Affiliated Xiaoshan Hospital, Hangzhou Normal University, Hangzhou, China.
CAS Key Laboratory of Mental Health, Institute of Psychology, Beijing, China; Department of Psychology, University of Chinese Academy of Sciences, Beijing, China.
Schizophr Res. 2024 Jul;269:48-55. doi: 10.1016/j.schres.2024.05.004. Epub 2024 May 9.
The effect of cognitive function on suicidal tendency in patients with schizophrenia is still inconclusive. This study aimed to explore the effect of cognitive impairment on suicidal tendency in schizophrenia patients and the risk factors of suicidal tendency in schizophrenia patients with cognitive impairment.
A total of 988 subjects were recruited for this study and finally 517 patients were included in the statistical analysis. Sociodemographic information was collected for each subject. Mini-Mental State Examination (MMSE) was used to assess patients' cognitive functioning. In addition, the Positive and Negative Syndrome Scale (PANSS) positive subscale, Insomnia Severity Index (ISI), and Beck Scale for Suicide Ideation (BSI) were used to assess psychotic symptoms, severity of insomnia, and intensity of suicidal ideation, respectively.
Schizophrenia patients with cognitive dysfunction were significantly less likely to develop suicidal tendencies than those without cognitive dysfunction (P < 0.05, OR = 0.58, 95%CI: 0.39-0.81). In patients with cognitive impairment, those with suicidal tendency had substantially higher scores on BSI, ISI, EC, PD, IRI, F1, and PANSS positive subscale, and took more types of antipsychotic drugs than those without suicidal tendency (all P < 0.05), and the results of binary logistic regression analysis showed that, PANSS positive subscale score (B = 0.06, p = 0.04, OR = 1.07, 95%CI: 1.00-1.13) was a risk factor for suicidal tendencies.
Our findings suggest that schizophrenia patients with cognitive dysfunction are significantly less likely to develop suicidal tendencies. Moreover, positive symptom is a risk factor for suicidal tendencies in schizophrenia patients with cognitive dysfunction.
认知功能对精神分裂症患者自杀倾向的影响仍存在争议。本研究旨在探讨认知障碍对精神分裂症患者自杀倾向的影响，以及认知障碍精神分裂症患者自杀倾向的危险因素。
本研究共招募了 988 名受试者，最终有 517 名患者纳入统计分析。收集每位受试者的社会人口学信息。采用简易精神状态检查表（MMSE）评估患者的认知功能。此外，还采用阳性和阴性症状量表（PANSS）阳性分量表、失眠严重程度指数（ISI）和贝克自杀意念量表（BSI）分别评估精神病症状、失眠严重程度和自杀意念强度。
与无认知功能障碍的精神分裂症患者相比，有认知功能障碍的精神分裂症患者发生自杀倾向的可能性显著降低（P<0.05，OR=0.58，95%CI：0.39-0.81）。在有认知障碍的患者中，有自杀倾向的患者 BSI、ISI、EC、PD、IRI、F1 和 PANSS 阳性分量表的评分显著更高，服用的抗精神病药物种类也显著更多（均 P<0.05），二元逻辑回归分析的结果显示，PANSS 阳性分量表评分（B=0.06，p=0.04，OR=1.07，95%CI：1.00-1.13）是自杀倾向的危险因素。
我们的研究结果表明，有认知功能障碍的精神分裂症患者发生自杀倾向的可能性显著降低。此外，阳性症状是认知功能障碍精神分裂症患者自杀倾向的危险因素。
