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Pathos - Self-Harm Assessment

This is a 5-question screening instrument used to identify high risk adolescents (ages 13-18 years) when they present with an overdose. Development of this instrument was based on the finding that adolescents' statements about suicide intent was a poor predictor of their subsequent actions.1 Research suggests that by considering such factors as the degree of depression, hopelessness, premeditation, problem duration and previous overdose history, it is possible to give a more accurate prediction of an individual's risk. The PATHOS instrument was able also to identify a high-risk group with a sensitivity of 100% and a specificity of 57%. All misclassifications were false positive. It is suggested that the instrument could be used as an aid for non-psychiatric assessors.2
Recent work has somewhat counteracted the argument that statement of intent is a poor predictor of suicide, 3 but this does not detract from the use of the instrument as an independent predictor of risk.

PATHOS - Self-harm assessment
'Have you had Problems for longer than 1 month?'
'Were you Alone in the house when you overdosed?'
'Did you plan the overdose for more than Three hours?'
Are you feeling HOpeless about the future- that things will not get much better?'
'Were you feeling Sad for most of the time before the overdose?'
The more features present - the greater the likelihood of significant suicidal intent and depression


Document References
  1. Kingsbury S; PATHOS: a screening instrument for adolescent overdose: a research note. J Child Psychol Psychiatry. 1996 Jul;37(5):609-11. [abstract]
  2. Kingsbury SJ; Clinical components of suicidal intent in adolescent overdose. J Am Acad Child Adolesc Psychiatry. 1993 May;32(3):518-20. [abstract]
  3. Kumar CT, Mohan R, Ranjith G, et al; Characteristics of high intent suicide attempters admitted to a general hospital. J Affect Disord. 2006 Mar;91(1):77-81. Epub 2006 Jan 27. [abstract]
Internet and Further Reading Acknowledgements EMIS is grateful to Dr Laurence Knott for writing this article. The final copy has passed scrutiny by the independent Mentor GP reviewing team. ©EMIS 2007.
DocID: 2580
Document Version: 21
DocRef: bgp24836
Last Updated: 5 Feb 2007
Review Date: 4 Feb 2009








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PS - Health and Poverty

Perhaps the biggest cause of ill health in the world is poverty. Help to Make Poverty History. For example, why not lend some of your money to disadvantaged communities to enable them to trade their way out of poverty through schemes such as Shared Interest.

See also MAKEPOVERTYHISTORY North East for details and links to campaigns against poverty.

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