SDS
Sheehan Disability Scale

The Sheehan Disability Scale (SDS) is a short, simple, treatment outcome measure of disability and functional impairment. It can be either patient-rated or clinician-rated.

Available versions: adult, adolescent, child.

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S-STS
Sheehan – Suicidality Tracking Scale

The Sheehan – Suicidality Tracking Scale (S-STS) assesses all of the core suicidality phenomena. The Clinically Meaningful Change Measure (CMCM) version of the S-STS is designed for use as a primary outcome measure in clinical research studies investigating the efficacy of anti-suicidality medications.

Available versions: adult, adolescent, child and adult and adolescent CMCM.

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S-HTS
Sheehan – Homicidality Tracking Scale

The Sheehan – Homicidality Tracking Scale (S-HTS) assesses all of the core homicidality phenomena. It can be used to assess and monitor these symptoms and behaviors over time.

Available versions: adult, adolescent, child and adult and adolescent CMCM.

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S-CGI & S-PGI

The Sheehan – Global Improvement Scales are designed to provide an overall assessment of how much a patient’s symptoms and behaviors have improved or worsened since the start of treatment. The S-CGI and S-PGI are 21 point scales and was designed to provide more sensitivity than a 10 point global improvement scale in assessing global improvement.

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MINI Tracking

The MINI Tracking is typically used to track change in symptom severity or change in a symptom cluster and monitor treatment response over time after an initial clinical interview using the MINI is conducted. A benefit of the MINI Tracking is that each of the tracking modules yields a score that can be plotted quantitatively on a graph.

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MINI Kid Tracking

The MINI Kid Tracking is typically used to track change in symptom severity or change in a symptom cluster and monitor treatment response over time after an initial clinical interview using the MINI is conducted. A benefit of the MINI Tracking is that each of the tracking modules yields a score that can be plotted quantitatively on a graph.

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SMS
Suicidality Modifiers Scale

The Suicidality Modifiers Scale (SMS) assesses factors that can influence key domains that can impact suicidality. These factors include impulsive suicidality, hopelessness, loss of enjoyment, and overwhelmed feeling.

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SPS
Sheehan Panic Disorder Scale

The Sheehan Panic Disorder Scale (SPS) assesses all of the core symptoms of Panic Disorder. It can be used to assess and monitor these symptoms and behaviors over time. It can be either patient-rated or clinician-rated.

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S-SHSQ
Sheehan – Suicidality / Homicidality Screening Questions

The Sheehan – Suicidality / Homicidality Screening Questions (S-SHSQ) is a set of brief screening questions for suicidality and homicidality. This is not a comprehensive suicidality or homicidality assessment and may be useful in primary care settings.

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SIAS
Suicidal Impulse Attack Scale

The Suicidal Impulse Attack Scale (SIAS) assesses the components of a suicidal impulse attack. It is designed as a quick measure to monitor symptoms while a patient is experiencing a suicidal impulse attack.

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HMS
Homicidality Modifiers Scale

The Homicidality Modifiers Scale (HMS) assesses factors that can influence key domains that can impact homicidality. These factors include impulsive homicidality, hopelessness, loss of enjoyment, and overwhelmed feeling.

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HIAS
The Homicidal Impulse Attack Scale

The Homicidal Impulse Attack Scale (HIAS) assesses the components of a homicidal impulse attack. It is designed as a quick measure to monitor symptoms while a patient is experiencing a homicidal impulse attack.

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SIS
Sheehan Irritability Scale

The Sheehan Irritability Scale (SIS) is a short self-report rating scale developed to measure the frequency, severity and impairment associated with irritability.

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Training

Training Form

COST

The cost of licensing Sheehan Scale can be found in each of the License Agreement template links provided above. This licensing fee applies to all uses. For customized versionsplease review the License Agreement template.

TRANSLATIONS

The English language versions of Dr. Sheehan’s scales and structured interviews are distributed directly by Dr. Sheehan and not by MAPI. You are required to get a license from Dr. Sheehan for all the administrations to be done in all languages in your study/clinical setting and to pay the invoice to me for this license. If you need a translation beyond the English version, you will need to reach out to MAPI after getting a fully executed license for all the administrations in any language. For more information visit the FAQ page.

Sheehan ScaleS TRAINING

For information about training on the the Sheehan Disability Scale (SDS), Sheehan – Suicidality Tracking Scale (S-STS) or, via Zoom or in person, for large groups or investigators meetings please contact: training@harmresearch.org or davidVsheehan@gmail.com. For information about virtual web-based training see our FAQ or download our Training Form.

- Adult Sheehan Disability Scale Training (SDS)

- Adult Standard S-STS Training

- 1. Adult Standard S-STS Interview Training, Case 1
  2. Adult Standard S-STS Interview Training, Case 2
  3. Adult Standard S-STS Interview Training, Case 3
  4. Adult Standard S-STS Interview Training, Case 4

- Adult S-STS CMCM Training

- 1. Adult S-STS CMCM Interview Training, Case 1
  2. Adult S-STS CMCM Interview Training, Case 2
  3. Adult S-STS CMCM Interview Training, Case 3
  4. Adult S-STS CMCM Interview Training, Case 4

- Pediatric Standard S-STS Training

There is also a quiz at the end of each of the videos. Those who pass each quiz get a certificate of completion of the training for that instrument. It is then up to the sponsors to certify them as raters – which is a credentialing issue.

Training Form

Sheehan Scale FAQ

General FAQ: Sheehan Scales

What are the Sheehan Scales?

Dr. Sheehan’s earliest scales, such as the Sheehan Panic Disorder Scale (SPS) and Sheehan Disability Scale (SDS) addressed the need for simple, clear easy-to-use instruments to assess and track symptom severity and functional impairment in trials of new medications for anxiety, phobic and panic disorders.

Early on, he also designed two global improvement scales, the Sheehan – Global Improvement Scales (S-CGI-21 & S-PGI-21). These 21-point clinician and patient rated improvement scales were initially developed to be more sensitive outcome measures to detect efficacy signals in schizophrenia trials. A benefit of the S-CGI-21 and the S-PGI-21 was that compared to the standard 7-point global impressions scales (such as the CGI-I & PGI-I), the S-CGI-21 & S-PGI-21 allowed more points to make finer discriminations to detect improvement or deterioration in response to treatment.

Dr. Sheehan’s later scales such as the Sheehan Irritability Scale (SIS), the Sheehan - Suicidality Tracking Scale (S-STS), and the Sheehan - Homicidality Tracking Scale (S-HTS) were developed to meet the need for key symptoms, such as irritability or suicidality in mood disorder trials and trials to specifically assess the effectiveness of anti-suicidal medications.

Although initially developed for clinical trials for treatments for specific mental health disorders, Dr. Sheehan’s scales are now widely used in primary care, in mental health settings, inpatient and outpatient, in population research and, in the case of the SDS, the CGI-21 & S-PGI-21, and the S-STS in treatment studies for many different physical and mental health disorders.

For a list of Dr. Sheehan’s scales, please CLICK HERE.

What are the Sheehan Scales used for?

The Sheehan Scales can be used:

To assess and monitor the severity of specific symptoms (such as anxiety, irritability, suicidality), to monitor global improvement or to assess functional impairment over time and in response to treatment in primary care as well as mental health settings.
To identify and track specific symptoms or clusters of symptoms or impairment as an efficacy outcome measure, adverse event and/or treatment emergent effect in clinical trials and treatment outcome studies.
To detect and describe the incidence or prevalence and severity of such symptoms or impairment in population research including national and international epidemiology studies and community surveys.

Which scales are best for my purposes?

Please CLICK HERE to be able to filter scales by disorder type, age group and type of research study. Use the filters on the left to make your selections. When you have determined which scales you need, you can complete the relevant license agreement found on the page of the scale.

Are the Sheehan Scales patient or clinician-rated scales?

All of the Sheehan Scales can be patient-rated, clinician-rated, or rated by patient and clinician together at the same visit. Because of this flexibility they are useful for inpatients as well as outpatients and can also be used in community and population studies. However, to ensure safety and precision in research studies, we recommend training in the use of scales such as the S-STS and SDS. For more information about training CLICK HERE.

Can I get versions for children and adolescents?

Yes. Many of Dr. Sheehan’s scales, most notably the Sheehan Disability Scale (SDS), the Sheehan-Suicidality Tracking Scale (S-STS), and Sheehan-Homicidality Tracking Scale (S-HTS) can be made available in pediatric and adolescent versions. Others can be customized for children and adolescents.

Can I get preview copies of a scale?

Yes, please CLICK HERE for watermarked preview copies only or contact Dr. Sheehan directly at davidVsheehan@gmail.com

Can I get a customized version of a scale?

Yes. Dr. Sheehan can design customized versions of most of his scales e.g. if you need a timeframe that is not an option for the version listed. Contact Dr. Sheehan at davidVsheehan@gmail.com to discuss a customized version designed for your needs.

Do I need a license to use a Sheehan scale?

A fully executed license and licensing fee applies to all uses. To license a Sheehan Scale for your use from Dr. Sheehan, you will need complete a license agreement. Links can be found on product pages to download a template license agreement for use. Then follow the instructions on the License Agreement form and once completed, please sign and send back to davidVsheehan@gmail.com

What does it cost to license a Sheehan scale?

The cost of licensing one of the Sheehan Scales is $4 USD for each use/administration. Use/administration includes use in training/preparation activities and administration in a study.

Note: Non-profit institutions sometimes incorrectly assume that the license fee does not apply because they are “not-for-profit”. The licensing fee applies to all uses.

I am a student. Can I get a no charge license?

The license fee applies to all uses.

Have the Sheehan scales been validated?

Most of the Sheehan scales have been validated. See individual listings of scales for specific information on validation.

Note: The Sheehan Scales are clinical decision support tools. They were tested for reliability and validity conditions in which they were rated in paper format as a primary source document. The results cannot be generalized to any other conditions or format.

Sheehan Disability Scale (SDS) FAQ

Who is the owner and copyright holder of the Sheehan Disability Scale (SDS)?

Dr. David V. Sheehan is the copyright and trademark holder of the Sheehan Disability Scale (SDS). This copyright is registered in the U.S. Copyright office. A license is needed for all use of the SDS.

Dr. Sheehan only provides consultation, guidance on regulatory agency questions, and training to those who license the MINI / MINI Kid or scales directly from him. Contact Dr. Sheehan at davidVsheehan@gmail.com for additional information. If you do not see a QR code on the Sheehan Disability Scale (SDS) you are using linking back to this website then you did not get the SDS from the author and Copyright Holder. Dr. David V. Sheehan is the Copyright Holder, Trademark Holder, and author of the SDS in all languages. This copyright for the SDS has been registered with the US Copyright Office.

SDS Licensing and Costs

Do I need a license to use the SDS?

A fully executed license is required for use of the Sheehan Disability Scale (SDS) in any language. To license the SDS directly from Dr. Sheehan, the author and copyright holder, you will need complete his license agreement. Click here to learn more about the SDS or to download a License for use.

Dr. Sheehan only provides consultation, guidance on regulatory agency questions, and training to those who license the SDS directly from him. Contact Dr. Sheehan at davidVsheehan@gmail.com for additional information. If you do not see a QR code on the SDS you are using linking back to this website then you did not get the SDS from the author and Copyright Holder. Dr. David V. Sheehan is the Copyright Holder, Trademark Holder, and author of the SDS in all languages. This copyright for the SDS has been registered with the US Copyright Office.

What does it cost to license the SDS?

The cost of licensing the SDS is $4 USD for each use, i.e. each administration to a subject and/or each use in training.

Note: Non-profit institutions sometimes incorrectly assume that the license fee does not apply because they are “not-for-profit”. The licensing fee applies to all uses.

I am a student. Can I get a no-charge license?

The license and license fee applies to all uses.

Is the SDS available in PDF format?

Dr. Sheehan licenses the SDS in paper format for distribution as follows: (1) in paper form for any uses, or (2) in fixed-pdf form, paper form, or both for use in clinical or academic research trials or studies.

About the Sheehan Disability Scale (SDS)

What is the the Sheehan Disability Scale (SDS)?

The Sheehan Disability Scale (SDS) is a short (5-item), easy-to-use 1 page measure of disability and functional impairment. Patients are asked to rate the extent to which their symptoms have disrupted their lives in the last week across 3 separate domains:

work/schoolwork
social life/ leisure activities
family life/ home responsibilities

For each domain, the subject is presented a horizontal graphic line with numeric and verbal descriptors. The subject marks the point on the line that best corresponds to the severity of their impairment for that domain. The SDS includes 2 additional items to identify the number of “days lost” and “days underproductive” due to symptoms in the last week. A benefit of the SDS is that it yields scores for each domain (work/ social/family life) that can be plotted quantitatively on a graph.

What is the SDS used for?

Many patients suffer impairment of functioning at work, at school, in social settings or at home above and beyond their symptoms. Insurance companies, employers, government agencies, clinicians and drug companies seeking regulatory approval want to be assured that treatment not only improves symptoms but also restores functioning. The SDS can be used:

To assess and monitor the severity of functional impairment over time and in response to treatment in primary care as well as mental health settings.
To identify and track disability and functional impairment as an efficacy outcome measure, adverse event and/or treatment emergent effect in clinical trials and treatment outcome studies.
To provide documentation of disability and impairment in detailed forensic evaluations.
To detect and describe the incidence or prevalence and severity of disability and impairment in population research including national and international epidemiology studies and community surveys.

What makes the SDS unique?

The SDS is unique in using a discretized analog (Discan) metric that subjects with different cognitive orientations (verbal, numeric, and visual spatial) can easily follow. Some people rate numerically (”he was 6’3” tall”), others use verbal descriptors (“he was very tall”), and still others communicate by rating space visually (using their hands to point while commenting “he was this tall”). Some choose a combination of two or all three methods. For each of its functional domains (work / social / family life), the SDS allows subjects to simultaneously anchor their perceptions of their own impairment all three ways (verbally, numerically and visually-spatially). It also allows enough points of discrimination so that subjects can make fine distinctions in degrees of impairment. This format makes the SDS uniquely sensitive to efficacy signals in treatment studies. Additionally, the SDS contains two numeric measures for “days lost” and “days underproductive” that can be used to assess the impact of disability on work and productivity.

How long does it take to administer the SDS?

Typically, the SDS takes 1-2 minutes to administer.

What qualifications do I need to administer the SDS?

No minimum qualification is needed to administer the SDS. However, in research settings where precision is required, training in the use of the SDS is recommended. For more information about training, CLICK HERE.

Note:Dr. Sheehan only provides consultation, guidance on regulatory agency questions, and training to those who license the Sheehan Disability Scale (SDS directly from him. Contact Dr. Sheehan at davidVsheehan@gmail.com for additional information. If you do not see a QR code on the Sheehan Disability Scale (SDS) you are using linking back to this website, then you did not get the Sheehan Disability Scale (SDS) from the author and Copyright Holder. Dr. David V. Sheehan is the Copyright Holder, Trademark Holder and author of the Sheehan Disability Scale (SDS) in all languages. This copyright for the SDS has been registered with the US Copyright Office.

Can I administer the SDS remotely?

Yes. Dr. Sheehan’s license allows you to administer the SDS remotely as long as you complete the interview on paper as a primary source document. It is up to your protocol to determine how appropriate remote administration is for your patient population. For best results, Dr. Sheehan’s recommendation is to conduct the interview using video, such as Zoom or Skype, rather than phone. The SDS can be rated by patient or clinician. Because of this flexibility it is useful for inpatients as well as outpatients and can also be used in community and population studies.

If you are doing research, you should also review other applicable rules to make sure that remote administration is acceptable to any agency, such as the FDA, who may have oversight of your research.

What age range is the SDS suitable for?

The standard version of the SDS for adults meets most needs, most of the time in clinical and research settings. The pediatric version (SDS-P) is useful for children since it can be parent or clinician rated for children over the age of 6-11. We recommend the adolescent version (SDS-A) for adolescents age 12-17 since it can be either self-rated or clinician rated.

Has the Sheehan Disability Scale (SDS) been validated?

Has the SDS been validated?

Note: The SDS is a clinical decision support tool to measure disability and impairment. The above listed studies validated the SDS under conditions in which it was used with its Discan metric (using graphic, numeric and verbal descriptors) and in which it was rated in paper format as a primary source document. The results cannot be generalized to any other conditions or format. For FDA guidance on CDS: visit the FDA website.

The SDS was originally developed to measure functional impairment and treatment response in clinical psychopharmacology trials. It has been extensively validated in mental health inpatient and outpatient services, in primary care, and in clinical trials.

Among other studies, the validity of the SDS was investigated in primary care (Leon et al., 1997), in populations with specific psychiatric disorders such as panic disorder (Leon et al., 1992), social anxiety disorder (Hambrick et al., 2003), bipolar disorder (Arbuckle et al., 2009), ADHD (Coles et al., 2014), major depressive disorder (Khan et al., 2016), and binge eating disorder (Yee et al., 2021), as well as in unique populations such as pregnant women (Hada et al., 2022). Validation studies have also been conducted using non English language versions in countries including Spain (Luciano et al., 2010), China (Leu et al., 2015), Sweden (Soler et al., 2021), Japan (Hada et al., 2022), Iran (Amin-Esmaeli, 2014), and Singapore (Abdin et al., 2024) to name a few. Overall, the SDS was found to be a reliable and valid measure of disability and functional impairment. Beyond its reliability and validity, the SDS it has been shown to be highly sensitive to placebo drug differences in clinical trials and treatment outcome studies (Sheehan et al. 2008). The SDS has also been linguistically validated in over 70 languages.

Is the SDS valid if it is patient-rated?

The SDS can be rated by patient or clinician. Because of this flexibility it is useful for inpatients as well as outpatients and can also be used in community and population studies. Clinician input and judgment are always recommended with making any assessment.

SDS Versions Available

Which version of the SDS is best for my needs?

The standard version of the SDS for adults meets most needs, most of the time in clinical and research settings. The pediatric version (SDS-P) is useful for children since it can be parent or clinician-rated. We recommend the adolescent version (SDS-A) for adolescents since it can be either self-rated or clinician rated.

Can I get a preview copy of the SDS for my IRB submission?

Yes. Please CLICK HERE for a watermarked preview copy for review only or contact Dr. Sheehan at davidVsheehan@gmail.com.

Can I get a customized version of the SDS?

Yes, Dr. Sheehan can design a customized version of the SDS to meet the needs of a specific study or clinical setting. Contact Dr. Sheehan at davidVsheehan@gmail.com to discuss a customized version.

SDS Translations

Is the SDS available in other languages?

Yes, the SDS is available in over 50 languages. To learn more about existing translations or to get new translations contact davidVsheehan@gmail.com.

How do I get a translation?

Requests to access existing non-English translations or for any new translations should be submitted through MAPI Research Trust’s ePROVIDE COA platform at

https://eprovide.mapi-trust.org/ using the following process:

Go to Submit a request
If you haven't registered yet, you'll be asked to sign up for free
Complete the request form. Please attach a copy of the signed and fully executed license agreement signed by Dr. David V Sheehan.

Sheehan-Suicidality Tracking Scale (S-STS) FAQ

Who is the owner and copyright holder of the Sheehan-Suicidality Tracking Scale (S-STS)?

Dr. David V. Sheehan is the copyright and trademark holder of the Sheehan-Suicidality Tracking Scale (S-STS). This copyright is registered in the U.S. Copyright office. A license is needed for all use of the S-STS.

Dr. Sheehan only provides consultation, guidance on regulatory agency questions, and training to those who license the MINI / MINI Kid or scales directly from him. Contact Dr. Sheehan at davidVsheehan@gmail.com for additional information. If you do not see a QR code on the Sheehan-Suicidality Tracking Scale (S-STS) you are using linking back to this website then you did not get the S-STS from the author and Copyright Holder. Dr. David V. Sheehan is the Copyright Holder, Trademark Holder, and author of the S-STS in all languages. This copyright for the S-STS has been registered with the US Copyright Office.

S-STS Licensing and Costs

Do I need a license to use the S-STS?

A fully executed license is required for use of the Sheehan-Suicidality Tracking Scale (S-STS) in any language. To license the S-STS directly from Dr. Sheehan, the author and copyright holder, you will need complete his license agreement. Click here to learn more about the S-STS or to download a License for use.

Dr. Sheehan only provides consultation, guidance on regulatory agency questions, and training to those who license the S-STS directly from him. Contact Dr. Sheehan at davidVsheehan@gmail.com for additional information. If you do not see a QR code on the S-STS you are using linking back to this website then you did not get the SDS from the author and Copyright Holder. Dr. David V. Sheehan is the Copyright Holder, Trademark Holder, and author of the S-STS in all languages. This copyright for the S-STS has been registered with the US Copyright Office.

CLICK HERE for more information about Sheehan Scales.

What does it cost to license the S-STS?

The cost of licensing the S-STS is $4 USD for each use, i.e. each administration to a subject and/or each use in training.

Note: Non-profit institutions sometimes incorrectly assume that the license fee does not apply because they are “not-for-profit”. The licensing fee applies to all uses.

I am a student. Can I get a no-charge license?

The license and license fee applies to all uses.

Is the S-STS available in PDF format?

Dr. Sheehan licenses the S-STS in paper format for distribution as follows: (1) in paper form for any uses, or (2) in fixed-pdf form, paper form, or both for use in clinical or academic research trials or studies.

About the Sheehan-Suicidality Tracking Scale (S-STS)

What is the Sheehan-Suicidality Tracking Scale (S-STS)?

The Sheehan-Suicidality Tracking Scale (S-STS) is a short, clear, easy-to-use, highly sensitive scale to assess and monitor the seriousness of symptoms of suicidality. A benefit of the S-STS is that it yields scores that can be plotted quantitatively on a graph. Also, the same version can be used as a patient-rated scale, a clinician-rated scale or as both rated together at the same visit. The S-STS is compatible with FDA categories for classification of suicidal ideation and behavior and has been shown to be useful in detecting an efficacy signal for anti-suicidal medications.

What is the S-STS used for?

The S-STS can be used as a systematic means:

To assess and monitor suicidality in primary care as well as mental health settings (inpatient and outpatient).
To identify and track suicidality as an efficacy outcome measure, adverse event, and/or treatment emergent effect in clinical trials and treatment outcome studies.
To provide detailed documentation of suicidality in forensic evaluations.
To detect and describe the incidence or prevalence and severity of suicidality in population research including national and international epidemiology studies and community surveys.

What makes the S-STS unique?

The S-STS is unique in the following ways:

The S-STS asks about a broader range of suicidality phenomena than other suicidality scales. For example, beyond suicidal ideation and behavior, it has questions about suicidal impulses, suicidal hallucinations, delusional suicidality, and suicidal dreams.
Unlike its most used alternative, the C-SSRS, which uses a binary (Yes/No) response format, confirming the presence or absence of suicidality, the S-STS uses a numeric Likert format. A benefit of this format is that it allows raters to make fine distinctions in the seriousness of suicidality symptoms and track changes over time. Also, item and cluster scores can be graphed quantitatively.
The S-STS can be mapped closely to FDA classification categories of suicidality.
In clinical trials the S-STS has been found to be uniquely sensitive in detecting drug-placebo differences and treatment effects.
To our knowledge, the S-STS is the only suicidal assessment scale that has been linguistically validated for children and adolescents.

What qualifications do I need to administer the S-STS?

No minimum qualification is needed to administer the S-STS. What is more critical is that raters be comfortable discussing suicidality with patients and nonjudgment in their approach to suicidality. However, in research settings where precision is required, we do advise training in the use of the S-STS.

This is to ensure that the S-STS is administered and interpreted correctly and to reduce the risk of false positives or false negatives. We leave the final decision of selection and credentialing of raters up to the local sites.

Note: Dr. Sheehan only provides consultation, guidance on regulatory agency questions, and training to those who license the Sheehan-Suicidality Tracking Scale (S-STS) directly from him. Contact Dr. Sheehan at davidVsheehan@gmail.com for additional information. If you do not see a QR code on the Sheehan-Suicidality Tracking Scale (S-STS) you are using linking back to this website, then you did not get the Sheehan-Suicidality Tracking Scale (S-STS) from the author and Copyright Holder. Dr. David V. Sheehan is the Copyright Holder, Trademark Holder and author of the Sheehan-Suicidality Tracking Scale (S-STS) in all languages. This copyright for the S-STS has been registered with the US Copyright Office.

Can I administer the S-STS remotely?

Yes. Dr. Sheehan’s license allows you to administer the S-STS remotely as long as you complete the S-STS on paper as a primary source document. It is up to your protocol to determine how appropriate remote administration is for your patient population. Be sure to review HIPAA and GDPR privacy rules. If you are doing research, you should also review other applicable rules to make sure that remote administration is acceptable to any agency, such as the FDA, who may have oversight of your research.

What age range is the S-STS suitable for?

The standard version of the S-STS for adults meets most needs, most of the time in clinical and research settings.

For children and adolescents, the S-STS is available in 3 age-related, linguistically validated versions (for 6 to 8 year olds, 9 to 10 year olds, and 13 to 17 year olds). The pediatric version (S-STS-P) is useful for all three age groups since it can be parent or clinician rated. We recommend the adolescent version (S-STS-A) for adolescents aged 13-17 since it can be either self-rated by the adolescent or clinician rated.

How long does it take to administer the S-STS?

The average time to administer the S-STS is 8.4 minutes. This administration time is comparable to that for the C-SSRS (8.1 minutes) and shorter than that that for the ISST-Plus (14.5 min).

Has the Sheehan-Suicidality Tracking Scale (S-STS) been validated?

Has the S-STS been validated?

Note: The S-STS is a clinical decision support tool to measure suicidality. The above listed studies validated the S-STS under conditions in which it was rated in paper format as a primary source document. The results cannot be generalized to any other conditions or format.

Yes. The validity of the Sheehan-Suicidality Tracking Scale (S-STS) has been evaluated in comparisons with other instruments such as the Columbia-Suicide Severity Rating Scale (C-SSRS), the InterSePT Scale for Suicidal Thinking-Plus (ISST-Plus), the Beck Scale for Suicide Ideation (BSS), and item #3 of the Hamilton Depression Scale (Sheehan et al., 2014, Youngstrom et al., 2015, Bestari, et al., 2020, Coric et al., 2009). Overall, the S-STS was found to be a reliable and valid measure of suicidality with good psychometric properties. The S-STS has also been found to have good discriminant validity (Preti et al., 2013), to be very sensitive in detecting placebo drug differences and treatment effects in clinical trials (Coric et al., 2009, Khan et al, 2011), and to map closely to FDA categories for suicidal classification categories (Sheehan et al., 2014).

Beyond psychometric validation, the standard S-STS has been linguistically validated in over 50 languages and the S-STS for children and adolescents has been validated linguistically for each of three age groups: 6- to 8-year-olds, 9- to 12-year-olds, and 13- to 17-year-olds (Amado et al., 2014).

Is the S-STS valid if it is patient-rated?

The S-STS can be patient or clinician rated but should always be clinician reviewed, preferably by someone with clinical mental health experience and training. To ensure that the S-STS is rated and interpreted correctly and to reduce the risk of false positives or false negatives, we recommend training in the use of the S-STS. For more information about training, CLICK HERE.

S-STS Versions Available

Which version of the S-STS is best for my needs?

Adults

The standard version of the S-STS meets most needs, most of the time for adult subjects in clinical and research settings. This version has 14 core questions and 9 additional questions contingent on responses to the core 14 questions. For ease of navigation, it is laid out on 3 pages.

The more expanded S-STS Clinically Meaningful Change Measure (S-STS CMCM) version is useful when a more comprehensive evaluation of suicidality is required e.g. for clinical trials investigating the efficacy of anti-suicidality medications where regulators want to see a “clinically meaningful change” over and above a statistical superiority of drug over placebo. The CMCM version is also useful for detailed forensic assessments. Additionally, CMCM version has benefits for training on how to conduct a comprehensive assessment of suicidality.

Children and Adolescents

The more expanded S-STS Clinically Meaningful Change Measure (S-STS CMCM) version also available for Adolescents and is useful when a more comprehensive evaluation of suicidality is required e.g. for clinical trials investigating the efficacy of anti-suicidality medications where regulators want to see a “clinically meaningful change” over and above a statistical superiority of drug over placebo. The CMCM version is also useful for detailed forensic assessments. Additionally, CMCM version has benefits for training on how to conduct a comprehensive assessment of suicidality.

Other Suicidality Measures

Other suicidality measures for more detailed assessment of suicidality in clinical practice and research include the 7-page Suicide Plan Tracking Scale (SPTS), the Suicidality Modifiers Scale (SMS) and the Suicidal Impulse Attack Scale (SIAS).

To view a flowchart for Suicidality Assessment in Clinical Practice Settings and to understand how to use the S-STS and other suicidality rating scales with the Suicidality Module of the Mini Neuropsychiatric Interview (MINI) or with the Suicidality Module of the Mini Neuropsychiatric Interview for Children and Adolescents (MINI Kid) , please CLICK HERE.

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