Mental Health Deparment, Corporació Sanitària Parc Taulí- Universitat Autònoma de Barcelona, Campus d'Excel·lència Internacional, Bellaterra 08193, Spain.
King's College of London, Institute of Psychiatry, Psychology and Neurosciences, Department of Psychosis Studies, London, UK.
Psychiatry Res. 2017 Jun;252:147-153. doi: 10.1016/j.psychres.2017.02.059. Epub 2017 Feb 27.
We aimed to test whether specific insight dimensions are associated with suicidality in patients with psychotic disorders.
143 patients with schizophrenia spectrum disorders were recruited. Suicidality was assessed by item 8 of the Calgary Depression Scale for Schizophrenia (CDSS). Insight was measured by the Scale of Unawareness of Mental Disorder (SUMD) and the Markova and Berrios Insight Scale. Bivariate analyses and multivariable logistic regression models were conducted.
Those subjects aware of having a mental illness and its social consequences had higher scores on suicidality than those with poor insight. Awareness of the need for treatment was not linked with suicidality. The Markova and Berrios Insight scale total score and two specific domains (awareness of "disturbed thinking and loss of control over the situation" and "having a vague feeling that something is wrong") were related to suicidality. However, no insight dimensions survived the multivariable regression model, which found depression and previous suicidal behaviour to predict suicidality.
Suicidality in psychosis was linked with some insight dimensions: awareness of mental illness and awareness of social consequences, but not compliance. Depression and previous suicidal behaviour mediated the associations with insight; thus, predicting suicidality.
本研究旨在测试特定的领悟维度是否与精神病患者的自杀意念有关。
共招募了 143 名精神分裂症谱系障碍患者。自杀意念通过 Calgary 精神分裂症抑郁量表（CDSS）的第 8 项进行评估。采用精神障碍觉察量表（SUMD）和 Markov 和 Berrios 领悟量表评估领悟。进行了双变量分析和多变量逻辑回归模型。
那些意识到自己患有精神疾病及其社会后果的患者的自杀意念得分高于领悟较差的患者。对治疗的需求的认识与自杀意念无关。Markova 和 Berrios 领悟量表的总分和两个特定领域（意识到“思维紊乱和对情况失去控制”以及“有一种模糊的感觉，感觉有些不对劲”）与自杀意念有关。然而，多变量回归模型并未发现任何领悟维度与自杀意念相关，该模型发现抑郁和以前的自杀行为可预测自杀意念。
精神病患者的自杀意念与一些领悟维度有关，包括对精神疾病的认识和对社会后果的认识，但与遵医行为无关。抑郁和以前的自杀行为是与领悟相关的中介因素，因此可以预测自杀意念。
