Fialko L, Freeman D, Bebbington P E, Kuipers E, Garety P A, Dunn G, Fowler D
Department of Psychology, Institute of Psychiatry, King's College London, University of London, London, UK.
Acta Psychiatr Scand. 2006 Sep;114(3):177-86. doi: 10.1111/j.1600-0447.2006.00849.x.
To examine the clinically important phenomenon of suicidal ideation in psychosis in relation to affective processes and the multidimensional nature of hallucinations and delusions.
In a cross-sectional study of 290 individuals with psychosis, the associations between level of suicidal ideation, affective processes, positive symptoms, clinical and demographic variables were examined.
Forty-one per cent of participants expressed current suicidal ideation. Suicidal ideation was associated with depressed mood, anxiety, low self-esteem, negative illness perceptions, negative evaluative beliefs about the self and others and daily alcohol consumption. Frequency of auditory hallucinations and preoccupation with delusions were not associated with suicidal ideation; however, positive symptom distress did relate to suicidal thoughts.
Affective dysfunction, including distress in response to hallucinations and delusions, was a key factor associated with suicidal ideation in individuals with psychotic relapse. Suicidal ideation in psychosis appears to be an understandable, mood-driven process, rather than being of irrational or 'psychotic' origin.
探讨精神病中自杀观念这一具有临床重要性的现象与情感过程以及幻觉和妄想的多维度性质之间的关系。
在一项对290名精神病患者的横断面研究中，考察了自杀观念水平、情感过程、阳性症状、临床及人口统计学变量之间的关联。
41%的参与者表示目前有自杀观念。自杀观念与情绪低落、焦虑、自卑、负面疾病认知、对自我和他人的负面评价信念以及每日饮酒量相关。幻听频率和对妄想的专注与自杀观念无关；然而，阳性症状困扰确实与自杀想法有关。
情感功能障碍，包括对幻觉和妄想的困扰，是精神病复发患者自杀观念的一个关键相关因素。精神病中的自杀观念似乎是一个可理解的、由情绪驱动的过程，而非源于非理性或“精神病性”。
