{
  "abstract": "AimThe Patient Safety Screener-3 (PSS-3) is a brief suicide-risk screening tool. Item 1 of this scale assesses depressive mood but is not included in the total score. We examined the association of item 1 with depressive symptom severity and characterized the suicide-related risk captured by PSS-3 total positivity.\n\nMethodsWe conducted a nationwide cross-sectional survey among resident physicians in Japan. Associations between PSS-3 item 1 endorsement and Patient Health Questionnaire-9 (PHQ-9) scores were evaluated using the Wilcoxon rank-sum test. Diagnostic performance of item 1 was evaluated using PHQ-9 positivity ([≥]10) as reference standard. We also compared Short-form Scale for Suicide Ideation (SIS-6) scores according to PSS-3 total positivity and PHQ-9 item 9 positivity.\n\nResultsA total of 1,844 participants were included. PSS-3 item 1 was endorsed by 443 physicians (24.0%), and 47 (2.5%) met the criteria for PSS-3 total positivity. Item 1 showed 79.3% sensitivity and 79.5% specificity for PHQ-9 positivity. SIS-6 scores were higher in the PSS-3 total-positive group than in the total-negative group (median [IQR], 6 [5-9] vs 0 [0-1]; p<0.001). The SIS-6 showed a higher area under the receiver operating characteristic curve (AUC) and Youden index using PSS-3 total positivity (AUC, 0.961; optimal cutoff, 3) than PHQ-9 item 9 positivity (AUC, 0.907; optimal cutoff, 2).\n\nDiscussionPSS-3 may support brief, simultaneous screening for depressive symptoms and suicide- related risk. Compared with PHQ-9 item 9, PSS-3 may capture a more severe spectrum of suicide- related risk. PSS-3 may facilitate identification of individuals requiring further mental health assessment.\n\nGraphical Abstract\n\nO_FIG O_LINKSMALLFIG WIDTH=200 HEIGHT=109 SRC=\"FIGDIR/small/26361711v1_ufig1.gif\" ALT=\"Figure 1\"> View larger version (30K): org.highwire.dtl.DTLVardef@1acee78org.highwire.dtl.DTLVardef@5c1eaeorg.highwire.dtl.DTLVardef@1e26602org.highwire.dtl.DTLVardef@9722c9_HPS_FORMAT_FIGEXP M_FIG C_FIG",
  "abstract_shown": true,
  "affiliations": [
    "Juntendo University Graduate School of Medicine"
  ],
  "article_type": "PUBLISHAHEADOFPRINT",
  "arxiv": null,
  "author_total": 10,
  "authors": [
    {
      "name": "K. Kiryu"
    },
    {
      "affs": [
        0
      ],
      "name": "H. Tamune"
    },
    {
      "name": "K. Takahashi"
    },
    {
      "name": "H. Fujikawa"
    },
    {
      "name": "H. Harada"
    },
    {
      "name": "S. Fukui"
    },
    {
      "name": "K. Nagasaki"
    },
    {
      "name": "Y. Nishizaki"
    },
    {
      "name": "T. Kato"
    },
    {
      "name": "Y. Tokuda"
    }
  ],
  "bibtex": "https://research.draconitic.com/paper/4a3kgkta4je73.bib",
  "cited_by": 0,
  "doi": "10.64898/2026.08.30.26361711",
  "fulltext_url": "https://www.medrxiv.org/content/10.64898/2026.08.30.26361711v1.full",
  "id": "4a3kgkta4je73",
  "issns": [],
  "landing_url": "https://www.medrxiv.org/content/10.64898/2026.08.30.26361711v1",
  "language": null,
  "licence": "CC-BY-NC-ND",
  "licence_label": "CC BY-NC-ND",
  "licence_source": "article",
  "licence_url": "https://creativecommons.org/licenses/by-nc-nd/4.0/",
  "metadata_licence": null,
  "native_subjects": [
    [
      "medrxiv",
      "psychiatry and clinical psychology"
    ],
    [
      "openalex",
      "3203|Suicide and Self-Harm Studies"
    ]
  ],
  "openalex": "W7204889701",
  "pdf_url": "https://www.medrxiv.org/content/10.64898/2026.08.30.26361711v1.full.pdf",
  "pmcid": null,
  "pmid": null,
  "published": "2026-08-30",
  "publisher": null,
  "ris": "https://research.draconitic.com/paper/4a3kgkta4je73.ris",
  "sources": [
    {
      "first_seen": "2026-10-30T12:17:27Z",
      "native_id": "10.64898/2026.08.30.26361711",
      "source": "medrxiv",
      "url": "https://www.medrxiv.org/content/10.64898/2026.08.30.26361711v1"
    }
  ],
  "subjects": [
    {
      "field": "medicine",
      "origin": "medrxiv:psychiatry and clinical psychology",
      "subfield": "psychiatry"
    }
  ],
  "title": "Associations of the Patient Safety Screener-3 With Depression and Suicide Risk: A Nationwide Cross-Sectional Study in Japan",
  "title_text": "Associations of the Patient Safety Screener-3 With Depression and Suicide Risk: A Nationwide Cross-Sectional Study in Japan",
  "type": "preprint",
  "updated_at": "2026-10-30T12:17:27Z",
  "url": "https://research.draconitic.com/paper/4a3kgkta4je73",
  "venue": "medRxiv",
  "versions": []
}