Abdel Samie Mai, Nasreldin Mohamed, Shahin Mostafa, Amer Dalal A, Mohamed Rania Mamdouh, Taher Dina Badie, Sayed Talha, Ahmed Nadine, Mabrouk Ali, Mamdouh Joseph, Gohar Sherif M
Department of Psychiatry, Faculty of Medicine, Cairo University, El Saraya Street, El Manyal, Cairo, 11956, Egypt.
TIPS Centre for Clinical Research in Psychosis, Stavanger University Hospital, Stavanger, Norway.
Soc Psychiatry Psychiatr Epidemiol. 2025 Feb;60(2):353-361. doi: 10.1007/s00127-024-02709-y. Epub 2024 Jul 17.
Suicidal thoughts are common among patients with first episode psychosis (FEP). The impact of symptoms' severity and social cognition on suicidal risk should be a focus of attention. This study aimed at assessment of the severity of suicidal ideation in patients with FEP and its potential association with the theory of mind (ToM) impairment and symptoms' severity.
Ninety-six participants were recruited consecutively and subdivided into three equal groups: FEP, schizophrenia, and healthy controls (HC). The symptoms' severity was assessed using Positive and Negative Syndrome Scale (PANSS) and Beck Depression Inventory (BDI). Suicidal ideation was evaluated using Beck Scale for Suicidal Ideation (BSSI). Reading the Mind in the Eyes revised version (RMET) was used to assess ToM.
Suicidal ideation was significantly higher only in FEP compared to HC (p = 0.001). Both FEP and schizophrenia had substantially lower performance than HC on RMET (p < 0.001). Higher depression (β = 0.452, p = 0.007) and negative symptoms (β = 0.433, p = 0.027) appeared to be significantly associated with increased suicidal ideation severity in FEP while RMET did not.
Patients with FEP and chronic schizophrenia have comparable deficits in theory of mind dimension of social cognition. The severity of negative and depressive symptoms potentially contributes to the increased risk of suicide in FEP.
自杀念头在首发精神病（FEP）患者中很常见。症状严重程度和社会认知对自杀风险的影响应成为关注焦点。本研究旨在评估FEP患者自杀意念的严重程度及其与心理理论（ToM）损害和症状严重程度的潜在关联。
连续招募96名参与者，并将其平均分为三组：FEP组、精神分裂症组和健康对照组（HC）。使用阳性和阴性症状量表（PANSS）和贝克抑郁量表（BDI）评估症状严重程度。使用贝克自杀意念量表（BSSI）评估自杀意念。使用修订版的读心术测试（RMET）评估ToM。
与HC相比，仅FEP组的自杀意念显著更高（p = 0.001）。FEP组和精神分裂症组在RMET上的表现均显著低于HC组（p < 0.001）。较高的抑郁（β = 0.452，p = 0.007）和阴性症状（β = 0.433，p = 0.027）似乎与FEP组自杀意念严重程度增加显著相关，而RMET则不然。
FEP患者和慢性精神分裂症患者在社会认知的心理理论维度上存在相当的缺陷。阴性和抑郁症状的严重程度可能导致FEP患者自杀风险增加。
