Department of Psychiatry and Human Behavior, Warren Alpert Medical School of Brown University, Box G-BH, Providence, RI 02912, United States of America; Bradley Hospital, 1011 Veterans Memorial Pkwy, Riverside, RI 02915, United States of America; Child and Adolescent Psychiatry, Rhode Island Hospital, One Hoppin Street, Coro West Suite 204, Providence, RI 02903, United States of America.
Department of Psychiatry and Human Behavior, Warren Alpert Medical School of Brown University, Box G-BH, Providence, RI 02912, United States of America; Bradley Hospital, 1011 Veterans Memorial Pkwy, Riverside, RI 02915, United States of America.
Schizophr Res. 2020 Apr;218:240-246. doi: 10.1016/j.schres.2019.12.037. Epub 2020 Jan 13.
Individuals in the early stages of psychosis have a markedly high risk for suicidal thoughts and behavior (STB). It is not well understood if STB among those with psychosis-risk symptoms is accounted for by co-occurring psychopathology (e.g., depression), unique experiences specific to psychosis-spectrum symptomatology (e.g., hallucinations, delusions), or combined effects of different factors. This cross-sectional study explored the link between psychosis-spectrum symptoms, co-occurring disorders, and STB.
This record review included 569 adolescents (mean age = 14.83) admitted to a psychiatric inpatient hospital due to exhibiting behavior indicating they were an imminent threat to themselves or others. Upon intake to the hospital, participants completed a diagnostic interview and self-report measures of suicidal ideation, suicide attempt history, and psychosis-spectrum symptoms. The primary analysis used linear regression to predict suicidal ideation from psychosis-spectrum symptom scores, controlling for known characteristics associated with STB including specific psychiatric disorders (i.e. depressive, anxiety, post-traumatic stress, and psychotic disorders), biological sex, and race.
Psychosis-spectrum symptoms predicted suicidal ideation above and beyond the significant effects of a depressive disorder diagnosis and sex, as well as the non-significant effects of anxiety, PTSD, full-threshold psychosis, and race. Item-level correlations demonstrated that several psychosis-spectrum symptoms were significantly associated with ideation and lifetime suicide attempts.
Results indicate that within this sample of psychiatrically hospitalized youth, psychosis-risk symptoms were uniquely linked to STB. These findings suggest that attention to psychosis-spectrum symptoms, including several specific psychosis-risk experiences, may be clinically important for better assessment and treatment of suicidal youth.
处于精神病早期阶段的个体自杀意念和行为（STB）的风险明显较高。目前尚不清楚，精神病风险症状患者的 STB 是否是由共病精神病理学（例如抑郁）、精神病谱系症状特有的独特经历（例如幻觉、妄想）或不同因素的综合效应所导致的。本横断面研究探讨了精神病谱系症状、共病障碍与 STB 之间的联系。
这项记录回顾性研究纳入了 569 名因表现出自杀或伤害自己或他人的风险行为而被收入精神病院的青少年（平均年龄=14.83 岁）。在入院时，参与者完成了诊断访谈和自杀意念、自杀尝试史以及精神病谱系症状的自我报告量表。主要分析使用线性回归，在控制已知与 STB 相关的特征（即抑郁、焦虑、创伤后应激和精神病性障碍）、生物性别和种族的情况下，从精神病谱系症状评分预测自杀意念。
精神病谱系症状预测自杀意念的能力超过了抑郁障碍诊断和性别的显著影响，以及焦虑、创伤后应激障碍、全阈值精神病和种族的非显著影响。项目层面的相关性表明，一些精神病谱系症状与意念和终生自杀尝试显著相关。
结果表明，在这个接受精神科住院治疗的青年样本中，精神病风险症状与 STB 存在独特的联系。这些发现表明，关注精神病谱系症状，包括一些特定的精神病风险经历，可能对评估和治疗有自杀意念的年轻人具有重要的临床意义。
