ArticlePrimary care companion to the Journal of clinical psychiatry2010
The p4 screener: evaluation of a brief measure for assessing potential suicide risk in 2 randomized effectiveness trials of primary care and oncology patients.
Article in Primary care companion to the Journal of clinical psychiatry, 2010. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to 5 registered trials, which are not on this map. Cited by 80 papers, 2 of them syntheses that pooled it.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
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.
Stepped Care for Affective Disorders and Musculoskeletal Pain
TeleCare Management of Pain and Depression in Cancer
Patient-centered Treatment of Anxiety After Low-Risk Chest Pain in the Emergency Room
Evaluation of Blended Stepped-care Mental Well-being Intervention for Adults: A Randomized Controlled Trial
Suicidal Risk in Adults in Panama: Validation of a Clinical Intervention Protocol
Who cites it
80 citing papers in PubMed, 2 syntheses or guidelines pooled it, 119 citations in OpenAlex.
- Individual participant data meta-analysis to compare EPDS accuracy to detect major depression with and without the self-harm item.Scientific reports · 2023Pooled it
- Improving Suicide Prevention Through Evidence-Based Strategies: A Systematic Review.The American journal of psychiatry · 2021Pooled it
- Efficacy of a Cognitive Behavioral Therapy-Based Online Self-Help Group for Depression and Suicide Ideation: Randomized Controlled Trial.JMIR mHealth and uHealth · 2026Trial
- Problem Gambling and its Relation to Delayed Reward Discounting: A Secondary Analysis of a Randomized Controlled Trial.Journal of gambling studies · 2026Trial
- The African youth in mind (Y-MIND) brief psychological intervention for depression among school-going adolescents in Ghana: a development case series.BMC psychiatry · 2026Trial
- Depression follow-up monitoring with the PHQ-9: an open cluster-randomised controlled trial.The British journal of general practice : the journal of the Royal College of General Practitioners · 2024Trial
- Patient-reported outcome measures for monitoring primary care patients with depression: the PROMDEP cluster RCT and economic evaluation.Health technology assessment (Winchester, England) · 2024Trial
- Trial
- Effects of a minimal-guided on-line intervention for alcohol misuse in Estonia: a randomized controlled trial.Addiction (Abingdon, England) · 2022Trial
- Buprenorphine physician-pharmacist collaboration in the management of patients with opioid use disorder: results from a multisite study of the National Drug Abuse Treatment Clinical Trials Network.Addiction (Abingdon, England) · 2021Trial
- Automated Self-management (ASM) vs. ASM-Enhanced Collaborative Care for Chronic Pain and Mood Symptoms: the CAMMPS Randomized Clinical Trial.Journal of general internal medicine · 2019Trial
- Feasibility and Acceptability of a Task-Shifted Intervention to Enhance Adherence to HIV Medication and Improve Depression in People Living with HIV in Zimbabwe, a Low Income Country in Sub-Saharan Africa.AIDS and behavior · 2018Trial
- A study of sertraline in dialysis (ASSertID): a protocol for a pilot randomised controlled trial of drug treatment for depression in patients undergoing haemodialysis.BMC nephrology · 2015Trial
- Mindfulness-based stress reduction for overweight/obese women with and without polycystic ovary syndrome: design and methods of a pilot randomized controlled trial.Contemporary clinical trials · 2015Trial
- Problem-solving intervention for caregivers of children with mental health problems.Archives of psychiatric nursing · 2013Trial
- Massed prolonged exposure for posttraumatic stress disorder among individuals in comprehensive substance use treatment: Study protocol for a randomized controlled trial.Contemporary clinical trials communications · 2026Article
- Development and validation of the SuPr-10 questionnaire for suicidality assessment in primary care patients with depressive symptoms.Scientific reports · 2026Article
- "Feeling unseen": Generation and psychometric validation of a scale assessing sense of absence.Journal of behavioral addictions · 2026Article
- Identifying Predictors of Gambling Episodes and Craving Using Ecological Momentary Assessment and Smartwatch-Based Physiological Measures: Protocol for a Longitudinal Observational Study.JMIR research protocols · 2026Observational
- Evidence-based therapist guided introduction to online heavy cannabis use treatment in Canadian adults: a Randomized Controlled Trial (RCT).Journal of cannabis research · 2026Article
20 more citing papers are in PubMed but not listed here.
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
5 authors at 2 institutions in 2 countries.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundDepression is the most common mental disorder, and suicide is its most serious consequence. The primary objective of this study was to evaluate preliminary evidence for the P4 screener as a brief measure to assess potential suicide risk.
methodThe P4 screener was prospectively evaluated in 2 randomized effectiveness trials of primary care (January 2005-June 2008; N = 250) and oncology patients (March 2006-August 2009; N = 309). Potential suicide ideation was assessed at 5 time points in both trials: baseline and 1, 3, 6, and 12 months. The P4 screener asks about the "4 P's": past suicide attempts, suicide plan, probability of completing suicide, and preventive factors. Patients were classified as minimal, lower, and higher risk based upon responses to these 4 items.
resultsA suicide assessment was triggered 1 or more times by 17.6% (44 of 250) of Stepped Care for Affective Disorders and Musculoskeletal Pain (SCAMP) participants and 16.5% (51 of 309) of Indiana Cancer Pain and Depression (INCPAD) participants at some point in the trial. Of the patients who triggered a suicide assessment, the majority (29 of 44 in SCAMP and 27 of 51 in INCPAD) were classified as minimal risk by the algorithm. Only 1 (0.4%) of the SCAMP participants and 5 (1.6%) of the INCPAD participants were classified as higher risk. Among the latter, the most common factors preventing patients from attempting suicide were the "4 F's": faith, family, future hope, and fear of failing in their attempt.
conclusionsPreliminary findings suggest that the P4 screener may be useful in assessing potential suicide risk in the clinical care of depressed patients as well as in clinical research.
trial registrationclinicaltrials.gov Identifier: NCT00118430 (SCAMP) and NCT00313573 (INCPAD).
Identifiers
What OpenQuestion holds
Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.