Psychotic experiences and incident suicidal ideation and behaviour: Disentangling the longitudinal associations from connected psychopathology

Abstract

Psychotic experiences and incident suicidal ideation and behaviour 2 ABSTRACT This study examines the longitudinal associations between psychotic experiences (PE) and incident suicidal ideation and behaviour in the general population, and to what degree the association may be confounded by nonpsychotic psychopathology. Data from three prospective, general population cohorts were combined into one dataset (n=15837) and analysed using logistic regression, controlling for continuous measures of depression, anxiety and mania symptoms. Analyses were conducted in the entire sample, and in subsamples stratified by presence or absence of mental disorders. The presence of PE at baseline increased the risk of incident suicidal ideation and behaviour. However, adjustment for dimensional measures of psychopathology reduced effect sizes, although PE remained significantly associated with suicide attempts. Further examination of the associations revealed that PE were only associated with suicide attempts in individuals with at least one mental disorder.Similarly, in individuals without mental disorders, the risk of suicidal ideation increased as PE co-occurred with more symptom domains. The results of this study confirm that individuals with PE are at increased risk of suicidal ideation and behaviour. However, these associations are not specific, but reflect the increased risk of suicidal ideation in individuals with subthreshold multidimensional psychopathology and suicide attempts in individuals with co-occurring mental disorders.

The interplay between childhood trauma, cognitive biases, and cannabis use on the risk of psychosis in nonclinical young adults in Poland

“…PLEs have been found to occur in 5-8% of nonclinical populations [2]. They have been associated with impairments in functioning [3], help-seeking behaviors [3,4], psychiatric diagnoses [3,4], self-harm thoughts and behaviors [5,6], as well as increased suicidality [3,7]. Moreover, PLEs have been linked to risk for developing a psychotic disorder and with many of the same risk factors as psychotic disorder, such as exposure to traumatic life events or cannabis use [2].…”

Evidence That Environmental and Familial Risks for Psychosis Additively Impact a Multidimensional Subthreshold Psychosis Syndrome

“…9 Similarly, increased levels of psychosis admixture in nonpsychotic disorders have been observed to impact illness severity, 10 comorbidity, 3 poor outcome, 11 functional impairment, 12,13 and suicidality. 14,15 Furthermore, in a recent study on the distribution of ultra-high risk criteria in the general population, however without applying the help-seeking criterion, the presence of nonpsychotic mental disorders and functional deficits was more likely when attenuated psychotic symptoms cooccurred with cognitive deficits (ie, cognitive-perceptive basic symptoms and cognitive disturbances). 16 The initial manifestation of a mental condition typically represents a mixture of signs and symptoms accompanied by impairment in various emotional and neurocognitive processes that may include aberrant salience, motivational alterations, affective dysregulation, and anxiety states.…”

Why are psychotic experiences associated with self-injurious thoughts and behaviours? A systematic review and critical appraisal of potential confounding and mediating factors

“…1) (Jang et al 2014). A longitudinal study found the PE-suicidality association was only present in those reporting common mental disorders at baseline (Honings et al 2016 b ), and adding a measure of depressive symptoms to PEs significantly improved prediction of later suicide attempts (Sullivan et al 2015). Conversely, a study of the Adult Psychiatric Morbidity Survey ( n = 7403) reported the strong association between hallucinations and suicide attempts was independent of common mental disorders such as depression (Kelleher et al 2017).…”