The Psychometric Utility of the Four-Item Suicidal Behavior Questionnaire-Revised (SBQ-R) as a Suicide Risk Screening Instrument in a Sample of Nigerians with Severe Mental Disorders

A bstract Background: The Suicidal Behavior Questionnaire-Revised (SBQ-R) is a self-report questionnaire designed to screen for suicidal behaviors in various settings. It has been widely used in psychiatric inpatients and adolescent populations but less so among psychiatric outpatients. Objectives: This study aimed to evaluate the factor structure and internal consistency of the SBQ-R in a sample of 348 Nigerian psychiatric outpatients. Materials and Methods: In addition to the SBQ-R, participants completed the Multidimensional Scale of Perceived Social Support, the Modified Internalized Stigma of Mental Illness Scale, and the World Health Organization Quality of Life Scale-Brief version. They were also interviewed using the suicidality module of the Mini International Neuropsychiatric Interview (MINI). Results: The confirmatory factor analysis (CFA) approach yielded a one-factor solution with high internal consistency and reliability. Multigroup nested CFA affirmed the gender invariance of the SBQ-R. A cutoff score of 13 (sensitivity = 0.800, specificity = 0.985) identified those categorized as high suicide risk. SBQ-R was positively correlated with stigma and MINI suicidality module, and negatively correlated with social support and quality of life. Conclusion: The SBQ-R is a valid and reliable suicide risk screener among patients with severe mental disorders in Nigeria.