Which mnemonic best captures the major modifiable and non-modifiable risk factors for suicide assessment in clinical practice?

Explanation

## SAD PERSONS Mnemonic for Suicide Risk Assessment **Mnemonic:** SAD PERSONS — a validated clinical tool for rapid suicide risk stratification. ### SAD PERSONS Components | Letter | Factor | Risk Level | |--------|--------|------------| | **S** | Sex (male) | Non-modifiable; males 3–4× higher completion rate | | **A** | Age (>45 years) | Non-modifiable; risk increases with age | | **D** | Depression | Modifiable; present in ~90% of suicides | | **P** | Previous attempt | Non-modifiable; strongest predictor of future attempt | | **E** | Ethanol/substance abuse | Modifiable; disinhibition + impulsivity | | **R** | Rational thought loss (psychosis) | Modifiable; command hallucinations, delusions | | **S** | Social support loss | Modifiable; isolation, bereavement, divorce | | **O** | Organized plan | Non-modifiable; specificity of intent | | **N** | No spouse (single/divorced/widowed) | Non-modifiable; marital status | | **S** | Sickness (chronic medical illness) | Non-modifiable; chronic pain, terminal illness | ### Scoring & Risk Stratification - **0–2 points:** Low risk — outpatient management - **3–4 points:** Medium risk — close follow-up, consider hospitalization - **5–6 points:** High risk — hospitalization recommended - **≥7 points:** Very high risk — urgent hospitalization **Key Point:** SAD PERSONS is the most widely taught and clinically validated mnemonic in psychiatry for suicide risk assessment. It integrates both static (non-modifiable) and dynamic (modifiable) factors, making it practical for bedside use. **High-Yield:** This is a **must-know** mnemonic for NEET PG exams. Questions often ask to identify the correct tool or to apply it to a clinical scenario. **Clinical Pearl:** The presence of a **specific, organized plan** (especially with access to lethal means) is one of the strongest predictors of imminent risk and should always trigger urgent intervention. **Tip:** When assessing suicide risk, always ask: 1. Do you have thoughts of harming yourself? (ideation) 2. Do you have a plan? (intent + method) 3. Do you have access to the means? (lethality) 4. What is stopping you? (protective factors)