Exploring the relation between psychosis‐like experiences and suicidal ideation, plans, and attempts among college students in the United States

Abstract

Aim The suicide rate among college students is particularly high, with evidence that psychosis‐like experiences (PLEs) put these individuals at greater risk. The current study explored whether there are differential relations between four subtypes of PLEs and three suicide outcomes. Methods We analysed a large sample of college students from the Fall semester cohort of the 2020 Healthy Minds Study (HMS) (weighted N = 36727). PLEs and suicide outcomes were assessed using binary variables from the World Health Organization Composite International Diagnostic Interview. Results Findings revealed that reporting any of the subtypes of PLEs was associated with greater odds of suicidal ideation (SI), a suicide plan (SP) and a suicide attempt (SA) (signficant a ORs ranging from 1.30 to 3.30). For college students who endorsed SI or a SP in the past year, experiencing delusional mood (aOR [95% CI] = 1.30 [1.02–1.65]), suspiciousness (aOR [95% CI] = 1.31 [1.00–1.71]) and hallucinatory experiences (aOR [95% CI] = 2.76 [2.05–3.71]) in their lifetime increased their odds of reporting a SA in the past year. There was also evidence of a dose‐dependent relation between the number of PLEs endorsed and all three suicide outcomes. Conclusions Certain subtypes of PLEs including delusional mood, suspiciousness and hallucinatory experiences may contribute to an elevated risk of suicide outcomes in college students. Moreover, the odds of reporting suicide outcomes were greater for individuals who endorsed a greater number of PLEs. It may be helpful to assess for indicated subtypes when determining suicide risk among college students and to be particularly mindful of those who report three or more PLEs.

Psychotic-Like Experiences and Suicidal Ideation Among Adolescents: The Chain Mediating Role of Insomnia Symptoms and Resilience

“…70 In addition, this study showed consistent mediating effects of insomnia symptoms and resilience in the relationship between DEs/ HEs and SI. Consistent with previous studies, 71 all subtypes of PLEs are positively associated with SI. Studies by Saha et al, 72 and participants were drawn from a large-scale cross-sectional survey, indicating that adolescents with delusional experiences were about two to four times as likely to report SI.…”

A call to action: informing research and practice in suicide prevention among individuals with psychosis

“…Given inconsistent findings regarding the relationship between psychosis experiences and suicide thoughts and behaviors, a fine-grained analysis of specific psychosis symptoms (and their severity) with subtypes of suicide thoughts and behaviors (i.e., ideation, plans, attempts, death) could help better understand whether, for example, the association between psychosis and suicide thoughts and behaviors is due to the presence of psychosis symptoms, to specific symptoms (e.g., auditory versus visual hallucinations ( 90 ), to the frequency or intensity of these ( 90 ), to the associated distress ( 91 ), or is mediated by another variable ( 55 ). Relatedly, considerations of unique risk factors and protective factors and sources of strengths for this population should be determined and routinely assessed.…”

Distress related to psychotic experiences: Enhancing the world health organization composite international diagnostic interview psychosis screen

“…Most people who report PE will not develop a psychotic disorder; however, some studies have shown that PE associate with an increased risk for persistent psychosis (Dominguez et al., 2011 ). Still, a growing and compelling body of literature shows that PE are associated with a host of negative outcomes, including mental health problems (DeVylder et al., 2014 ), chronic health conditions (Oh et al., 2019 ; Oh, Waldman, et al., 2018 ), disability (Navarro‐Mateu et al., 2017 ; Oh, Koyanagi, et al., 2018 ), behavioral problems (Koyanagi et al., 2016 ; Koyanagi & Stickley, 2015 ; Oh, Koyanagi, et al., 2016 ; Oh, Singh, et al., 2016 ), suicidal thoughts and behaviors (DeVylder et al., 2020 ; Jay et al., 2022 ; Oh, Koyanagi, et al., 2022 ; Yates et al., 2019 ), and reduced lifespan (Sharifi et al., 2015 ). As such, PE may play a role in screening, prevention, and early intervention not only for psychotic disorders but also other adverse health outcomes (Oh, DeVylder, et al., 2021 ).…”