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. 2025 Jun 13;68(1):e83.
doi: 10.1192/j.eurpsy.2025.10030.

Symptoms of the suicide crisis syndrome and associated risk factors in an acute psychiatric population, a cross-sectional study

Linde Melby  1   2 , Karina Høyen  1   2 , Astrid Prestmo  1 , Arne Vaaler  1   2 , Tuva Kvithyld  1 , Igor Galynker  3 , Fredrik Walby  4 , Mette Langaas  5 , Terje Torgersen  1   2
Affiliations

Symptoms of the suicide crisis syndrome and associated risk factors in an acute psychiatric population, a cross-sectional study

Linde Melby et al. Eur Psychiatry. .

Abstract

Background: The focus of suicide research changes from traditional risk factors to acute warning signs. Patient self-reported suicidal ideation (SI) is not a reliable measure of acute suicide risk. Presuicidal syndromes such as suicide crisis syndrome (SCS) attempt to describe measurable syndromes based on warning signs other than SI.

Methods: Seven hundred and ten acutely admitted patients were included in the study. Identification of symptoms describing the five components of SCS was done by performing a retrospective text analysis of the patient records (electronic medical records). Patients were grouped according to high or low level of SCS symptoms. We performed statistical tests for group differences in demographics, traditional risk factors, and clinical variables, including agitation assessed by the Positive and Negative Symptom Scale-Excited Component (PANSS-EC).

Results: Seventy-two patients had high levels of SCS symptoms. They reported less SI the last month before admission; suicidality was less relevant for referral, the intake suicide assessment more often concluded with high suicide risk, they were more often referred and admitted involuntarily, and they had higher total scores on PANSS-EC.

Conclusion: The individual SCS symptoms may provide useful information in the evaluation of acute suicide risk at intake. A high level of SCS symptoms suggests more severe conditions. The lower reports among high-level than low-level SCS patients of self-reported SI last month before admission, shows the limitation of using SI as a warning sign. The association between the level of SCS symptoms and PANSS-EC total score suggests that agitation could give valuable additional information for suicide risk assessments.

Keywords: agitation; risk factors; suicidal behavior; suicide crisis syndrome; warning signs.

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Conflict of interest statement

The authors declare none.

Figures

Figure 1.
Figure 1.
Combination of SCS symptoms described in the electronic medical records of 710 acutely admitted patients by retrospective text analysis.
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