Table 2

Suicidality event rating definitions

Code no.


C-CASA definitiona


Completed suicide

A self-injurious behavior that resulted in fatality and was associated with at least some intent to die as a result of the act


Suicide attempt

A potentially self-injurious behavior, associated with at least some intent to die, as a result of the act. Evidence that the individual intended to kill him/herself, at least to some degree, can be explicit or inferred from the behavior or circumstance. A suicide attempt may or may not result in actual injury.


Preparatory acts toward imminent suicidal behavior

The individual takes steps to injure him or herself, but is stopped by self or others from starting the self-injurious act before the potential for harm has begun


Suicidal ideation: passive, active, active with plans, type unknown

Passive thoughts about wanting to be dead or active thoughts about killing oneself, not accompanied by preparatory behavior


Self-injurious behavior, intent unknown

Self-injurious behavior where associated intent to die is unknown and cannot be inferred. The injury or potential for injury is clear, but why the individual engaged in that behavior is unclear.


Not enough information: death

Insufficient information to determine whether the event involved deliberate suicidal behavior or ideation. There is reason to suspect the possibility of suicidality but not enough to be confident that the event was not something other, such as an accident or psychiatric symptom.


Self-injurious behavior, no suicidal intent

Self-injurious behavior associated with no intent to die. The behavior is intended purely for other reasons, either to relieve distress (often referred to as 'self-mutilation', for example superficial cuts or scratches, hitting/banging, or burns) or to effect change in others or the environment.


Other: accident, death, psychiatric, medical

No evidence of any suicidality or deliberate self-injurious behavior associated with the event. The event is characterized as an accidental injury, psychiatric or behavioral symptoms only, or medical symptoms or procedure only.


Not enough information: non-death

Same as no. 6 above, with the event not resulting in death

aDefinitions from [3]: Posner et al., Am J Psych 2007, 164:1035-1043.

C-CASA = Columbia Classification Algorithm for Suicide Assessment

Redden et al. Annals of General Psychiatry 2011 10:1   doi:10.1186/1744-859X-10-1

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