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Columbia - Suicide Severity Rating Scale (C-SSRS)
Please visit this website for more information about the instrument:
Core: General CDE Recommendation for all diseases (this or a similar instrument for suicidal ideation)
Supplemental - Highly Recommended: Parkinson's Disease (PD)
Recommendations for use: Indicated for use as a safety measure.
Short Description of Instrument
The Columbia - Suicide Severity Rating Scale (C-SSRS) is a widely used instrument across research, clinical and institutional settings that was developed to assess suicidal ideation and behavior and is available in over 100 languages.
The Columbia - Suicide Severity Rating Scale (C-SSRS) was designed to provide a prospective, standardized measure of suicidality. The scale allows researchers to assess the severity of suicidal behaviors and ideations.
The C-SSRS supports suicide risk assessment through a series of simple, plain-language questions. Scale administrators ask a series of questions about suicidal thoughts and behaviors. The number and choice of questions are contingent on the answers received.  
Mitochondrial Disease-Specific: Depression has been reported in individuals with mitochondrial disorders. There have been no studies to validate the assessment in individuals with mitochondrial disorders.
Comments/Special Instructions
NeuroRehab-Specific: Limited data by population has been implemented in number of national screening programs including universal screening at the Department of Veterans Affairs.
Parkinson's Disease-Specific: A 2014 study found that suicidal ideation is a concern in both psychiatric and non-psychiatric PD patients (Greist et al.). Conclusions regarding the issue of suicidality in PD using the C-SSRS have been conflicting (Elfil et al., 2020; Belvisi et al., 2019).
Training is available from The Columbia Lighthouse Project:
Scoring and Psychometric Properties
There are two separate types of outcomes with codes for yes (1) and no (2) of each type of ideation or behavior. Higher scores indicate a higher level of suicidality.
Parkinson's Disease-Specific:
Strengths: Standardized tool recommended by SAMHSA; available in 114 languages; provides connection to additional resources; can be used in a variety of administration settings
Weaknesses: Can be problematic because it has a skip pattern that can be hard to use in research and ideally suicidality is a low endorse symptom.
Key References:
Posner, K., Brent, D., Lucas, C., Gould, M., Stanley, B., Brown, G., Fisher, P., Zelazny, J., Burke, A., Oquendo, M. and Mann, J., 2008. Columbia-Suicide Severity Rating Scale (C-SSRS). New York, NY: The Research Foundation for Mental Hygiene.
Posner K, Brown GK, Stanley B, Brent DA, Yershova KV, Oquendo MA, Currier GW, Melvin GA, Greenhill L, Shen S, Mann JJ. The Columbia-Suicide Severity Rating Scale: initial validity and internal consistency findings from three multisite studies with adolescents and adults. Am J Psychiatry. 2011 Dec;168(12):1266-77.
Additional Reference:
Greist JH, Mundt JC, Gwaltney CJ, Jefferson JW, Posner K. Predictive Value of Baseline Electronic Columbia-Suicide Severity Rating Scale (eC-SSRS) Assessments for Identifying Risk of Prospective Reports of Suicidal Behavior During Research Participation. Innov Clin Neurosci. 2014 Sep;11(9-10):23-31.
Parkinson's Disease-Specific References:
Belvisi D, Berardelli I, Ferrazzano G, Costanzo M, Corigliano V, Fabbrini G, Berardelli A, Pompili M. The clinical correlates of suicidal ideation in Parkinson's disease. Parkinsonism Relat Disord. 2019 Jun;63:54-59.
Elfil M, Ahmed N, Alapati A, Bahekar R, Kandil M, Kim C, Schaefer S, Tinaz S, Patel AS, de Figueiredo JM, Louis ED, Koo BB. Suicidal risk and demoralization in Parkinson disease. J Neurol. 2020 Apr;267(4):966-974.
Document last updated August 2022