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Journal Article

Citation

Freeman D, Bold E, Chadwick E, Taylor KM, Collett N, Diamond R, Cernis E, Bird JC, Isham L, Forkert A, Carr L, Causier C, Waite F. Compr. Psychiatry 2019; 93: 41-47.

Affiliation

Department of Psychiatry, University of Oxford, UK; Oxford Health NHS Foundation Trust, UK.

Copyright

(Copyright © 2019, Elsevier Publishing)

DOI

10.1016/j.comppsych.2019.07.001

PMID

31319194

Abstract

BACKGROUND: To determine the prevalence of suicidal ideation and behaviour - and their correlates - in patients with persecutory delusions.

METHODS: 110 patients with persecutory delusions in the context of non-affective psychosis were assessed for suicidal thoughts and behaviours over the past month. Symptom and psychological assessments were also completed.

RESULTS: The severity of suicidal ideation was: no suicidal ideation (n = 26, 23.6%); wish to be dead (n = 21, 19.1%); nonspecific active suicidal thoughts (n = 14, 12.7%); suicidal thoughts with methods but no intent (n = 29, 26.4%); suicidal thoughts with intent but no specific plan (n = 13, 11.8%); and suicidal intent with plan (n = 7, 6.4%). In the past month, five patients (4.5%) had made an actual, interrupted, or aborted suicide attempt. The severity of suicidal ideation was associated with higher levels of depression, paranoia, hallucinations, anger, insomnia, negative beliefs about the self and others, pessimism, worry, and delusion safety-seeking behaviours and lower levels of psychological well-being and reward responsiveness. Severity of ideation was not associated with cannabis or alcohol use, working memory, pain, or meaningful activity levels.

CONCLUSIONS: Patients with persecutory delusions are typically in a severe state of psychological stress, and at risk of suicide, as indicated by very high levels of suicidal ideation. This exploratory study also identifies correlates of suicidal ideation that could be investigated in causal research designs.

Copyright © 2019 The Authors. Published by Elsevier Inc. All rights reserved.


Language: en

Keywords

Depression; Persecutory delusions; Schizophrenia; Suicide

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