Pfluger Julia, Green James B, Qi Wenhui, Goods Claire, Rodriguez Joey, West Michelle L, Keshavan Matcheri, Friedman-Yakoobian Michelle
Psychosis Research Program, Beth Israel Deaconess Medical Center, Boston, Massachusetts, USA.
Harvard Medical School Department of Psychiatry, Boston, Massachusetts, USA.
Early Interv Psychiatry. 2025 Jan;19(1):e13633. doi: 10.1111/eip.13633. Epub 2024 Dec 9.
Individuals with psychosis symptoms are at high risk for suicidal ideation and attempts. The prevalence and correlates of suicidal ideation and attempts in clinical high risk for psychosis (CHR-P) have yet to be clarified. This study reports on the prevalence and clinical correlates of suicidal ideation and attempts in a clinical CHR-P sample.
Participants (n = 135) included CHR-P clients at a CHR-P community specialty clinic, who participated in a clinical assessment between 2017 and 2022. Assessments measured attenuated psychosis symptoms, suicidal ideation and attempts, clinical covariates, and functioning. Frequency analyses assessed the prevalence of lifetime suicidal ideation and attempts and t-test and Chi-square identified clinical correlates. Logistic regression assessed the relationship between significant clinical correlates and lifetime suicide attempts.
Sixty-five percent of participants at CHR-P endorsed lifetime suicidal ideation, while 22.2% reported at least one lifetime attempt. Correlates for lifetime suicidal ideation included self-reported gender expansive identity, hopelessness, depression, trauma, obsessive compulsive symptoms, insight: reflectiveness, trauma diagnoses, mood disorder diagnoses, and perceptual abnormalities/hallucinations. Significant correlates for lifetime suicide attempts included self-reported hopelessness, depression, trauma diagnosis and mood disorder diagnosis.
CHR-P clients are at a higher risk for suicidal ideation and attempts compared to the general population. Correlates of suicidal ideation and attempts may be diagnostically heterogeneous and therefore interventions should be tailored to specific clinical needs. Clients with trauma-disorder diagnoses may be at highest risk for suicidal ideation and attempts. Continued intervention and longitudinal research is needed to clarify causal risk factors and establish evidence-based treatments for suicidal ideation and attempts in CHR-P.
有精神病症状的个体存在自杀意念和自杀企图的高风险。精神病临床高危人群（CHR-P）中自杀意念和自杀企图的患病率及相关因素尚未明确。本研究报告了临床CHR-P样本中自杀意念和自杀企图的患病率及临床相关因素。
参与者（n = 135）包括一家CHR-P社区专科诊所的CHR-P患者，他们在2017年至2022年期间参与了临床评估。评估测量了精神病症状减弱、自杀意念和自杀企图、临床协变量及功能状况。频率分析评估了终生自杀意念和自杀企图的患病率，t检验和卡方检验确定了临床相关因素。逻辑回归评估了显著临床相关因素与终生自杀企图之间的关系。
CHR-P参与者中有65%认可终生有自杀意念，而22.2%报告至少有过一次终生自杀企图。终生自杀意念的相关因素包括自我报告的性别认同扩展、绝望感、抑郁、创伤、强迫症状、洞察力：反思性、创伤诊断、情绪障碍诊断以及感知异常/幻觉。终生自杀企图的显著相关因素包括自我报告的绝望感、抑郁、创伤诊断和情绪障碍诊断。
与普通人群相比，CHR-P患者有更高的自杀意念和自杀企图风险。自杀意念和自杀企图的相关因素在诊断上可能具有异质性，因此干预措施应根据具体临床需求进行调整。有创伤障碍诊断的患者可能自杀意念和自杀企图的风险最高。需要持续的干预和纵向研究来阐明因果风险因素，并为CHR-P中的自杀意念和自杀企图建立循证治疗方法。
