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This is a PatientPlus article. PatientPlus articles are written for doctors and so the language can be technical, however some people find that they add depth to the patient information leaflets. You may find the abbreviations record helpful.
Pathos - Self-Harm Assessment
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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 but this does not detract from the use of the instrument as an independent predictor of risk.3
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| '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
- Kingsbury S; PATHOS: a screening instrument for adolescent overdose: a research note. J Child Psychol Psychiatry. 1996 Jul;37(5):609-11. [abstract]
- Kingsbury SJ; Clinical components of suicidal intent in adolescent overdose. J Am Acad Child Adolesc Psychiatry. 1993 May;32(3):518-20. [abstract]
- 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
- Self-harm: The short-term physical and psychological management and secondary prevention of self-harm in primary and secondary care, NICE (2004)
- Assessment following self-harm in adults, Royal College of Psychiatrists (2004)
- YouthNet UK; TheSite.org. Young People and Self-harm.
Document ID: 2580
Document Version: 21
Document Reference: bgp24836
Last Updated: 19 Feb 2009
Planned Review: 19 Feb 2011
The authors and editors of this article are employed to create accurate and up to date content reflecting reliable research evidence, guidance and best clinical practice. They are free from any commercial conflicts of interest. Find out more about updating.
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