Assessment of near-term risk for suicide attempts using the suicide crisis inventory

•Suicide Crisis Inventory (SCI) is validated for the assessment of pre-suicidal mental state among psychiatric inpatients and outpatients.•SCI scores predicted near-term suicide attempts without relying on self-report of suicidal ideation.•SCI has incremental predictive validity for near-term attempts over suicidal ideation and attempt history. The Suicide Crisis Syndrome (SCS) describes a pre-suicidal mental state marked by entrapment accompanied by affective disturbances, loss of cognitive control, hyperarousal and social withdrawal. This study tested the consistency and validity of the Suicide Crisis Inventory (SCI), a proposed measure of SCS severity, amongst a large, heterogeneous patient sample. The SCI was used to assess 867 adult psychiatric inpatients and outpatients. Confirmatory factor analysis, logistic regressions and area under the curve analyses (AUC) were used to examine internal structure, construct validity and predictive validity for suicide ideation, plan and attempt one-month post-assessment. The five-factor model of the SCS demonstrated good fit and excellent internal consistency. SCI scores indicated significant associations but non-redundancy with depression, anxiety, and independence from other dimensions of psychiatric distress. SCI scores specifically predicted suicide attempts with an AUC of 0.733 and odds ratio=8.62 (p