Service of Mental Health, General Management of Healthcare Programs, The Canary Islands Health Service, The Canary Islands, Spain; Research Network on Health Services for Chronic Conditions (REDISSEC), Carlos III Health Institute, Madrid, Spain; Insular University Hospital of Gran Canaria, Canary Islands, Spain.
Mental Health Unit of Ciudad Alta, Service of Psychiatry, Doctor Negrín University Hospital of Gran Canaria, Canary Islands, Spain.
Schizophr Res. 2020 Jun;220:147-154. doi: 10.1016/j.schres.2020.03.042. Epub 2020 Mar 28.
Suicidal behavior is highly prevalent in schizophrenia. Among the risk factors, insight has been little studied and has yielded contradictory results. In addition, it has been studied neglecting relevant psychological aspects, such as beliefs about illness and coping styles.
We assessed 133 outpatients diagnosed with schizophrenia according to ICD-10 criteria. Evaluation included sociodemographic, general clinical, psychopathological, psychological and suicidal behavior variables.
Neither insight nor insight coupled with negative beliefs and/or coping styles were associated with suicidal behavior. Nevertheless, insight coupled with negative beliefs and/or coping styles was associated with greater hopelessness and depression, internalized stigma, worse control over illness and greater global severity as compared to insight coupled with positive beliefs and coping styles. Suicide attempt and suicidal ideation groups showed greater depression and hopelessness, worse global beliefs and worse control over illness, higher socio-economic level, and greater number of previous psychiatric admissions compared to the non-suicidal group.
Insight coupled with negative beliefs and/or coping style was not associated with suicidal behavior. Nevertheless, it was associated with greater depression and hopelessness, both of which are firmly established risk factors for suicide in schizophrenia. Prospective studies with long-term follow-up and large samples are needed to clarify this issue. Clinicians should assess these psychological features associated with insight, both in patients with insight and in those with poor insight when promoting it.
自杀行为在精神分裂症中非常普遍。在风险因素中，洞察力研究较少，结果相互矛盾。此外，在研究中忽略了与疾病相关的心理方面，例如对疾病的信念和应对方式。
我们根据 ICD-10 标准评估了 133 名被诊断为精神分裂症的门诊患者。评估包括社会人口统计学、一般临床、精神病理学、心理和自杀行为变量。
无论是洞察力还是洞察力加上消极的信念和/或应对方式都与自杀行为无关。尽管如此，洞察力加上消极的信念和/或应对方式与更大的绝望和抑郁、内化的耻辱感、对疾病的控制更差以及整体严重程度更高有关，而不是洞察力加上积极的信念和应对方式。与非自杀组相比，自杀未遂和自杀意念组表现出更大的抑郁和绝望、更差的整体信念和对疾病的控制更差、更高的社会经济水平以及更多的先前精神科住院治疗。
洞察力加上消极的信念和/或应对方式与自杀行为无关。尽管如此，它与更大的抑郁和绝望有关，而抑郁和绝望是精神分裂症自杀的既定风险因素。需要进行前瞻性研究，进行长期随访和大样本研究，以澄清这一问题。临床医生在促进洞察力时，应评估与洞察力相关的这些心理特征，包括有洞察力的患者和洞察力差的患者。
