de Cates, Angharad N, Catone, Gennaro, Marwaha, Steven et al. (3 more authors) (2021) Self-harm, suicidal ideation, and the positive symptoms of psychosis : Cross-sectional and prospective data from a national household survey. Schizophrenia Research. pp. 80-88. ISSN 0920-9964
Abstract
BACKGROUND: Schizophrenia is associated with premature mortality, partly through increased suicide rates. AIMS: To examine (1) if persecutory ideas, auditory hallucinations, and probable cases of psychosis are associated with suicidal thoughts or attempts cross-sectionally and prospectively, and (2) if such links are mediated by specific affective factors (depression, impulsivity, mood instability). METHOD: We analysed the 2000, 2007, and 2014 British Adult Psychiatric Morbidity Surveys (APMS) separately. Measures of psychosis provided independent variables for multi-stage logistic regressions, with suicidal thoughts and attempts as dependent variables. We also conducted analyses to assess mediation by affective variables, and longitudinal analyses on a subset of the 2000 dataset. RESULTS: In every dataset, persecutory ideas, auditory hallucinations and probable psychosis were associated cross-sectionally with lifetime suicidal attempts and thoughts, even after controlling for confounders, with a single exception (persecutory ideation and suicide attempts were unconnected in APMS 2014). Cross-sectional associations between auditory hallucinations and suicidal phenomena were moderated by persecutory ideation. In the 2000 follow-up, initial persecutory ideas were associated with later suicidal thoughts (O.R. 1.77, p < 0.05); there were no other longitudinal associations. In the 2007 and 2014 datasets, mood instability mediated the effects of psychotic phenomena on suicidality more strongly than impulsivity; depression was also an important mediator. There were appreciable direct effects of positive symptoms on suicidal thoughts and behaviour. CONCLUSIONS: Improving psychotic symptoms and ameliorating co-morbid distress may in itself be effective in reducing suicidal risk in schizophrenia. Given their potential mediating role, mood instability and depression may also be targets for intervention.
Metadata
Authors/Creators: |
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Copyright, Publisher and Additional Information: | © 2021 The Authors. |
Keywords: | Cross-Sectional Studies, Humans, Prospective Studies, Psychotic Disorders/epidemiology, Risk Factors, Self-Injurious Behavior, Suicidal Ideation |
Dates: |
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Institution: | The University of York |
Academic Units: | The University of York > Faculty of Sciences (York) > Psychology (York) |
Depositing User: | Pure (York) |
Date Deposited: | 01 Apr 2022 08:50 |
Last Modified: | 06 Dec 2023 14:39 |
Published Version: | https://doi.org/10.1016/j.schres.2021.06.021 |
Status: | Published |
Refereed: | Yes |
Identification Number: | https://doi.org/10.1016/j.schres.2021.06.021 |
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Description: Self-harm, suicidal ideation, and the positive symptoms of psychosis: Cross-sectional and prospective data from a national household survey
Licence: CC-BY 2.5