The Concise Health Risk Tracking Self-Report (CHRT-SR) assessment of suicidality in depressed outpatients: A psychometric evaluation

Nancy De La Garza, A. John Rush, Michael O. Killian, Bruce D. Grannemann, Thomas J Carmody, Madhukar H Trivedi

Research output: Contribution to journalArticlepeer-review

8 Scopus citations


Background: The 12-item Concise Health Risk Tracking Self-Report (CHRT-SR 12 ) is a brief, self-report measure that systematically assesses both suicidal thinking and associated thoughts that may indicate the propensity for suicidal acts. It can be used as a tool to both assess risk and guide treatment interventions targeting associated cognitions. Methods: This report used acute treatment data from a clinically representative sample of outpatients with nonpsychotic major depressive disorder (N = 665) participating in the Combining Medications to Enhance Depression Outcomes trial, who received up to 12 weeks of escitalopram, escitalopram plus bupropion SR, or venlafaxine XR plus mirtazapine. Outcome assessors and patients were masked to treatment. Results: Factor analysis of CHRT-SR 12 confirmed that the 12 items have higher order structure with two subscales (Propensity, Suicidal Thoughts) and a total score. Internal consistencies were acceptable for both subscales and total score. All three scales were modestly correlated with overall depression severity (r = 0.54 to r = 0.21) and highly discriminating among patients grouped by suicide item ratings on three different depressive symptom ratings. The three scales also distinguished change over the acute phase treatment for those with different levels of baseline suicidal ideation (measured by 30-item Inventory of Depressive Symptomatology (item 18) and for those with change in suicidal ideation (baseline to last visit). Conclusions: The CHRT-SR 12 has good to excellent psychometric properties and is sensitive to change in suicidal thinking and propensity toward suicidal behavior in outpatients with major depressive disorder. It allows for the monitoring of thoughts and feelings associated with increased suicidal risk as well as levels of thoughts about suicide.

Original languageEnglish (US)
Pages (from-to)313-320
Number of pages8
JournalDepression and anxiety
Issue number4
StatePublished - Apr 2019


  • Concise Health Risk Tracking Scale (CHRT-SR)
  • depression
  • psychometrics
  • suicidal ideation
  • suicidality
  • suicide risk

ASJC Scopus subject areas

  • Clinical Psychology
  • Psychiatry and Mental health


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