Using the Columbia Suicide Severity Rating Scale (C-SSRS), which combination indicates the HIGHEST risk requiring immediate psychiatric hospitalization?
- A Passive death ideation only, no plan, no intent
- B Active ideation with no plan and no intent, Hamilton Depression score 24
- C Active ideation with intent, specific plan, and recent preparatory behavior ✓
- D History of non-suicidal self-injury without ideation
Correct answer: C. Active ideation with intent, specific plan, and recent preparatory behavior
Explanation
The C-SSRS identifies the highest acute risk when active suicidal ideation is coupled with intent, a specific plan, and preparatory behaviors (e.g., giving away possessions, acquiring means). This triad — intent + plan + preparation — necessitates immediate inpatient admission. Passive death ideation and ideation without plan/intent warrant close outpatient monitoring but not necessarily hospitalization.
Reference: Kaplan & Sadock's Synopsis of Psychiatry, 11th ed.
High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP
Written and medically reviewed by the StethoPrep medical team.