Suicidal Crisis

France is among the countries with one of the highest suicide rates in the world, far above those of its neighboring countries \[Wasserman et al., 2012\]. Suicide is the second leading cause of death among 15-24-year-olds, just after road traffic accidents, and the leading cause of death among 25-34-year-olds. Current models emphasize the variability of suicidal trajectories and the possible fluctuation in the duration of suicidal crises: for some individuals, the crisis evolves rapidly and explosively (brief), whereas for others, distress becomes more chronic, often in connection with underlying psychiatric disorders \[Stanley, Brodsky, and Monahan, 2023\]. In this context, the concept of a 'brief suicidal crisis' is an emerging one in psychiatry. It is characterized by an acute phase of psychological vulnerability, during which the main risk is progression to suicidal behavior, but it remains a temporary and reversible psychic crisis (lasting less than 24 hours). The crisis state is marked by a sudden inability to mobilize one's usual coping resources in the face of difficulties, making the individual highly vulnerable. Nevertheless, this concept has been little described, and a better assessment seems desirable, particularly in populations consulting a psychiatrist. Indeed, around 25% of people who die by suicide had consulted a psychiatrist in the month before their death \[Luoma et al., 2002\], yet few data are available on this topic. Primary objective is to assess the prevalence of brief suicidal crisis episodes (lasting less than 24 hours) over the past 12 months among patients attending outpatient psychiatric care and within a sample of patients from a population catchment area in the Clermont-Ferrand region.

The goal of this observational validation study is to assess the psychometric properties of the Spanish versions of the Suicide Crisis Inventory-Revised (SCS-2) and the Suicidal Crisis Syndrome Checklist (SCS-C) in adults recently hospitalized for suicidal behavior in Chile. The study aims to determine whether the Spanish versions of the SCS-2 and SCS-C demonstrate adequate internal consistency, construct validity, interrater reliability, and test-retest stability, and whether these tools validly assess imminent suicide risk in a Spanish-speaking psychiatric population. Clinical assessments using the SCS-2 and SCS-C will be compared with established diagnostic and functional measures, including the Mini International Neuropsychiatric Interview (MINI), the Sheehan Disability Scale (SDS), and the Sheehan Suicidality Tracking Scale (S-STS), to evaluate convergent and discriminant validity. Participants will complete the SCS-2 and SCS-C at both admission and discharge from a psychiatric intensive care unit, undergo structured interviews and functional assessments, be evaluated by two independent raters for interrater reliability, and be reassessed within a short time interval to measure test-retest reliability. Follow-up contacts at 7 and 30 days post-discharge will be used to assess suicidal behavior outcomes. This is the first study to culturally adapt and validate these suicide-specific instruments in Latin America.