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Suicidality in Schizophrenia Spectrum Disorders: The Relationship to Hallucinations and Persecutory Delusions

Published online by Cambridge University Press:  16 April 2020

E. Kjelby ,
I. Sinkeviciute ,
R. Gjestad ,
R.A. Kroken ,
E.-M. Løberg ,
H.A. Jørgensen ,
K. Hugdahl  and
E. Johnsen
E. Kjelby*
Affiliation:
Division of Psychiatry, Haukeland University Hospital, Bergen, Norway
I. Sinkeviciute
Affiliation:
Division of Psychiatry, Haukeland University Hospital, Bergen, Norway
R. Gjestad
Affiliation:
Division of Psychiatry, Haukeland University Hospital, Bergen, Norway
R.A. Kroken
Affiliation:
Division of Psychiatry, Haukeland University Hospital, Bergen, Norway Department of Clinical Medicine, Section of Psychiatry, Faculty of Medicine and Dentistry, University of Bergen, Norway
E.-M. Løberg
Affiliation:
Division of Psychiatry, Haukeland University Hospital, Bergen, Norway Department of Clinical Psychology, University of Bergen, Norway
H.A. Jørgensen
Affiliation:
Department of Clinical Medicine, Section of Psychiatry, Faculty of Medicine and Dentistry, University of Bergen, Norway
K. Hugdahl
Affiliation:
Division of Psychiatry, Haukeland University Hospital, Bergen, Norway Department of Biological and Medical Psychology, University of Bergen, Norway NORMENT Centre of Excellence, University of Oslo, Norway
E. Johnsen
Affiliation:
Division of Psychiatry, Haukeland University Hospital, Bergen, Norway Department of Clinical Medicine, Section of Psychiatry, Faculty of Medicine and Dentistry, University of Bergen, Norway
*
*Corresponding author. E-mail address: eirik.kjelby@helse-bergen.no (E. Kjelby).
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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.

Keywords

Schizophrenia and psychosisSuicidePsychiatry in Europe
Type
Original article
Information
European Psychiatry , Volume 30 , Issue 7 , October 2015 , pp. 830 - 836
Copyright
European Psychiatric Association 2015

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