Insight and suicidality in psychosis: A cross-sectional study

Abstract

Insight and suicidality in psychosis: A crosssectional study, Psychiatry Research, http://dx.doi.org/10.1016Research, http://dx.doi.org/10. /j.psychres.2017 This is a PDF file of an unedited manuscript that has been accepted for publication. As a service to our customers we are providing this early version of the manuscript. The manuscript will undergo copyediting, typesetting, and review of the resulting galley proof before it is published in its final citable form. Please note that during the production process errors may be discovered which could affect the content, and all legal disclaimers that apply to the journal pertain. Insight scale total score and two specific domains (awareness of "disturbed thinking and loss of control over the situation" and "having a vague feeling that something is wrong") were related to suicidality. However, no insight dimensions survived the multivariable regression model, which found depression and previous suicidal behaviour to predict suicidality. Conclusions: Suicidality in psychosis was linked with some insight dimensions: awareness of mental illness and awareness of social consequences, but not compliance. Depression and previous suicidal behaviour mediated the associations with insight; thus, predicting suicidality.

Insight and risk of suicidal behaviour in two first-episode psychosis cohorts: Effects of previous suicide attempts and depression

“…Also, previous suicide attempts, but not baseline insight scores, were associated with suicidal behaviours in the multivariable models, with 'significant' (at p<0.05) HRs ranging from 2.75 (AESOP) to 5.31 (GAP), hence a strong association. In other words, previous suicide attempts seem to explain in part the apparent association between insight and suicidal behaviour in psychosis, which is consistent with a previous cross-sectional study (Massons et al, 2017). Nevertheless, up to 42% of suicide completers with schizophrenia spectrum disorder have no previous suicide attempts (LopezMorinigo et al, 2014b;Lopez-Morinigo et al, 2016).…”

Insight in schizophrenia spectrum disorders: relationship with behavior, mood and perceived quality of life, underlying causes and emerging treatments

“…Other studies have found that the relationship of insight and suicidality may be fully mediated by depression 97 .…”

Validity of the Birchwood insight scale in patients with schizophrenia spectrum- and bipolar disorders

“…On the other hand, studies also find that insight is associated with reduced quality of life (Boyer et al, 2012;van Baars et al, 2013), lower self-esteem and increased hopelessness (Cooke et al, 2007;Hasson-Ohayon et al, 2006), as well as increased risk for depression (Mintz et al, 2004) and suicidal behavior (Barrett et al, 2010). There are however conflicting results including opposite findings concerning the relationship between insight and several of these aspects, such as suicidality (Massons et al, 2017), depressive symptoms (Cobo et al, 2016) and quality of life (Montemagni et al, 2014). These contradictory findings may be related to differences in the study populations, but may also depend on the use of different instruments to assess insight.…”