Columbia-Suicide Severity Rating
Scale (C-SSRS) 24
Purpose The C-SSRS was designed to provide a clinical trials and was found to possess an overall
prospective, standardized measure of suicidality. reliability of .89.
The scale allows clinicians and researchers alike
to assess the severity and lethality of suicidal Obtaining a Copy The scale is free for use in
behaviors and ideations, and can be used to moni- clinical settings. To obtain a copy, contact:
tor treatment outcomes and establish suicide risk Kelly Posner
in a variety of research and clinical settings. Center for Suicide Risk Assessment
Columbia University Department of Psychiatry
Population for Testing The scale has been used 1051 Riverside Drive, Unit 74, New York, NY
in a number of different populations, both adult 10032, USA
and pediatric. Email: [email protected]
Administration Requiring approximately 5 min Scoring In terms of suicidal behaviors, the scale
for completion, the C-SSRS is administered in is divided into several categories [3]: actual
the form of a clinical interview (though a self- attempts, interrupted attempts, aborted attempts,
report version is also available). Interviewers are and preparatory acts or behaviors. Interviewers
not required to possess mental health training, establish the presence or absence of these
allowing the scale to be used in any number of behaviors and, where applicable, the number of
health care settings [1]. attempts, both over the course of a lifetime and in
the period of interest (the last week or month).
Reliability and Validity Though the scale itself Similarly, five aspects of suicidal ideation are
has not been validated, it was created to be the queried: the wish to be dead, nonspecific active
prospective counterpart to the classification suicidal thoughts, active ideation without intent
system called the Columbia Classification to act, active ideation with some intent to act, and
Algorithm for Suicide Assessment (C-CASA; active ideation with specific plan or intent. The
[2]). The C-CASA was developed as a retrospec- presence and frequency of these different thoughts
tive method for evaluating adverse events in are evaluated.
A. Shahid et al. (eds.), STOP, THAT and One Hundred Other Sleep Scales, 131
DOI 10.1007/978-1-4419-9893-4_24, © Springer Science+Business Media, LLC 2012
132 24 Columbia-Suicide Severity Rating Scale (C-SSRS)
24 Columbia-Suicide Severity Rating Scale (C-SSRS) 133
134 24 Columbia-Suicide Severity Rating Scale (C-SSRS)
Representative Studies Using Scale 135
References FDA website: http://www. fda.gov/ohrms/DOCKETS/
a c / 0 7 / s l i d e s / 2 0 0 7 - 4 3 0 6 s 1 - 0 1 - C U - P o s n e r.
ppt#540,1,Slide 1
1. Gangwisch, J. E., & Jacobson, C. M. (2009). New
perspectives on assessment of suicide risk. Current
Treatment Opinions in Neurology, 11(5), 371–376.
2. Posner, K. Oquendo, M. A., Gould, M., Stanley, B., & Representative Studies Using Scale
Davies, M. (2007). Columbia Classification Algorithm
of Suicide Assessment (C-CASA): Classification of
Faulconbridge, L. F., Wadden, T. A., Berkowitz, R. I.,
suicidal events in the FDA’s pediatric suicidal risk
Sarwer, D. B., Womble, L. G., Hesson. L. A., Stunkard,
analysis of antidepressants. American Journal of
A. J., & Fabricatore, A. N. (2009). Changes in symp-
Psychiatry, 164(7), 1035–1043.
toms of depression with weight loss. Obesity, 17(5),
3. Posner, K. (2007). Suicidality issues in clinical trials:
1009–1016.
Columbia suicidal adverse event identification in PDA
safety analysis [PowerPoint slides]. Retrieved from
