Honesty in reporting suicidal ideations and behaviors in Alzheimer’s disease, mild cognitive impairment, and dementias
Keywords:Suicidal ideations and behaviors, Alzheimer’s disease, Cognitive impairment
Background: Detection of patients’ suicidal ideations and behaviors (SIB) is critical to patient safety. It is important to consider the needs, abilities and propensity for honesty in reporting SIB in populations with compromised cognitive abilities. We surveyed patients with compromised cognitive abilities to determine if they feel they would report SIB and the conditions under which they would be honest in reporting SIB?
Methods: Patients reporting diagnoses such as Alzheimer’s disease (AD), mild cognitive impairment (MCI) or other dementias completed online surveys. Participants were asked their likelihood for honesty, preferences and comfort when answering questions on SIB in-person and using electronic self-report.
Results: 73 patients with AD, MCI or other dementias, 95% reported they were likely to report SIB honestly electronically and 92% would be honest with a health care provider (HCP). However, 96% would be honest in-person with an HCP they knew but less than 88% said they would be honest if they didn’t know the HCP.
Conclusions: These data suggest that patients with cognitive conditions may be more likely to report SIB truthfully using electronic self-report than a clinical face to face interview but that either form of reporting is an effective methodology for obtaining honest responses about SIB. Taking the FDA guidance on suicidality and the potential for cognitive decrements in this population, multiple tools for assessing depression and SIB should be implemented when treating or working this population.
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