Citation

Peng P, Wang Q, Zhou Y, Hao Y, Chen S, Wu Q, Li M, Wang Y, Yang Q, Wang X, Liu Y, Ma Y, He L, Liu T, Zhang X. Prog. Neuropsychopharmacol. Biol. Psychiatry 2024; 129: e110899.

Copyright

(Copyright © 2024, Elsevier Publishing)

DOI

10.1016/j.pnpbp.2023.110899

PMID

38007211

Abstract

BACKGROUND: Insomnia is common in patients with schizophrenia, which contributes to worsening psychiatric symptoms and suicidality. We aimed to assess the inter-relationships of insomnia and psychopathology with suicidal ideation (SI) among 1407 Chinese patients with chronic schizophrenia via the network approach.
METHOD: We used Positive and Negative Syndrome Scale, Insomnia Severity Index, and Beck Scale for Suicidal Ideation to assess psychiatric symptoms, insomnia, and SI, respectively. Lifetime suicidal attempts (SA) were collected.
RESULTS: (1) The incidence of insomnia, lifetime SI, lifetime SA, and current SI was 13.5% (n = 190), 22.8% (n = 321), 13.5% (n = 190), and 9.7% (n = 136), respectively. (2) Patients with insomnia had worse clinical symptoms and higher suicidal risk. (3) Daytime dysfunction, sleep-related distress, conceptual disorganization, delusions, anxiety, and poor rapport were the core symptoms, while late sleep onset and sleep dissatisfaction emerged as bridge symptoms connecting insomnia and psychopathology. (4) Depressive mood, hallucinations, poor impulse control, guilty feelings, insomnia-related impaired quality of life, and sleep dissatisfaction were directly associated with SI.
CONCLUSION: Our findings called for formal assessment of insomnia in patients with schizophrenia, which should cover both nocturnal and daytime insomnia symptoms. Targeted interventions for key symptoms may help reduce insomnia, psychiatric symptoms, and SI in patients with schizophrenia.

Language: en

Keywords

Humans; Insomnia; Mental Disorders; Network analysis; Quality of Life; Schizophrenia; Sleep Initiation and Maintenance Disorders; Suicidal attempt; Suicidal ideation; Suicidal Ideation