The Modular Assessment of Risk for Imminent Suicide (MARIS): A validation study of a novel tool for suicide risk assessment

•Reliable diagnostic tools for the assessment of short-term suicide risk are needed.•Utility of self-reported suicidal intent is over-estimated.•We developed the multi-informant Modular Assessment of Risk for Imminent Suicide (MARIS).•Clinicians' emotional responses may help to identify patients at imminent risk. Reliable diagnostic tools for the short-term suicide risk assessment are needed. The recently developed multi-informant Modular Assessment of Risk for Imminent Suicide (MARIS) includes four modules: two are patient-rated and two clinician-rated. The patient-rated modules assess a proposed pre-suicidal cognitive/emotional state (Module 1) as well as patients’ attitudes towards suicide (Module 2). The clinician-rated modules assess traditional suicide risk factors (Module 3) and clinicians’ emotional responses to the patient (Module 4). With the aim of extending our previous preliminary proof of concept findings, the MARIS was administered to 618 psychiatric patients (167 inpatients, 451 outpatients) and their clinicians (N = 115). Patients were assessed with a battery including the Columbia-Suicide Severity Rating Scale. Four outcomes were considered: lifetime and past month suicidal thoughts and behaviors (STB) (0–10 point scale) and suicidal behaviors (SB) (0–5 point scale). Reliability and concurrent, convergent/divergent and incremental validity were assessed. Good internal consistency was found for modules 1 and 4 (Cronbach's α: 0.87 and 0.86, respectively) but not for the others. Module 1′s total score positively correlated with lifetime STB/SB and past month STB (all p ≤ 0.003). Module 4′s total score positively correlated with all four outcomes (all p