ArticleAnnals of family medicine
Improving detection of suicidal ideation among depressed patients in primary care.
Article in Annals of family medicine. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 23 papers, 1 of them a synthesis that pooled it.
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Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
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Who cites it
23 citing papers in PubMed, 1 synthesis or guideline pooled it.
- Collaborative care for depression and anxiety problems.The Cochrane database of systematic reviews · 2012Pooled it
- Ethical and methodological challenges slowing progress in primary care-based suicide prevention: Illustrations from a randomized controlled trial and guidance for future research.Journal of psychiatric research · 2022Trial
- Tailored Activation of Middle-Aged Men to Promote Discussion of Recent Active Suicide Thoughts: a Randomized Controlled Trial.Journal of general internal medicine · 2020Trial
- The effect of targeted and tailored patient depression engagement interventions on patient-physician discussion of suicidal thoughts: a randomized control trial.Journal of general internal medicine · 2014Trial
- Yield of practice-based depression screening in VA primary care settings.Journal of general internal medicine · 2012Trial
- Physician personality characteristics and inquiry about mood symptoms in primary care.Journal of general internal medicine · 2008Trial
- Impacts of evidence-based quality improvement on depression in primary care: a randomized experiment.Journal of general internal medicine · 2006Trial
- Suicide inquiry in primary care: creating context, inquiring, and following up.Annals of family medicineTrial
- Ethical Issues and Challenges Regarding the Use of Mental Health Questionnaires in Public Health Nutrition Research.Nutrients · 2025Review
- Stakeholder views regarding a planned primary care office-based interactive multimedia suicide prevention tool.Patient education and counseling · 2019Article
- The Development of a Brief Suicide Screening and Risk Assessment Training Webinar for Rural Primary Care Practices.Rural mental health · 2018Article
- Indo-Canadian Collaboration for Suicide Prevention: Training Needs Assessment for Healthcare Professionals in India.Community mental health journal · 2016Article
- Suicidality in primary care patients who present with sadness and anhedonia: a prospective European study.BMC psychiatry · 2016Article
- Suicidal ideations, plans and attempts in primary care: cross-sectional study of consultants at primary health care system in Morocco.The Pan African medical journal · 2016Article
- Article
- Predictors of primary care physicians' self-reported intention to conduct suicide risk assessments.The journal of behavioral health services & research · 2012Article
- Self-perceived Difficulties With Suicidal Patients in A Sample of Italian General Practitioners.Journal of clinical medicine research · 2011Article
- Patient health questionnaire depression scale as a suicide screening instrument in depressed primary care patients: a cross-sectional study.The primary care companion for CNS disorders · 2011Article
- The p4 screener: evaluation of a brief measure for assessing potential suicide risk in 2 randomized effectiveness trials of primary care and oncology patients.Primary care companion to the Journal of clinical psychiatry · 2010Article
- Suicidal ideation and its recurrence in boys and men from early adolescence to early adulthood: an event history analysis.Journal of abnormal psychology · 2008Article
Corrections and comments
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Authors and funding
6 authors.
Funding
Abstract
purposePrimary care clinicians have difficulty detecting suicidal patients. This report evaluates the effect of 2 primary care interventions on the detection and subsequent referral or treatment of patients with depression and recent suicidal ideation.
methodsAdult patients in 12 mixed-payer primary care practices and 9 not-for-profit staff model health maintenance organization (HMO) practices were screened for depression. Matched practices were randomized within plan type to intervention or usual care. The intervention for mixed-payer practices entailed brief training of physicians and office nurses to provide care management. The intervention for HMO practices consisted of guided development of quality improvement teams for depression care. A total of 880 enrolled patients met study criteria for depression, 232 of whom met criteria for recent suicidal ideation. Intervention effects on suicide detection and referral to mental health specialty care were evaluated with mixed-effects multilevel models in intent-to-treat analyses.
resultsDepressed patients with recent suicidal ideation were detected on 40.7% of index visits in intervention practices, compared with 20.5% in usual care practices (odds ratio = 2.64, 95% confidence interval, 1.45-5.07), with HMO plan type and male sex associated with detection. The interventions had no effect on referral of patients, starting an antidepressant, or suicidal ideation reported at a 6-month follow-up, although power was limited for all 3 analyses.
conclusionsPrimary care interventions to improve depression care can improve detection of recent suicidal ideation. Further work is needed to improve physician response to detection, including referral to specialty care and more aggressive treatment, and to observe the effect on outcomes.
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