記述言語：英語   掲載種別：研究論文（学術雑誌）  

BACKGROUND: Suicide remains a major public health challenge across Asia, where psychiatrist shortages are severe. In Japan, psychiatric emergencies for suicide attempts frequently occur during times without psychiatrist availability. Accurate prediction of suicide itself remains difficult, therefore, the decision by psychiatrists to hospitalize suicide attempters might be a practical outcome for triage. OBJECTIVE: As a pilot study, we aimed to develop a Japanese version of the Modified SAD PERSONS Scale (MSPS-J), evaluate its reliability and validity for psychiatrists' hospitalization decisions among suicide attempters, and determine whether inclusion of an agitation item improves the performance. METHODS: This retrospective study analyzed medical records of 203 consecutive suicide attempters from 2022 to 2024. After excluding 59 cases with missing data, 144 cases were included. The primary outcome was psychiatrists' admission decisions. Receiver operating characteristic (ROC) analysis assessed predictive accuracy. Reliability was evaluated using K-fold cross-validation and bootstrapping. Sensitivity analyses using multiple imputation were performed for missing data. RESULTS: The MSPS-J achieved an AUC of 0.867 (95 % CI 0.805-0.930). At a cut-off ≥ 6, specificity was 76.3 % and sensitivity 78.7 %. Adding a one‑point agitation item raised the AUC to 0.879 and two points to 0.885. K-fold cross-validation and bootstrapping demonstrated high reproducibility. Sensitivity analysis using multiple imputation suggested robustness although selection bias of excluded cases remained. CONCLUSIONS: The MSPS-J is expected to be a practical tool to support non-specialists' decisions regarding psychiatric hospitalization in suicide attempters when psychiatrists are unavailable. MSPS-J could support suicide prevention in resource-limited clinical settings. Further study is needed.

DOI： 10.1016/j.ajp.2025.104817

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