Suicidality in schizophrenia spectrum disorders: The relationship to hallucinations and persecutory delusions

• Published in: European psychiatry Vol. 30; no. 7; pp. 830 - 836
• Main Authors: Kjelby, E, Sinkeviciute, I, Gjestad, R, Kroken, R.A, Løberg, E.-M, Jørgensen, H.A, Hugdahl, K, Johnsen, E
• Format: Journal Article
• Language: English
• Published: England Elsevier Masson SAS 01.10.2015
• Subjects: Adult; Delusions - diagnosis; Delusions - etiology; Delusions - therapy; Depression - diagnosis; Depression - etiology; Depression - therapy; Female; Hallucinations - diagnosis; Hallucinations - etiology; Hallucinations - therapy; Humans; Internal Medicine; Male; Middle Aged; Psychiatric Department, Hospital; Psychiatry; Psychiatry in Europe; Psychotic Disorders - complications; Psychotic Disorders - diagnosis; Psychotic Disorders - therapy; Risk Factors; Schizophrenia - diagnosis; Schizophrenia and psychosis; Substance-Related Disorders - complications; Suicidal Ideation; Suicide; Suicide - prevention & control; Suicide - psychology; Schizophrenia and psychosis; Suicide; Psychiatry in Europe
• ISSN: 0924-9338; 1778-3585
• DOI: 10.1016/j.eurpsy.2015.07.003

Abstract Background Assessment of suicide risk is crucial in schizophrenia and results concerning risk contributed by hallucinations and persecutory delusions are inconsistent. We aimed to determine factors associated with suicidal ideation and plans at the time of acute admission in patients suffering from schizophrenia spectrum disorders. Methods One hundred and twenty-four patients older than 18 years admitted to an acute psychiatric ward due to psychosis were consecutively included. Predictors of suicidal ideation and suicide plans at the time of admission were examined with multinominal logistic regression and structural equation modelling (SEM). The study design was pragmatic, thus entailing a clinically relevant representation. Results Depression Odds Ratio (OR) 12.9, Drug use OR 4.07, Hallucinations OR 2.55 and Negative symptoms OR 0.88 significantly predicted Suicidal ideation. Suspiciousness/ Persecution did not. Only Depression and Hallucinations significantly predicted Suicide plans. In the SEM-model Anxiety, Depression and Hopelessness connected Suspiciousness/Persecution, Hallucinations and Lack of insight with Suicidal ideation and Suicide plans. Conclusions The study contributes to an increasing evidence base supporting an association between hallucinations and suicide risk. We want to emphasise the importance of treating depression and hallucinations in psychotic disorders, reducing hopelessness while working with insight and reducing drug abuse in order to lower suicide risk. Trial registration ClinicalTrials.gov ID; URL: http://www.clinicaltrials.gov/ NCT00932529.