Validation of the German Version of the P4 Suicidality Tool
Abstract
:1. Introduction
2. Material and Methods
2.1. Study Design and Setting
2.2. Recruitment and Data Collection
2.3. Study Population
2.4. The P4 Questionnaire
2.5. The German Translation
2.6. Other Instruments
2.7. Data Analysis
3. Results
3.1. P4 Results
3.2. Suicide Plan and Preventive Factors
3.3. Subgroup Analyses
4. Discussion
4.1. Suicidal Risk Stratification
4.2. Strengths, Limitations, and Future Development
5. Conclusions
Supplementary Materials
Author Contributions
Funding
Institutional Review Board Statement
Informed Consent Statement
Data Availability Statement
Acknowledgments
Conflicts of Interest
Abbreviations
GP | General practitioner |
PHQ-9 | Patient Health Questionnaire-9 |
PMH | Positive mental health-scale |
SBQ-R | Suicide Behaviors Questionnaire-Revised |
SI | Suicide ideations |
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Total (n = 222) * | Women (n = 138) | Men (n = 84) | ||||
---|---|---|---|---|---|---|
Mean | SD | Mean | SD | Mean | SD | |
Age (n = 220) | 47.61 | 15.1 | 47.88 | 15.70 | 47.17 | 14.15 |
% | N | % | N | % | N | |
Setting | ||||||
Primary care | 46.7 | 104 | 48.6 | 67 | 42.9 | 36 |
Specialized care | 53.4 | 119 | 51.5 | 71 | 57.1 | 48 |
Main diagnosis | ||||||
F3 | 46.9 | 104 | 47.1 | 65 | 46.4 | 39 |
F4 | 7.2 | 16 | 6.5 | 9 | 8.3 | 7 |
Both F3 and F4 | 27.0 | 60 | 28.3 | 39 | 25.0 | 21 |
No F diagnosis | 15.8 | 35 | 14.5 | 20 | 17.9 | 15 |
Other F diagnosis | 3.2 | 7 | 3.6 | 5 | 2.4 | 2 |
Marital status | ||||||
Married/relationship | 40.5 | 90 | 38.4 | 53 | 44.1 | 37 |
Separated/divorced/widowed | 21.6 | 48 | 27.5 | 38 | 11.8 | 10 |
Single | 37.8 | 84 | 34.1 | 47 | 44.1 | 37 |
Parenthood | ||||||
Yes | 53.2 | 118 | 57.2 | 79 | 46.4 | 39 |
No | 46.9 | 104 | 42.8 | 59 | 53.6 | 45 |
Total (n = 223) | Women (n = 139) | Men (n = 84) | ||||
---|---|---|---|---|---|---|
Mean | SD | Mean | SD | Mean | SD | |
Scale scores (range) | ||||||
PHQ-9 depression (0–27) | 15.00 | 4.36 | 15.10 | 4.45 | 14.90 | 4.21 |
SBQ-R (3–18) | 7.38 | 4.16 | 7.36 | 4.13 | 7.37 | 4.23 |
PMH (0–27) | 8.18 | 7.00 | 8.26 | 7.23 | 8.06 | 6.68 |
Total (n = 223) * | Women (n = 139) | Men (n = 84) | Intercorrelations (Convergent Validity) * | |||||||||||
---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
No Risk | Risk | No Risk | Risk | No Risk | Risk | SBQ-R_1 (Lifetime SI/Attempts) | SBQ-R_2 (12 Month SI) | SBQ-R_3 (Threatened Suicide) | SBQ-R_4 (Suicide Likelihood) | SBQ-R _sum | PMH _sum | PHQ9 _sum | PHQ9_09 | |
P4_1 (past attempt) | 159 (71.3%) | 64 (28.7%) | 95 (68.8%) | 43 (31.2%) | 64 (78.2%) | 20 (23.8%) | 0.696 | 0.292 | 0.282 | 0.267 | 0.465 | 0.016 | 0.118 | 0.238 |
P4_2 (suicide plan) | 84 (37.7%) | 139 (62.3%) | 46 (33.3%) | 92 (66.7%) | 38 (45.2%) | 46 (54.8%) | 0.588 | 0.556 | 0.510 | 0.205 | 0.580 | −0.015 | 0.130 | 0.220 |
P4_3 (suicide likelihood) | 200 (89.7%) | 23 (10.3%) | 123 (89.1%) | 15 (10.9%) | 76 (90.5%) | 8 (9.5%) | 0.178 | 0.248 | 0.193 | 0.355 | 0.329 | −0.108 | 0.240 | 0.364 |
P4_4 (preventive factors) | 202 (90.6%) | 21 (9.4%) | 127 (92.0%) | 11 (8.0%) | 74 (88.1%) | 10 (11.9%) | 0.024 | 0.047 | 0.043 | 0.051 | 0.550 | 0.191 | 0.053 | 0.121 |
P4_risk | minimal: 68 (30.5%) | lower: 120 (53.8%) higher: 35 (15.7%) | minimal: 36 (26.1%) | lower: 81 (58.7%) higher: 21 (15.2%) | minimal: 32 (38.1%) | lower: 38 (45.2%) higher: 14 (16.7%) | 0.683 | 0.512 | 0.464 | 0.365 | 0.634 | −0.095 | 0.219 | 0.383 |
Suicide Plan | N | % |
---|---|---|
Medication overdose | 47 | 28.8 |
Intentional vehicular accident | 29 | 17.8 |
Cutting oneself | 29 | 17.8 |
Others | 21 | 12.9 |
Falls | 14 | 8.6 |
No answer | 12 | 7.4 |
Hanging | 9 | 5.5 |
Using a gun | 2 | 1.2 |
Total | 163 | 100 |
Preventive Factors | N | % |
Family | 147 | 67.4 |
Future hope | 33 | 15.1 |
Faith | 12 | 5.5 |
Fear of failing | 8 | 3.7 |
Others | 18 | 8.3 |
Total | 218 | 100 |
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Schluessel, S.; Halfter, K.; Haas, C.; Kroenke, K.; Lukaschek, K.; Gensichen, J., on behalf of the POKAL-Group. Validation of the German Version of the P4 Suicidality Tool. J. Clin. Med. 2023, 12, 5047. https://doi.org/10.3390/jcm12155047
Schluessel S, Halfter K, Haas C, Kroenke K, Lukaschek K, Gensichen J on behalf of the POKAL-Group. Validation of the German Version of the P4 Suicidality Tool. Journal of Clinical Medicine. 2023; 12(15):5047. https://doi.org/10.3390/jcm12155047
Chicago/Turabian StyleSchluessel, Sabine, Kathrin Halfter, Carolin Haas, Kurt Kroenke, Karoline Lukaschek, and Jochen Gensichen on behalf of the POKAL-Group. 2023. "Validation of the German Version of the P4 Suicidality Tool" Journal of Clinical Medicine 12, no. 15: 5047. https://doi.org/10.3390/jcm12155047