Turkish Adaptation Study of the Ask Suicide-Screening Questions in Adolescents

Introduction: This study aimed to demonstrate the validity of the Ask Suicide-Screening Questions (ASQ) in a clinical sample consisting of adolescents admitted to child and adolescent psychiatry (CAP), and then to confirm its validation in those presenting to the pediatric emergency department (PED), which was the main target group for the study. Method: This cross-sectional study evaluated the compatibility of the ASQ with the suicide probability scale, which is a standardized measure, to identify cases with suicide risk in 248 adolescents aged 10–18 years. To demonstrate the clinical validity of the scale, sensitivity, specificity, positive predictive value (PPV), negative predictive value (NPV), positive likelihood ratio (PLR), negative likelihood ratio (NLR), Kappa, and area under the curve (AUC) performance metrics and 95% confidence interval (CI) values were calculated. Results: Positive screening rate, sensitivity, specificity, PPV and NPV for the CAP patients were calculated as 31.8%, 100% (95% CI: 100.0–100.0), 70.9% (95% CI: 63.4–78.4), 12.8% (95% CI: 3.2–22.3) and 100% (95% CI: 100.0–100.0), respectively. The PLR and AUC were calculated as 3.4% (95% CI: 2.7–4.5) and 0.855 (95% CI: 0.817–0.892), respectively. Positive screening rate, sensitivity, specificity, PPV and NPV for the PED patients were calculated as 28%, 100% (95% CI: 100.0–100.0), 75.3% (95% CI: 66.3–84.2), 21.4% (95% CI: 6.2–36.6) and 100% (95% CI: 100.0–100.0), respectively. The PLR, Kappa and AUC were 4.05% (95% CI: 2.82–5.81), 0.278 and 0.876 (95% CI: 0.832–0.921), respectively. Conclusion: This study showed the first evidence that Turkish adaptation of the ASQ is a valid screening tool for identifying those at risk of suicide among adolescents who applied to the CAP and PED.