INTRODUCTION
Suicidal ideation and behaviors (SIB) are common among individuals at clinical high risk for psychosis (CHR-P), but their relationship with the overall clinical profile remains unclear. This study aimed to identify sociodemographic/clinical factors associated with SIB in CHR-P individuals and to examine whether subthreshold psychotic symptom severity increases with suicidal risk.
METHODS
Data from the AMP SCZ initiative included 1443 CHR-P participants aged 12-30 years. SIB were assessed using the Columbia Suicide Severity Rating Scale (C-SSRS). Three Elastic Net regression models examined associations between suicidal ideation severity, intensity, and behaviors using 54 variables spanning sociodemographics, general psychopathology, subthreshold psychotic symptoms, and socio-occupational functioning. Moreover, ANCOVA compared overall psychotic symptom severity across five groups defined by increasing severity on the C-SSRS.
RESULTS
Sixty-eight percent of participants reported lifetime suicidal ideation, and 26% reported previous suicidal behaviors. Model performance was modest but significant (cross-validated ideation severity: R2 = 0.161, RMSE = 0.916; ideation intensity: R2 = 0.193, RMSE = 0.898; suicidal behavior: accuracy = 0.685; AUC = 0.675; p < 0.001). Across all models, concurrent depressive symptoms, present/past diagnosis of depression, female sex at birth, cannabis use, visual/gustatory abnormalities, guilt, and lower role functioning were the most consistent correlates of SIB. Ideation was associated with lower disorganized communication expression and lower negative symptoms, whereas behaviors were associated with schizotypal personality disorder. Other core CHR-P symptoms, including Unusual Thoughts and Experiences, did not contribute to any model. ANCOVA (p < 0.001, partial η2 = 0.041) indicated increasing overall subthreshold psychotic symptoms across the SIB spectrum.
CONCLUSION
SIB in CHR-P individuals reflects a multidimensional clinical profile primarily outside of core psychosis-risk symptoms.
TRIAL REGISTRATION
ClinicalTrials.gov identifier: NCT05905003.
S. Damiani, M. Orlandi, U. Provenzani et al.· Acta Psychiatrica Scandinavi...· 0 citations
Abstract Background and Hypothesis Sleep disturbance is a well-established risk factor for suicide, though few studies to date have examined whether sleep disturbance contributes to suicide risk among individuals at clinical high risk for psychosis (CHR). The current study addressed this gap in the literature. We hypothesized that sleep disturbance would have a unique relationship with suicidal ideation/attempts when accounting for other variables in the model. We also hypothesized that the interaction between sleep disturbance/attenuated positive symptoms and sleep disturbance/stress would be related to suicidal ideation/attempts in CHR. Study Design The current study used data generated by the Accelerating Medicines Partnership® Schizophrenia Observational Study. The total sample included 1,048 participants (827 CHR and 221 community controls). Participants completed measures of suicidal ideation/attempts, attenuated positive symptoms, depressive symptoms, perceived stress, and sleep disturbance. Study Results Results supported a relationship between sleep disturbance and suicidal ideation/attempts in CHR, with participants who had lifetime ideation and attempts experiencing more sleep disturbance than those with no ideation or attempts. We also found small, but significant positive correlations between sleep disturbance and suicide risk in CHR. When accounting for other variables in the model, the effect of sleep disturbance remained significant for past month ideation, but not lifetime ideation or attempts. Both interaction models were non-significant. Conclusions Our findings highlight the potential value of sleep measures in early identification and treatment of suicide risk in CHR. Further research in this area is warranted.
H. Wastler, Aubrey M. Moe, Alexandra M Blouin et al.· Schizophrenia Bulletin Open· 0 citations
ABSTRACT Background: While not all trauma-exposed individuals develop post-traumatic stress disorder (PTSD), many experience severe and enduring emotional effects. In Singapore, no study has investigated the prevalence and correlates of subthreshold PTSD and PTSD using gold-standard clinical interviews. Objectives: This study was the first to examine the prevalence and correlates of PTSD, subthreshold PTSD, and correlates associated while exploring a broad range of adverse experiences, including Criterion A (e.g. physical and sexual abuse) and non-Criterion A (e.g. emotional abuse) events. Method: We recruited 500 outpatients, aged 21–65, with mood or schizophrenia spectrum disorders from Singapore’s only tertiary psychiatric hospital. Self-report measures assessed emotion dysregulation, suppression, and total trauma events. Clinical interviews, like the Clinician-Administered PTSD Scale (CAPS-5), measured dissociation and PTSD, while the Brief Psychiatric Rating Scale measured negative affect. Among trauma-exposed individuals (n = 461), multinomial regression examined differences between subthreshold PTSD, PTSD and the no-PTSD reference group, with analyses conducted separately for Criterion A and non-Criterion A events. Results: In the overall sample, PTSD prevalence was 15.0% and subthreshold PTSD was 18.4% among individuals with an index event classified as Criterion A. PTSD following an index event classified as Criterion A was associated with a broader range of correlates than index events classified as non-Criterion A. Conversely, among individuals exposed to events classified as non-Criterion A, PTSD was primarily associated with emotional correlates when subthreshold PTSD was defined as ‘two of four criteria.’ PTSD is also associated with a broader set of correlates than subthreshold PTSD across exposure types and subthreshold PTSD definitions. Correlates of subthreshold PTSD vary depending on exposure type. Negative affect was most frequently associated with multiple definitions of subthreshold PTSD and PTSD across trauma types. Conclusion: Findings suggest distinct symptom profiles by trauma type and emphasise the clinical relevance of non-Criterion A events and subthreshold PTSD.
C. Tan, Vanessa Ai Ling Seet, Rachel Hsiao Shen Tan et al.· European Journal of Psychotr...· 0 citations
We use cookies to run the site and, with your consent, for analytics and to show ads.
See our Cookie Policy.
