Dataset Information

Self-harm, suicidal ideation, and the positive symptoms of psychosis: Cross-sectional and prospective data from a national household survey.

ABSTRACT:

Background

Schizophrenia is associated with premature mortality, partly through increased suicide rates.

Aims

To examine (1) if persecutory ideas, auditory hallucinations, and probable cases of psychosis are associated with suicidal thoughts or attempts cross-sectionally and prospectively, and (2) if such links are mediated by specific affective factors (depression, impulsivity, mood instability).

Method

We analysed the 2000, 2007, and 2014 British Adult Psychiatric Morbidity Surveys (APMS) separately. Measures of psychosis provided independent variables for multi-stage logistic regressions, with suicidal thoughts and attempts as dependent variables. We also conducted analyses to assess mediation by affective variables, and longitudinal analyses on a subset of the 2000 dataset.

Results

In every dataset, persecutory ideas, auditory hallucinations and probable psychosis were associated cross-sectionally with lifetime suicidal attempts and thoughts, even after controlling for confounders, with a single exception (persecutory ideation and suicide attempts were unconnected in APMS 2014). Cross-sectional associations between auditory hallucinations and suicidal phenomena were moderated by persecutory ideation. In the 2000 follow-up, initial persecutory ideas were associated with later suicidal thoughts (O.R. 1.77, p < 0.05); there were no other longitudinal associations. In the 2007 and 2014 datasets, mood instability mediated the effects of psychotic phenomena on suicidality more strongly than impulsivity; depression was also an important mediator. There were appreciable direct effects of positive symptoms on suicidal thoughts and behaviour.

Conclusions

Improving psychotic symptoms and ameliorating co-morbid distress may in itself be effective in reducing suicidal risk in schizophrenia. Given their potential mediating role, mood instability and depression may also be targets for intervention.

SUBMITTER: de Cates AN

PROVIDER: S-EPMC8388846 | biostudies-literature |

REPOSITORIES: biostudies-literature

ACCESS DATA

Similar Datasets

Project description:ObjectivesAssociation between employment contract (temporary vs. permanent) and suicidal ideation (persistent suicidal ideation [i.e., with onset before COVID-19] or newly developed under COVID-19 pandemic) was examined using a nationally representative cross-sectional study in Japan.MethodsAn Internet survey was conducted from August to September 2020. The participants' inclusion criteria for this study were as follows: (i) 20-65 years old, (ii) employees (excluding self-employed, students, retired, housewives, and unemployed). The associations of suicidal ideation with the employees' factors were analyzed using the multinomial logistic regression model, adjusting for covariates (sex, age, marital status, education, company size, industries, and a history of psychiatric disease).ResultsOf total 12 249 participants, 72.4% were permanent and 27.6% were temporary employees. The prevalence was 8.5% for persistent suicidal ideation and 3.2% for newly developed suicidal ideation in the COVID-19 pandemic. Temporary employment was significantly associated with persistent suicidal ideation (adjusted odds ratio [aOR] = 1.36 [95% confidence interval, CI: 1.16-1.59]; P < .001), but not associated with newly developed suicidal ideation (aOR = 1.10 [0.85-1.42]; P = .457) after adjusting the covariates. Sensitivity analysis showed temporary employment was significantly associated with persistent suicidal ideation only in women. Newly developed suicidal ideation was significantly higher among participants of a young age, employees in drinking/eating/hotel business industry, and those having a history of psychiatric disease than among the counterparts.ConclusionsWorking on a temporary employment contract was associated with persistent suicidal ideation under conditions of COVID-19 outbreaks in Japan. However, the result showed no significant difference in newly developed suicidal ideation. Further longitudinal study will be needed to examine the risk of being employed on an unstable occupational contract in the prolonged pandemic.