Assessing Functional Impairment and Distress Associated with the Suicide Crisis Syndrome in Psychiatric Inpatients

The Suicide Crisis Syndrome (SCS) is a proposed diagnostic construct designed to identify individuals at imminent risk for suicide, characterized by feelings of entrapment, affective disturbance, cognitive dyscontrol, hyperarousal, and social withdrawal. For a disorder to be included in the Diagnostic and Statistical Manual of Mental Disorders (DSM), it must be associated with clinically significant distress or functional impairment across major life domains. This study examined the relationship between SCS and both distress and functional impairment in a psychiatric inpatient sample to assess its clinical significance and potential DSM inclusion. A total of 218 psychiatric inpatients completed the clinician-administered SCS Checklist (SCS-C), the self-report Suicide Crisis Inventory-2 (SCI-2), and the Sheehan Disability Scale. Psychiatric diagnoses were determined using the Mini International Neuropsychiatric Interview (MINI). Analyses included independent samples t-tests, hierarchical regression, and multiple regressions. Participants meeting diagnostic criteria for SCS reported significantly greater impairment and distress across all Sheehan domains (Cohen’s ds = 0.33–0.95). Hierarchical regressions showed that SCS accounted for additional variance in functional impairment beyond other psychiatric diagnoses (ΔR² = .042–.116, ps ≤ .002), particularly in family and social functioning. Among individuals with SCS, higher SCI-2 scores were associated with greater distress and impairment (partial η² = .057–.239), with affective disturbance and social withdrawal emerging as primary contributors. These findings demonstrate that SCS, measured both categorically and dimensionally, is linked to clinically significant distress and impairment across work, social, and family domains, providing empirical support for its potential recognition as a DSM disorder.