Comments on: Thoughts about SAD PERSONS Screen

By: Anthony Pisani

Anthony Pisani — Sat, 31 Jul 2010 08:48:13 +0000

Thank you for your comment, Carole. I did not know (but I’m not surprised) that there are different versions out there. You make a good point that a tool like this can help to “raise some flags” and it’s probably better than nothing. As long as it’s not framed as a “scale” I suppose it can be useful, which was something that Justin pointed out as well. Thanks again.

By: Carole

Carole — Sat, 31 Jul 2010 01:39:05 +0000

I read your comments with interest. I’m an MA in Counseling major and since the SAD PERSONS acronym came across in some of my course mateirals, I decided to learn more about it. I actually found three different versions of it with differing ages listed in some, and some of the letters standing for differing words in others. That alone gives me concern. Simple is one thing. Given to random versions with differing criteria is another. Having worked with many families who have lost loved ones to suicide, I can appreciate the importance of an accurate assessment. I personally would never make a clinical decision based on this assessment tool but it can certainly raise some flags for a clinician who may not handle suicidal issues very often that it’s time for a referral.

By: Tony_P

Tony_P — Mon, 31 Mar 2008 12:31:31 +0000

Hi Justin: Thank you for your comment. First of all, I really like your blog and have just subscribed. Second, regarding the content of your comment, you make some good points. We don’t want to throw the baby out with the bath water. The mneumonic, in itself, can be useful and I’m glad you remind us of that. Where I object is the use of it as a “scale.” The scoring doesn’t make sense and I think it could mislead a person into thinking that suicide risk can be judged based on a score like this, and lead people away from the key idea that assessing risk involves a clinical judgment that comes from a synthesis of lots of different data. Thanks for the reminder that clinicians can still use the mneumonic as a tool, while being aware of its limitations as scale. I look forward to following your blog. Tony

By: Justin Kopp

Justin Kopp — Sun, 30 Mar 2008 22:22:20 +0000

Although I agree that the SADPERSONS mneumonic most certainly does not cover all of the intricacies of depression and, if used alone, would be incredibly inadequate to detect all cases, I don’t think that’s where the real utility of the scale comes into play. Depression is something that, in its conventional presentation, can be detected with enough time with a patient. What this mneumonic is useful for are those atypical presentations. Certainly the example of the woman presenting with a depressed mood after just being discharged from a psychiatric hospital would not get blown off by the competent physician simply because of a low SADPERSONS score. The separated male with diabetes without overt signs of depression, however, may be the one who ends up going home and committing suicide because he did not present in the typical way. By going through the atypical presentations that SADPERSONS presents, one can pick up a risk of suicide where it might otherwise be missed. That being said, you could also miss atypical presentations simply because they receieved a low score. These people at risk are the hardest to detect, and why the involvment of somebody like yourself is so important in the lives of patients.