Department of Psychiatry and Psychology, South Limburg Mental Health Research and Teaching Network, Maastricht University Medical Centre, Maastricht, The Netherlands.
Katholieke Universiteit Leuven, Department of Neuroscience, Research Group Psychiatry, Centre for Contextual Psychiatry, Leuven, Belgium.
Psychiatry Res. 2016 Nov 30;245:267-275. doi: 10.1016/j.psychres.2016.08.002. Epub 2016 Aug 16.
This study examines the longitudinal associations between psychotic experiences (PE) and incident suicidal ideation and behaviour in the general population, and to what degree the association may be confounded by non-psychotic psychopathology. Data from three prospective, general population cohorts were combined into one dataset (n=15,837) and analysed using logistic regression, controlling for continuous measures of depression, anxiety and mania symptoms. Analyses were conducted in the entire sample, and in subsamples stratified by presence or absence of mental disorders. The presence of PE at baseline increased the risk of incident suicidal ideation and behaviour. However, adjustment for dimensional measures of psychopathology reduced effect sizes, although PE remained significantly associated with suicide attempts. Further examination of the associations revealed that PE were only associated with suicide attempts in individuals with at least one mental disorder. Similarly, in individuals without mental disorders, the risk of suicidal ideation increased as PE co-occurred with more symptom domains. The results of this study confirm that individuals with PE are at increased risk of suicidal ideation and behaviour. However, these associations are not specific, but reflect the increased risk of suicidal ideation in individuals with subthreshold multidimensional psychopathology and suicide attempts in individuals with co-occurring mental disorders.
这项研究考察了一般人群中精神病性体验（PE）与自杀意念和行为的纵向关联，以及非精神病性精神病理学在多大程度上可能混淆这种关联。将来自三个前瞻性、一般人群队列的数据合并到一个数据集（n=15837）中，并使用逻辑回归进行分析，同时控制抑郁、焦虑和躁狂症状的连续测量。在整个样本中以及存在或不存在精神障碍的亚组中进行了分析。基线时存在 PE 会增加发生自杀意念和行为的风险。然而，对精神病理学的维度测量进行调整会降低效应大小，但 PE 仍然与自杀企图显著相关。对关联的进一步研究表明，PE 仅与至少有一种精神障碍的个体的自杀企图有关。同样，在没有精神障碍的个体中，随着 PE 与更多的症状领域同时出现，自杀意念的风险增加。本研究的结果证实，PE 个体自杀意念和行为的风险增加。然而，这些关联并不具有特异性，而是反映了亚阈值多维精神病理学个体自杀意念风险增加，以及共病精神障碍个体自杀企图风险增加。
