The Columbia-Suicide Severity Rating Scale (C-SSRS) is available in more than 140 country-specific languages. Many of these translations have been linguistically validated.

  • To obtain Spanish translations of the scale for use in communities and healthcare settings, select “Spanish” in the language filter when you build your C-SSRS toolkit.
  • To obtain the scale translated into other languages, or to find out if there is a translation that is not listed below, contact The Columbia Lighthouse Project. To request new translations, contact ICON Language Services, the company managing C-SSRS translations.
  • For a list of all available linguistically validated translations of the C-SSRS, see the List of Available Translations in The Columbia Lighthouse Project database.

Available Languages, by Country

Below, “(T)” indicates that training with subtitles is available in this language on the C-SSRS training YouTube channel or by request.

  • Albania/Albanian
  • Algeria/Arabic
  • Algeria/French
  • Argentina/Spanish
  • Australia/English
  • Austria/German (T)
  • Belarus/Belarusian
  • Belarus/Russian
  • Belgium/Dutch (T)
  • Belgium/French
  • Belgium/German
  • Bosnia/Bosnian
  • Bosnia/Croatian
  • Bosnia/Serbian
  • Brazil/Portuguese (T)
  • Bulgaria/Bulgarian (T)
  • Canada/English
  • Canada/French
  • Chile/Spanish
  • China/Mandarin Chinese (T)
  • Columbia/Spanish
  • Costa Rica/Spanish
  • Croatia/Croatian
  • Czech Republic/Czech (T)
  • Denmark/Danish
  • Dominican Republic/Spanish
  • Ecuador/Spanish
  • Egypt/Arabic
  • Estonia/Estonian (T)
  • Estonia/Russian
  • El Salvador/Spanish
  • Finland/Finnish (T)
  • Finland/Swedish
  • France/French (T)
  • Georgia/Georgian
  • Georgia/Russian
  • Germany/German (T)
  • Greece/Greek (T)
  • Guatemala/Spanish
  • Hong Kong/Cantonese
  • Hong Kong/English
  • Hungary/Hungarian (T)
  • Iceland/Icelandic
  • India/Bengali
  • India/English
  • India/Gujarati
  • India/Hindi
  • India/Kannada
  • India/Malayalam
  • India/Marathi
  • India/Odia
  • India/Punjabi
  • India/Tamil
  • India/Telugu
  • India/Urdu
  • Indonesia/Indonesian
  • Ireland/English
  • Israel/Arabic
  • Israel/English
  • Israel/Hebrew
  • Israel/Russian
  • Italy/Italian (T)
  • Japan/Japanese (T)
  • Jordan/Arabic
  • Korea/Korean (T)
  • Latvia/Latvian
  • Latvia/Russian
  • Lithuania/Lithuanian (T)
  • Lebanon/Arabic
  • Lebanon/Russian
  • Macedonia/Macedonian
  • Malaysia/English
  • Malaysia/Malay (T)
  • Malaysia/Mandarin
  • Malaysia/Tamil
  • Mexico/Spanish (T)
  • Moldova/Romanian
  • Moldova/Russian
  • Montenegro/Montenegrin
  • Morocco/Arabic
  • Morocco/French
  • Netherlands/Dutch (T)
  • New Zealand/English
  • Norway/Norwegian
  • Pakistan/Urdu
  • Panama/Spanish
  • Peru/Spanish
  • Philippines/Cebuano
  • Philippines/English
  • Philippines/Filipino
  • Philippines/Hiligaynon
  • Philippines/Tagalog
  • Poland/Polish (T)
  • Portugal/Portuguese (T)
  • Puerto Rico/Spanish
  • Qatar/Arabic
  • Romania/Romanian (T)
  • Russia/Russian (T)
  • Saudi Arabia/Arabic
  • Serbia/Serbian
  • Singapore/English
  • Singapore/Malay
  • Singapore/Mandarin Chinese
  • Singapore/Tamil
  • Slovak Republic/Slovak
  • Slovenia/Slovenian
  • South Africa/Afrikaans (T)
  • South Africa/English (T)
  • South Africa/Sesotho
  • South Africa/Tswana
  • South Africa/Xhosa
  • South Africa/Zulu
  • Spain/Spanish
  • Spain/Catalan
  • Sri Lanka/Sinhalese
  • Sri Lanka/Tamil
  • Sweden/Swedish (T)
  • Switzerland/French
  • Switzerland/German
  • Switzerland/Italian
  • Taiwan/Mandarin Chinese
  • Thailand/Thai
  • Tunisia/Arabic
  • Tunisia/French
  • Turkey/Turkish (T)
  • Ukraine/Russian
  • Ukraine/Ukrainian
  • United Arab Emirates/Arabic
  • United Kingdom/English
  • USA/English (T)
  • USA/Farsi
  • USA/Mandarin
  • USA/Spanish (T)
  • USA/Vietnamese
  • Vietnam/Vietnamese

Linguistic Validation

The Need for Linguistic Validation

The prerequisite for using translations of clinical outcomes assessments (COAs) in clinical trials is the evidence of their validation for use in the population and for measuring the concept of interest (e.g., suicide risk), according to guidance from the Food and Drug Administration and the European Medicines Agency. The linguistic validation process aims to provide foreign-language versions of the original instrument that retain its original concepts and measurement properties. Validated translations help users:

  • Incorporate assessments with the C-SSRS into their clinical studies
  • Pool data from different countries in multinational studies
  • Compare scores between countries and establish norms
  • Learn about cross-cultural differences related to health

Linguistic Validation Process

Validated C-SSRS translations are done by ICON Language Services, the worldwide leader in medical translation and linguistic validation, with global headquarters in Lyon, France, and North American headquarters in Lexington, Kentucky. To address the scientific and regulatory requirements that are specific to the COA field, ICON Language Services has developed a unique methodology. To date, the company has produced more than 40,000 translated versions of more than 2,500 COAs.

ICON Language Services completes the linguistic validation from the original-language version of the C-SSRS to provide translations that are:

  • Clear and easy to read and understand
  • Expressed in a language of common use
  • Conceptually equivalent to the original version and culturally relevant

ICON Language Services’ methodology ensures conceptual equivalence and cultural relevance across languages by taking the following steps:

  • Two forward-translations by native speakers of the targeted language
  • Comparison and reconciliation of the translations
  • Back-translation by a native English speaker
  • Comparison of the original and back-translations
  • Review by a clinician

Purpose of Country-Specific Translations

Country-specific translations of the C-SSRS enable users to prove, through linguistic validation, that a given version is suitable for use in a given country. Although the versions may be similar or even identical across countries, linguistic validation guarantees that the data collected during the study are reliable and can ultimately be safely pooled with data from other countries or from other languages of the same country without compromising accuracy.

Furthermore, to support a labeling claim, regulatory bodies ask for evidence that the version used in a trial is adapted to the language and culture of the country where the trial is being conducted. That’s why it’s not advisable to use a translation validated for one country in countries for which it has not been validated.

Obtaining New Translations

If the translations needed for your study do not exist, you may request them by contacting ICON Language Services. Keep in mind that you may modify the format of existing validated translations to fit the needs of your study; for example, you may increase the font size or add a header to collect and study data.

The timelines for developing new translations vary, ranging from two to three weeks when only minor updates are needed to eight to 10 weeks for completely new translations. For an accurate estimate of time required for your specific project, please contact ICON Language Services.