Citation

López-Moríñigo JD, Wiffen B, O'Connor J, Dutta R, Di Forti M, Murray RM, David AS. Early Interv. Psychiatry 2014; 8(2): 113-121.

Copyright

(Copyright © 2014, John Wiley and Sons)

DOI

10.1111/eip.12042

PMID

unavailable

Abstract

AIM: Lack of insight is a cardinal feature of psychosis with crucial implications for outcome. Concerns have been raised regarding a link between insight and suicidality. This study aimed to test the relationship between suicidal behaviour preceding first-episode psychosis (FEP) and insight dimensions at treatment onset.

METHODS: A total of 112 FEP inpatients were recruited. Suicidal events prior to admission were recorded. Insight was assessed multidimensionally with the Schedule for the Assessment of Insight - Expanded version shortly after admission. Suicidal and non-suicidal patients were compared regarding scores on 'total insight' and three insight domains: 'awareness of mental illness', 'relabeling of psychotic experiences as abnormal' and 'compliance'. This analysis was also adjusted for a set of sociodemographic, clinical, neurocognitive and psychopathological variables.

RESULTS: Bivariate analyses demonstrated a direct association between previous suicidality and all insight domains. However, these associations did not survive multivariable regression models, which demonstrated gender (female), shorter duration of untreated psychosis (DUP) and psychopathological symptoms - depression and disorganization - to mediate the influence of suicidal history on insight, and therefore to underlie the latter.

CONCLUSIONS: Insight dimensions in FEP patients are influenced by having suicidal antecedents through some mediating variables such as gender, DUP and depression. Further prospective studies are needed to clarify the potential implications of these findings on the management of insight in FEP. As suicidal history is associated with greater levels of both depression and insight at first presentation, these three variables might be useful in predicting further suicidal events. © 2013 Wiley Publishing Asia Pty Ltd.

Language: en

Keywords

Humans; adolescent; Adult; Aged; Female; Male; Middle Aged; adult; human; Adolescent; Depression; Suicide; female; male; Young Adult; aged; Suicide, Attempted; depression; sex difference; Case-Control Studies; psychosis; suicide attempt; suicidal behavior; psychology; First-episode psychosis; awareness; Psychotic Disorders; article; major clinical study; mental disease; controlled study; priority journal; middle aged; patient compliance; negative syndrome; self evaluation; disorientation; mania; positive syndrome; Insight; case control study; disease duration; introspection; Positive and Negative Syndrome Scale; Self-Assessment; young adult; time to treatment