Demirkol Mehmet Emin, Tamam Lut, Namli Zeynep, Karaytuğ Mahmut Onur, Uğur Kerim
Department of Psychiatry, Çukurova University Medical School, Adana.
Şanliurfa Mehmet Akif İnan State Hospital, Şanliurfa.
J Nerv Ment Dis. 2019 Aug;207(8):668-674. doi: 10.1097/NMD.0000000000001023.
Suicide is a leading cause of death in patients with schizophrenia. Previous studies have mostly investigated the association between suicide and sociodemographics, positive and negative symptoms, and depressive symptoms. This study evaluated psychache and alexithymia in patients with schizophrenia, which have both been associated with suicide attempts and thoughts in patients with other psychiatric disorders. Positive and Negative Syndrome Scale (PANSS), Psychache Scale (PAS), Beck Scale for Suicidal Ideation (BSSI), Calgary Depression Scale for Schizophrenia (CDSS), and Toronto Alexithymia Scale (TAS) scores were obtained in 113 patients with schizophrenia, including 50 with suicide attempts. PANSS positive symptoms and general psychopathology subscale, CDSS, BSSI, TAS, and PAS scores were significantly higher in patients with suicide attempts. In multivariate logistic regression analysis, only the PAS score was an independent predictor of attempted suicide. Mediation analysis demonstrated that psychache (both directly and indirectly) and alexithymia (indirectly) might be associated with the risk of suicide in these patients.
自杀是精神分裂症患者的主要死因。以往研究大多调查了自杀与社会人口统计学、阳性和阴性症状以及抑郁症状之间的关联。本研究评估了精神分裂症患者的精神痛苦和述情障碍，这两者都与其他精神疾病患者的自杀未遂和自杀念头有关。对113例精神分裂症患者进行了阳性与阴性症状量表（PANSS）、精神痛苦量表（PAS）、贝克自杀意念量表（BSSI）、卡尔加里精神分裂症抑郁量表（CDSS）和多伦多述情障碍量表（TAS）评分，其中50例有自杀未遂史。自杀未遂患者的PANSS阳性症状和一般精神病理学子量表、CDSS、BSSI、TAS和PAS评分显著更高。在多因素逻辑回归分析中，只有PAS评分是自杀未遂的独立预测因素。中介分析表明，精神痛苦（直接和间接）和述情障碍（间接）可能与这些患者的自杀风险有关。
