health (SuPreMH), Mental Health institute Rivierduinen

   School for Mental Health and Neuroscience (MHeNs), Maastricht University

2. Damien S. E. Broekharst Aachen Department Suicide Prevention in Mental Health (SuPreMH) Mental Health Institute Rivierduinen

   Maastricht University · GGZ Rivierduinen

   Affiliation as printed

   Department Suicide Prevention in Mental Health (SuPreMH), Mental Health institute Rivierduinen

   School for Mental Health and Neuroscience (MHeNs), Maastricht University

3. Connie M. Meijer

   Parnassia Groep

   Affiliation as printed

   Psychiatry Department, Mental Health Institute Parnassia Group

4. Nienke Kool-Goudzwaard

   Parnassia Groep

   Affiliation as printed

   Psychiatry Department, Mental Health Institute Parnassia Group

5. Anne T. van den Bos Aachen Department Suicide Prevention in Mental Health (SuPreMH) Mental Health Institute Rivierduinen

   GGZ Rivierduinen

   Affiliation as printed

   Department Suicide Prevention in Mental Health (SuPreMH), Mental Health institute Rivierduinen

6. John H. Enterman

   Parnassia Groep

   Affiliation as printed

   Psychiatry Department, Mental Health Institute Parnassia Group

7. Manuela Gemen Aachen Department Suicide Prevention in Mental Health (SuPreMH) Mental Health Institute Rivierduinen

   GGZ Rivierduinen

   Affiliation as printed

   Department Suicide Prevention in Mental Health (SuPreMH), Mental Health institute Rivierduinen

8. Chani Nuij

   University of Twente

   Affiliation as printed

   Section of Clinical Psychology, Free University (VU)

   Section of Psychology, Health and Technology, University of Twente

9. Mirjam C. Hazewinkel

   Parnassia Groep

   Affiliation as printed

   Psychiatry Department, Mental Health Institute Parnassia Group

10. Danielle Steentjes Aachen Department Suicide Prevention in Mental Health (SuPreMH) Mental Health Institute Rivierduinen

    GGZ Rivierduinen

    Affiliation as printed

    Department Suicide Prevention in Mental Health (SuPreMH), Mental Health institute Rivierduinen

11. Gabriëlle E. van Son Aachen Department Suicide Prevention in Mental Health (SuPreMH) Mental Health Institute Rivierduinen

    GGZ Rivierduinen

    Affiliation as printed

    Department Suicide Prevention in Mental Health (SuPreMH), Mental Health institute Rivierduinen

12. Jonas Gijs Weijers Aachen Department Suicide Prevention in Mental Health (SuPreMH) Mental Health Institute Rivierduinen

    Maastricht University · GGZ Rivierduinen

    Affiliation as printed

    Department Suicide Prevention in Mental Health (SuPreMH), Mental Health institute Rivierduinen

    School for Mental Health and Neuroscience (MHeNs), Maastricht University

13. Derek Paul De Beurs

    University of Amsterdam

    Affiliation as printed

    Psychology Department, University of Amsterdam

    Section of Clinical Psychology, Free University (VU)

14. Marieke H. de Groot

    Lentis

    Affiliation as printed

    Psychiatry Department, Mental Health Institute Lentis