Affordable Access

Publisher Website

Detection of adolescent suicidality in primary care: an international utility study of the bullying‐insomnia‐tobacco‐stress test

  • Binder, Philippe
  • Heintz, Anne‐Laure
  • Haller, Dagmar
  • Favre, Anne‐Sophie
  • Tudrej, Benoit
  • Ingrand, Pierre
  • Vanderkam, Paul
Publication Date
May 06, 2019
DOI: 10.1111/eip.12828
PMID: 31058453
OAI: oai:HAL:hal-02128277v1
External links


Aim : General practitioners (GPs) are ideally placed to identify suicidality in adolescents. However, adolescents are often reluctant to confide in their GPs about these problems, and GPs are not comfortable when questioning them about suicide. We previously proposed the BITS test, a set of four opening and four additional questions, to alert doctors about possible suicidality in an adolescent. We validated its use in the identification of suicidality (“frequent suicidal ideation or suicide attempts at one time or another)” in 15‐year‐old adolescents in a school setting. The objective of the present study was to assess the detection utility of this method in 13‐to‐18‐year‐olds in primary care.Methods : We carried out a screening utility study in general practices in 17 French‐speaking sites in four countries and three continents. Each GP was instructed to use the bullying, insomnia, tobacco, stress (BITS) test with five to ten 13‐to‐18‐year‐old adolescents, consulting consecutively, for any reason. They subsequently asked them questions about their suicidality.Results : One hundred and two GPs tested a total of 693 adolescents; 13.0% of the adolescents (girls 15.4%, boys 9.9%) reported suicidality (1.6% known, 11.4% previously unknown). A score of at least 3 on the BITS scale was associated with suicidality (sensitivity: 65.9, specificity: 82.5%).Conclusions : The BITS test is a pragmatic instrument, alerting the GP to an adolescent's previously unknown suicidability, whatever the reason for consultation.

Report this publication


Seen <100 times