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BackgroundInternet gaming disorder (IGD) is an emerging behavioral addiction with mental health implications among adolescents. Low self-control is an established risk factor of IGD. Few studies have, however, examined the moderating role of meaning in life (MIL) on the relationships between low self-control and IGD symptoms and functioning. ObjectiveThis study aimed to examine the effects of low self-control and MIL and their interaction effects on IGD symptoms and family and school functioning in a structural equation model. MethodsA sample of 2064 adolescents (967, 46.9% male; mean age 14.6 years) was recruited by multistage cluster random sampling from 5 middle schools in Sichuan, China, in 2022. The participants completed a self-report questionnaire with validated measures on low self-control, presence of MIL, search for MIL, IGD symptoms, school commitment, and family functioning. Construct validity, measurement invariance, and structural invariance of the measures were evaluated by confirmatory factor analysis across sex. Structural equation modeling was conducted to examine the indirect effects of low self-control and MIL on family and school functioning through IGD symptoms. Latent moderated structural equation modeling was performed to examine the interaction effects between low self-control and MIL on IGD symptoms, school commitment, and family functioning. ResultsAll scales showed satisfactory model fit and scalar measurement invariance by sex. Males showed significantly greater IGD symptoms and lower levels of self-control (Cohen d=0.25-1.20, P

Background Life expectancy and life disparity are 2 useful indicators to assess the health condition of a society. Both Hong Kong and Japan have one of the longest life expectancies in the world. Recently, Hong Kong has overtaken Japan and topped the life expectancy rankings. However, whether Hong Kong has also outperformed Japan in life disparity is still unknown. Methods Decomposition analyses have been conducted to evaluate age-specific contributions to the changes in life expectancy and life disparity for each of the populations. Furthermore, the differences between the 2 populations were examined over the period 1977-2016. Results Reduction in mortality of the adult and the old age groups contributes most to the increase in life expectancy for the study period. Hong Kong has a higher life disparity than Japan, and due to the great improvement in reducing premature deaths, the Hong Kong-Japan gap has been narrowing. However, in recent years, further reduction in mortality of the oldest elderly in Hong Kong has actually contributed to the increase in its disparity, thus widening its gap with Japan again. Conclusion Increasing dominant influence of “saving lives at late ages” is very likely to cause the reemergence of increasing life disparity in these 2 long-lived populations.

Globally, colorectal cancer (CRC) is a substantial public health burden, and it is increasingly affecting populations in Asian countries. The overall prevalence of CRC is reported to be low in Asia when compared with that in Western nations, yet it had the highest number of prevalent cases. This review described the prevalence of CRC in Asia according to the International Agency for Research on Cancer from World Health Organization (WHO) database and summarized its major risk factors. Non-modifiable factors include genetic factors, ethnicity, age, gender, family history and body height; smoking, alcohol drinking, weight, Westernized diet, physical inactivity, chronic diseases and microbiota were involved in environmental factors. These risk factors were separately discussed in this review according to published literature from Asian countries. CRC screening has been playing an important role in reducing its disease burden. Some recommendations on its screening practices have been formulated in guidelines for Asia Pacific countries.

BackgroundThe electronic health record sharing system (eHRSS) was implemented as a new health care delivery platform to facilitate two-way communication between the public and private sectors in Hong Kong. ObjectiveThis study aimed to investigate the perceptions of and factors associated with the adoption of eHRSS among patients, the general public, and private physicians. MethodsTelephone interviews were conducted in 2018 by using a simple random sampling strategy from a list of patients who had enrolled in the eHRSS and a territory-wide telephone directory for nonenrolled residents. We completed 2000 surveys (1000 each for enrolled and nonenrolled individuals). Private physicians completed self-administered questionnaires, including 762 valid questionnaires from 454 enrolled physicians and 308 nonenrolled physicians. ResultsMost participants (707/1000, 70.70%) were satisfied with the overall performance of the eHRSS. Regarding registration status, most nonenrolled patients (647/1000, 64.70%) reported that “no recommendation from their physicians and family members” was the major barrier, whereas more than half of the physicians (536/1000, 53.60%) expressed concerns on “additional workload due to use of eHRSS.” A multivariate regression analysis showed that patients were more likely to register when they reported “other service providers could view the medical records” (adjusted odds ratio [aOR] 6.09, 95% CI 4.87-7.63; P

The National Spherical Torus Experiment (NSTX) has made considerable progress in advancing the scientific understanding of high performance long-pulse plasmas needed for future spherical torus (ST) devices and ITER. Plasma durations up to 1.6 s (five current redistribution times) have been achieved at plasma currents of 0.7 MA with non-inductive current fractions above 65% while simultaneously achieving βT and βN values of 17% and 5.7 (%m T MA-1), respectively. A newly available motional Stark effect diagnostic has enabled validation of current-drive sources and improved the understanding of NSTX 'hybrid'-like scenarios. In MHD research, ex-vessel radial field coils have been utilized to infer and correct intrinsic EFs, provide rotation control and actively stabilize the n ≤ 1 resistive wall mode at ITER-relevant low plasma rotation values. In transport and turbulence research, the low aspect ratio and a wide range of achievable β in the NSTX provide unique data for confinement scaling studies, and a new microwave scattering diagnostic is being used to investigate turbulent density fluctuations with wavenumbers extending from ion to electron gyro-scales. In energetic particle research, cyclic neutron rate drops have been associated with the destabilization of multiple large toroidal Alfven eigenmodes (TAEs) analogous to the 'sea-of-TAE' modes predicted for ITER, and three-wave coupling processes have been observed for the first time. In boundary physics research, advanced shape control has enabled studies of the role of magnetic balance in H-mode access and edge localized mode stability. Peak divertor heat flux has been reduced by a factor of 5 using an H-mode-compatible radiative divertor, and lithium conditioning has demonstrated particle pumping and results in improved thermal confinement. Finally, non-solenoidal plasma start-up experiments have achieved plasma currents of 160 kA on closed magnetic flux surfaces utilizing coaxial helicity injection. © 2007 IAEA.

Research on the spherical torus (or spherical tokamak) (ST) is being pursued to explore the scientific benefits of modifying the field line structue fro that in more moderate aspect ratio devices. The ST experiments are being conducted in various US research facilities. The area of power and particle handling is expected to be challenging because of the higher power density expected in the ST relative to that in conventional aspect-ratio tokamaks.

A major research goal of the national spherical torus experiment is establishing long-pulse, high beta, high confinement operation and its physics basis. This research has been enabled by facility capabilities developed during 2001 and 2002, including neutral beam (up to 7 MW) and high harmonic fast wave (HHFW) heating (up to 6 MW), toroidal fields up to 6 kG, plasma currents up to 1.5 MA, flexible shape control, and wall preparation techniques. These capabilities have enabled the generation of plasmas with βT ≡ /(BT02/2μ0) of up to 35%. Normalized beta values often exceed the no-wall limit, and studies suggest that passive wall mode stabilization enables this for H mode plasmas with broad pressure profiles. The viability of long, high bootstrap current fraction operations has been established for ELMing H mode plasmas with toroidal beta values in excess of 15% and sustained for several current relaxation times. Improvements in wall conditioning and fuelling are likely contributing to a reduction in H mode power thresholds. Electron thermal conduction is the dominant thermal loss channel is auxiliary heated plasmas examined thus far. HHFW effectively heats electrons, and its acceleration of fast beam ions has been observed. Evidence for HHFW current drive is obtained by comparison of the loop voltage evolution in plasmas with matched density and temperature profiles but varying phases of launched HHFW waves. Studies of emissions from electron Bernstein waves indicate a density scale length dependence of their transmission across the upper hybrid resonance near the plasma edge that is consistent with theoretical predictions. A peak heat flux to the divertor targets of 10 MW m-2 has been measured in the H mode, with large asymmetries being observed in the power deposition between the inner and outer strike points. Non-inductive plasma startup studies have focused on coaxial helicity injection. With this technique, toroidal currents up to 400 kA have been driven, and studies to assess flux closure and coupling to other current drive techniques have begun.

Background Ageing has become a serious challenge in Hong Kong and globally. It has serious implications for health expenditure, which accounts for nearly 20% of overall government expenditure. Here we assess the contribution of ageing and related factors to hospitalisation days in Hong Kong. We used hospital discharge data from all publicly funded hospitals in Hong Kong between 2001 and 2012. Methods A decomposition method was used to examine the factors that account for the change of total hospitalisation days during the two periods, 2001-2004 and 2004-2012. The five factors include two demographic factors – population size and age-gender composition – and three service components – hospital discharge rate, number of discharge episodes per patient, and average length of stay (LOS) – which are all measured at age-gender group level. In order to assess the health cost burden in the future, we also project the total hospitalisation days up to 2041, for a range of scenarios. Results During the decreasing period of hospitalisation days (2001-2004), the reduction of LOS contributed to about 60% of the reduction. For the period of increase (2004-2012), ageing is associated with an increase in total hospitalisation days of 1.03 million, followed by an increase in hospital discharge rates (0.67 million), an increase in the number of discharge episodes per patient (0.62 million), and population growth (0.43 million). The reduction of LOS has greatly offset these increases (-2.19 million days), and has become one of the most significant factors in containing the increasing number of hospitalisation days. Projected increases in total hospitalisation days under different scenarios have highlighted that the contribution of ageing will become even more prominent after 2022. Conclusion Hong Kong is facing increasing healthcare burden caused by the rapid increase in demand for inpatient services due to ageing. Better management of inpatient services with the aim of increasing efficiency and reducing LOS, avoidable hospitalisation and readmission, without compromising patient satisfaction and quality of service, are crucial for containing the rapid and enormous increases in total hospitalisation days for Hong Kong. The results would be relevant to many rapidly ageing societies in this region.

The Tokamak Fusion Test Reactor (TFTR) is a large tokamak which has performed experiments with 50:50 deuterium-tritium fuelled plasmas. Since 1993, TFTR has produced about 1090 D-T plasmas using about 100 grams of tritium and producing about 1.6 GJ of D-T fusion energy. These plasmas have significant populations of 3.5 MeV alphas (the charged D-T fusion product). TFTR research has focused on alpha particle confinement, alpha driven modes, and alpha heating studies. Maximum D-T fusion power production has aided these studies, requiring simultaneously operation at high input heating power and large energy confinement time (to produce the highest temperature and density), while maintaining low impurity content. The principal limitation to the TFTR fusion power production was the disruptive stability limit. Secondary limitations were the confinement time, and limiter power handling capability. © 1997 IOP Publishing Ltd.

Experiments in the Tokamak Fusion Test Reactor (TFTR) [Phys. Plasmas 2, 2176 (1995)] have explored several novel regimes of improved tokamak confinement in deuterium–tritium (D–T) plasmas, including plasmas with reduced or reversed magnetic shear in the core and high-current plasmas with increased shear in the outer region (high [formula omitted]). New techniques have also been developed to enhance the confinement in these regimes by modifying the plasma-limiter interaction through in situ deposition of lithium. In reversed-shear plasmas, transitions to enhanced confinement have been observed at plasma currents up to 2.2 MA [formula omitted] accompanied by the formation of internal transport barriers, where large radial gradients develop in the temperature and density profiles. Experiments have been performed to elucidate the mechanism of the barrier formation and its relationship with the magnetic configuration and with the heating characteristics. The increased stability of high-current, high-[formula omitted] plasmas produced by rapid expansion of the minor cross section, coupled with improvement in the confinement by lithium deposition has enabled the achievement of high fusion power, up to 8.7 MW, with D–T neutral beam heating. The physics of fusion alpha-particle confinement has been investigated in these regimes, including the interactions of the alphas with endogenous plasma instabilities and externally applied waves in the ion cyclotron range of frequencies. In D–T plasmas with [formula omitted] and weak magnetic shear in the central region, a toroidal Alfvén eigenmode instability driven purely by the alpha particles has been observed for the first time. The interactions of energetic ions with ion Bernstein waves produced by mode conversion from fast waves in mixed-species plasmas have been studied as a possible mechanism for transferring the energy of the alphas to fuel ions. © 1997, American Institute of Physics. All rights reserved.

A search for alpha driven beta-induced Alfvén eigenmodes (BAEs) was conducted in low current (1.0-1.6 MA) TFTR supershots. Stable high beta deuterium-tritium (DT) discharges were obtained with βp = 2.4 and a central alpha beta of 0.1%. Instabilities between 75 and 200 kHz were observed by magnetics probes in many DT discharges, but the activity was also present in deuterium-deuterium (DD) comparison discharges, indicating that these modes are not destabilized (principally) by the alpha particle population. Losses of fusion products are also similar in the two sets of discharges. Theoretical simulations confirm that the achieved alpha particle pressure is too small to produce instability.

Experiments with plasmas having nearly equal concentrations of deuterium and tritium have been carried out on TFTR. To date (September 1995), the maximum fusion power has been 10.7 MW, using 39.5 MW of neutral beam heating, in a supershot discharge and 6.7 MW in a high beta P discharge following a current ramp-down. The fusion power density in the core of the plasma has reached 2.8 MW/m3, exceeding that expected in the International Thermonuclear Experimental Reactor (ITER). The energy confinement time tau E is observed to increase in DT, relative to D plasmas, by 20% and the n1(0).T1(0). tau E product by 55%. The improvement in thermal confinement is caused primarily by a decrease in ion heat conductivity in both supershot and limiter H mode discharges. Extensive lithium pellet injection increased the confinement time to 0.27 s and enabled higher current operation in both supershot and high beta P discharges. First measurements of the confined alpha particles have been performed and found to be in good agreement with TRANSP simulations assuming classical confinement. Measurements of the alpha ash profile have been compared with simulations using particle transport coefficients from helium gas puffing experiments. The loss of energetic alpha particles to a detector at the bottom of the vessel is well described by the first-orbit loss mechanism. No loss due to alpha particle driven instabilities has yet been observed. ICRF heating of a DT plasma, using the second harmonic of tritium, has been demonstrated. DT experiments on TFTR will continue both to explore the physics underlying the ITER design and to examine some of the physics issues associated with an advanced tokamak reactor.

Routine tritium operation in TFTR has permitted investigations of alpha particle physics in parameter ranges resembling those of a reactor core. ICRF wave physics in a DT plasma and the influence of isotopic mass on supershot confinement have also been studied. Continued progress has been made in optimizing fusion power production in TFTR, using extended machine capability and Li wall conditioning. Performance is currently limited by MHD stability. A new reversed magnetic shear regime is being investigated with reduced core transport and a higher predicted stability limit.

TFTR has begun its campaign to study deuterium-tritium fusion under reactor-like conditions. Variable amounts of deuterium and tritium neutral beam power have been used to maximize fusion power, study alpha heating, investigate alpha particle confinement, and search for alpha driven plasma instabilities. Additional areas of study include energy and particle transport and confinement, ICRF heating schemes for DT plasmas, tritium retention, and fusion in high βp plasmas. The majority of this work is done in the TFTR supershot confinement regime. To obtain supershots, extensive limiter conditioning using helium fueled ohmic discharges and lithium pellet injection into ohmic and neutral beam heated plasmas is performed, resulting in a low recycling limiter. The relationship between recycling and core plasma confinement has been studied by using helium, deuterium and high-Z gas puffs to simulate high recycling limiter conditions. These studies show that confinement in TFTR supershots is very sensitive to the influx of neutral particles at the plasma edge. © 1995, All rights reserved.

Three campaigns, prior to July 1994, attempted to increase the fusion power in DT plasmas on the Tokamak Fusion Test Reactor (TFTR). The first campaign was dedicated to obtaining >5 MW of fusion power while avoiding MHD events similar to the JET X-event. The second was aimed at producing maximum fusion power irrespective of proximity to MHD limits, and achieved 9 MW limited by a disruption. The third campaign increased the energy confinement time using lithium pellet conditioning while raising the ratio of alpha heating to beam heating.

The Tomamak Fusion Test reactor has performed initial high-power experiments with the plasma fueled with nominally equal densities of deuterium and tritium. Compared to pure deuterium plasmas, the energy stored in the electron and ions increased by ∼20%. These increases indicate improvements in confinement associated with the use of tritium and possibly heating of electrons by α particles created by the D-T fusion reactions. © 1994 The American Physical Society.

Peak fusion power production of 6.2±0.4 MW has been achieved in TFTR plasmas heated by deuterium and tritium neutral beams at a total power of 29.5 MW. These plasmas have an inferred central fusion alpha particle density of 1.2×1017 m-3 without the appearance of either disruptive magnetohydrodynamics events or detectable changes in Alfvén wave activity. The measured loss rate of energetic alpha particles agreed with the approximately 5% losses expected from alpha particles which are born on unconfined orbits. © 1994 The American Physical Society.

BackgroundTraditional offline assessment of suicide probability is time consuming and difficult in convincing at-risk individuals to participate. Identifying individuals with high suicide probability through online social media has an advantage in its efficiency and potential to reach out to hidden individuals, yet little research has been focused on this specific field. ObjectiveThe objective of this study was to apply two classification models, Simple Logistic Regression (SLR) and Random Forest (RF), to examine the feasibility and effectiveness of identifying high suicide possibility microblog users in China through profile and linguistic features extracted from Internet-based data. MethodsThere were nine hundred and nine Chinese microblog users that completed an Internet survey, and those scoring one SD above the mean of the total Suicide Probability Scale (SPS) score, as well as one SD above the mean in each of the four subscale scores in the participant sample were labeled as high-risk individuals, respectively. Profile and linguistic features were fed into two machine learning algorithms (SLR and RF) to train the model that aims to identify high-risk individuals in general suicide probability and in its four dimensions. Models were trained and then tested by 5-fold cross validation; in which both training set and test set were generated under the stratified random sampling rule from the whole sample. There were three classic performance metrics (Precision, Recall, F1 measure) and a specifically defined metric “Screening Efficiency” that were adopted to evaluate model effectiveness. ResultsClassification performance was generally matched between SLR and RF. Given the best performance of the classification models, we were able to retrieve over 70% of the labeled high-risk individuals in overall suicide probability as well as in the four dimensions. Screening Efficiency of most models varied from 1/4 to 1/2. Precision of the models was generally below 30%. ConclusionsIndividuals in China with high suicide probability are recognizable by profile and text-based information from microblogs. Although there is still much space to improve the performance of classification models in the future, this study may shed light on preliminary screening of risky individuals via machine learning algorithms, which can work side-by-side with expert scrutiny to increase efficiency in large-scale-surveillance of suicide probability from online social media.

BackgroundInternet-based learning programs provide people with massive health care information and self-help guidelines on improving their health. The advent of Web 2.0 and social networks renders significant flexibility to embedding highly interactive components, such as games, to foster learning processes. The effectiveness of game-based learning on social networks has not yet been fully evaluated. ObjectivesThe aim of this study was to assess the effectiveness of a fully automated, Web-based, social network electronic game on enhancing mental health knowledge and problem-solving skills of young people. We investigated potential motivational constructs directly affecting the learning outcome. Gender differences in learning outcome and motivation were also examined. MethodsA pre/posttest design was used to evaluate the fully automated Web-based intervention. Participants, recruited from a closed online user group, self-assessed their mental health literacy and motivational constructs before and after completing the game within a 3-week period. The electronic game was designed according to cognitive-behavioral approaches. Completers and intent-to-treat analyses, using multiple imputation for missing data, were performed. Regression analysis with backward selection was employed when examining the relationship between knowledge enhancement and motivational constructs. ResultsThe sample included 73 undergraduates (42 females) for completers analysis. The gaming approach was effective in enhancing young people’s mental health literacy (d=0.65). The finding was also consistent with the intent-to-treat analysis, which included 127 undergraduates (75 females). No gender differences were found in learning outcome (P=.97). Intrinsic goal orientation was the primary factor in learning motivation, whereas test anxiety was successfully alleviated in the game setting. No gender differences were found on any learning motivation subscales (P>.10). We also found that participants’ self-efficacy for learning and performance, as well as test anxiety, significantly affected their learning outcomes, whereas other motivational subscales were statistically nonsignificant. ConclusionsElectronic games implemented through social networking sites appear to effectively enhance users’ mental health literacy.

Abstract Background Media reporting of suicide and its relationship with actual suicide has rarely been investigated in Mainland China. The "Foxconn suicides" is a description referring to a string of suicides/attempts during 2010, all of which were related to a giant electrical manufacturing company, Foxconn. This study aimed to examine the clustering and copycat effects of the Foxconn suicides, and to investigate temporal patterns in how they were reported by the media in Mainland China, Hong Kong (HK), and Taiwan (TW). Methods Relevant articles were collected from representative newspapers published in three big cities in Mainland China (Beijing (BJ), Shenzhen (SZ), and Guangzhou (GZ)), HK, and TW, together with searching intensity data on the topic conducted using the Baidu search engine in Mainland China. The temporal clustering effects of the Foxconn suicides and their media prominence were assessed using the Kolmogorov-Smirnov test. The media reports of the Foxconn suicides' temporal patterns were explored using a nonparametric curve estimation method (that is, the local linear method). The potential mutual interactions between the Foxconn suicides and their media prominence were also examined, using logistic and Poisson regression methods. Results The results support a temporal clustering effect for the Foxconn suicides. The BJ-based newspapers' reporting and the occurrence of a Foxconn suicide/attempt are each found to be associated with an elevated chance of a further Foxconn suicide 3 days later. The occurrence of a Foxconn suicide also immediately influenced the intensity of both Baidu searching and newspaper reporting. Regional diversity in suicide reporting tempo-patterns within Mainland China, and similarities between HK and TW, are also demonstrated. Conclusions The Foxconn suicides were temporally clustered. Their occurrences were influenced by the reporting of BJ-based newspapers, and contagion within the company itself. Further suicide research and prevention work in China should consider its special media environment.

Abstract Background Considerable attention has been focused on the study of suicides among those who have received help from healthcare providers. However, little is known about the profiles of suicide deceased who had psychiatric illnesses but made no contact with psychiatric services prior to their death. Behavioural model of health service use is applied to identify factors associated with the utilization of psychiatric service among the suicide deceased. Methods With respect to completed suicide cases, who were diagnosed with a mental disorder, a comparison study was made between those who had (contact group; n = 52; 43.7%) and those who had not made any contact (non-contact group; n = 67; 56.3%) with a psychiatrist during the final six months prior to death. A sample of 119 deceased cases aged between 15 and 59 with at least one psychiatric diagnosis assessed by the Structured Clinical Interview for DSM-IV-TR (SCID I) were selected from a psychological autopsy study in Hong Kong. Results The contact and non-contact group could be well distinguished from each other by "predisposing" variables: age group & gender, and most of the "enabling", and "need" variables tested in this study. Multiple logistic regression analysis has found four factors are statistically significantly associated with non-contact suicide deceased: (i) having non-psychotic disorders (OR = 13.5, 95% CI:2.9-62.9), (ii) unmanageable debts (OR = 10.5, CI:2.4-45.3), (iii) being full/partially/self employed at the time of death (OR = 10.0, CI:1.6-64.1) and (iv) having higher levels of social problem-solving ability (SPSI) (OR = 2.0, CI:1.1-3.6). Conclusion The non-contact group was clearly different from the contact group and actually comprised a larger proportion of the suicide population that they could hardly be reached by usual individual-based suicide prevention efforts. For this reason, both universal and strategic suicide prevention measures need to be developed specifically in non-medical settings to reach out to this non-contact group in order to achieve better suicide prevention results.

Abstract Background A surge in suicide rates in middle age people in Hong Kong and many Asian countries was recently observed. However, there is a paucity of suicide research on this subgroup of people in Asia. Methods The next-of-kin of 85 suicide cases and 85 community subjects aged 30–49 years were interviewed by a psychological autopsy approach. Information was triangulated by interview notes, coroner's court files, and police investigation reports. Results A multiple logistic regression analysis identified the following risk factors for suicide among the middle age people in Hong Kong: the presence of at least one psychiatric disorder (OR = 37.5, 95% CI 11.5–121.9, p < 0.001), indebtedness (OR = 9.4, 95% CI 2.2–40.8, p < 0.01), unemployment (OR = 4.8, 95% CI 1.3–17.5, p < 0.05), never married (OR = 4.2, 95% CI 1.1–16.3, p < 0.05), and lived alone (OR = 3.9, 95% CI 1.2–13.4, p < 0.05). Conclusion The data show that socio-economical factors had a strong impact on suicide in the target group. Further research is needed to explore any positive qualities that protect the middle-aged from suicide. The prevention of suicide in the middle-aged requires multiple strategies.

Abstract Background Lengthy questionnaires reduce data quality and impose a burden on respondents. Previous researchers proposed that a single item ("My future seems dark to me") and a 4-item component of the Beck's Hopelessness Scale (BHS) can summarise most of the information the BHS provides. There is no clear indication of what BHS cutoff values are useful in identifying people with suicide tendency. Methods In a population-based study of Chinese people aged between 15 and 59 in Hong Kong, the Chinese version of the BHS and the Centre for Epidemiologic Studies – Depression scale were administered by trained interviewers and suicidal ideation and suicidal attempts were self-reported. Receiver operating characteristics curve analysis and regression analysis were used to compare the performance of the BHS and its components in identifying people with suicidality and depression. Smoothed level of suicidal tendency was assessed in relation to scores on the BHS and its component to identify thresholds. Results It is found that the 4-item component and, to a lesser extent, the single item of the BHS perform in ways similar to the BHS. There are non-linear relationship between suicidality and scores on the BHS and the 4-item component; cutoff values identified accordingly have sensitivity and specificity of about 65%. Conclusion The 4-item component is a useful alternative to the BHS. Shortening of psycho-social measurement scales should be considered in order to reduce burden on patients or respondents and to improve response rate.