Citation

Thompson E, Spirito A, Frazier E, Thompson A, Hunt J, Wolff J. Schizophr. Res. 2020; ePub(ePub): ePub.

Affiliation

Department of Psychiatry and Human Behavior, Warren Alpert Medical School of Brown University, Box G-BH, Providence, RI 02912, United States of America; Bradley Hospital, 1011 Veterans Memorial Pkwy, Riverside, RI 02915, United States of America; Child and Adolescent Psychiatry, Rhode Island Hospital, One Hoppin Street, Coro West Suite 204, Providence, RI 02903, United States of America. Electronic address: jennifer_wolff@brown.edu.

Copyright

(Copyright © 2020, Elsevier Publishing)

DOI

10.1016/j.schres.2019.12.037

PMID

31948902

Abstract

BACKGROUND: Individuals in the early stages of psychosis have a markedly high risk for suicidal thoughts and behavior (STB). It is not well understood if STB among those with psychosis-risk symptoms is accounted for by co-occurring psychopathology (e.g., depression), unique experiences specific to psychosis-spectrum symptomatology (e.g., hallucinations, delusions), or combined effects of different factors. This cross-sectional study explored the link between psychosis-spectrum symptoms, co-occurring disorders, and STB.

METHODS: This record review included 569 adolescents (mean age = 14.83) admitted to a psychiatric inpatient hospital due to exhibiting behavior indicating they were an imminent threat to themselves or others. Upon intake to the hospital, participants completed a diagnostic interview and self-report measures of suicidal ideation, suicide attempt history, and psychosis-spectrum symptoms. The primary analysis used linear regression to predict suicidal ideation from psychosis-spectrum symptom scores, controlling for known characteristics associated with STB including specific psychiatric disorders (i.e. depressive, anxiety, post-traumatic stress, and psychotic disorders), biological sex, and race.

RESULTS: Psychosis-spectrum symptoms predicted suicidal ideation above and beyond the significant effects of a depressive disorder diagnosis and sex, as well as the non-significant effects of anxiety, PTSD, full-threshold psychosis, and race. Item-level correlations demonstrated that several psychosis-spectrum symptoms were significantly associated with ideation and lifetime suicide attempts.

CONCLUSIONS: Results indicate that within this sample of psychiatrically hospitalized youth, psychosis-risk symptoms were uniquely linked to STB. These findings suggest that attention to psychosis-spectrum symptoms, including several specific psychosis-risk experiences, may be clinically important for better assessment and treatment of suicidal youth.

Copyright © 2020 Elsevier B.V. All rights reserved.

Language: en

Keywords

Adolescents; Clinical high risk (CHR) for psychosis; PRIME screen; Psychiatric hospital; Suicidal ideation; Suicidal thoughts and behavior (STB)