Screening suicide-related ideation using the Kessler psychological distress scale-10: an indirect predictive model...

This study developed a predictive model for suicide-related ideation among university students using three items from the Kessler Psychological Distress Scale-10: hopelessness, depressed mood, and worthlessness.

Data collected between 2021 and 2023 from 5642 first-year students at Hokkaido University were used for model development, with a temporal validation cohort of 1803 students surveyed in 2024. Suicide-related ideation was defined as a score of at least 1 on item 9 of the Patient Health Questionnaire-9, which assesses thoughts of self-harm and suicide.

Logistic regression analysis identified the Kessler Psychological Distress Scale-10 items 4 (hopelessness), 7 (depressed mood), and 10 (worthlessness) as the strongest predictors. The final model demonstrated excellent discrimination, with an area under the receiver operating characteristic curve of 0.908 in the temporal validation cohort. At the optimal cutoff, the sensitivity and specificity were 89.8% and 81.7%, respectively. This indirect screening approach offers a non-invasive method to estimate suicide-related ideation without directly probing sensitive topics, potentially easing respondent resistance and reducing response burden.

By relying on general psychological distress items, the model enables the early identification of at-risk students within existing mental health screening frameworks and offers a practical and efficient tool for suicide-related ideation detection in academic settings.