Psychotic experiences and risk of self-injurious behaviour in the general population: a systematic review and meta-analysis

Honings, Steven; Drukker, Marjan; Groen, Robin N.; Os, Jim van

doi:10.1017/s0033291715001841

Cited by 90 publications

(99 citation statements)

References 65 publications

(112 reference statements)

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“…Recently, PE have been identified as a risk factor for suicidal ideation and behaviour in general population individuals (Honings et al, 2015). A similar association has been reported for individuals at risk for psychosis (Taylor et al, 2015).…”

Section: Introductionsupporting

confidence: 61%

“…A recent meta-analysis concluded that general population individuals with PE are at increased risk of suicidal ideation and behaviour, but that this association is confounded by the presence of co-occurring non-psychotic psychopathology (Honings et al, 2015). The reported association between PE and suicidal ideation and behaviour was hypothesized to reflect the increased risk of these outcomes in distressed participants with comorbid mental disorders or high levels of psychopathology.…”

Section: Discussionmentioning

confidence: 99%

“…The presence of low grade psychotic experiences (PE) in the general population has been associated with an increased risk of suicidal ideation and behaviour (Honings et al, 2015). It remains unclear, however, how to isolate this specific association from the association between non-psychotic psychopathology and suicidal ideation and behaviour, since non-psychotic psychopathology is strongly connected to both PE (DeVylder et al, 2014;Guloksuz et al, 2015;Jeppesen et al, 2015;Kelleher et al, 2012b;Van Os et al, 2000), and suicidal behaviour (Cavanagh et al, 2003;ten Have et al, 2009;Ten Have et al, 2013).…”

Section: Introductionmentioning

confidence: 99%

“…suicidal attempts or completed suicide) compared with individuals without PE. Pooled odds ratios (OR) were 2.47 (95% CI 1.71 -3.59; suicidal thoughts) and 3.03 (95% CI 2.08 -4.41; suicidal behaviour), respectively (Honings et al, 2015).…”

Section: Introductionmentioning

confidence: 99%

“…However, the association between PE and suicidal ideation and behaviour is confounded, since adjustment for non-psychotic psychopathology in longitudinal studies resulted in a 74% excess risk reduction (Honings et al, 2015).…”

Section: Introductionmentioning

confidence: 99%

See 4 more Smart Citations

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

Honings

Drukker

Nierop

et al. 2016

Psychiatry Research

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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.

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Section: Introductionsupporting

confidence: 61%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 3 more Smart Citations

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

Honings

Drukker

Nierop

et al. 2016

Psychiatry Research

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Association Between Psychotic Experiences and Subsequent Suicidal Thoughts and Behaviors

et al. 2017

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IMPORTANCE Community-based studies have linked psychotic experiences (PEs) with increased risks of suicidal thoughts and behaviors (STBs). However, it is not known if these associations vary across the life-course or if mental disorders (antecedent to the STBs) contribute to these associations. OBJECTIVE To examine the temporal association between PEs and subsequent STBs across the life span as well as the influence of mental disorders (antecedent to the STBs) on these associations. DESIGN, SETTING, AND PARTICIPANTS A total of 33,370 adult respondents across 19 countries from the WHO World Mental Health (WMH) Surveys were assessed for PEs, STBs (ideation, plans, and attempts), and 21 DSM-IV mental disorders. Discrete-time survival analysis was used to investigate the associations of PEs with subsequent onsets of STBs. MAIN OUTCOMES AND MEASURES Prevalence and frequency of STBs with PEs, and odds ratios and 95%CIs. Results Of 33 370 included participants, among those with PEs (n = 2488), the lifetime prevalence (SE) of suicidal ideation, plans, and attempts was 28.5%(1.3), 10.8%(0.7), and 10.2%(0.7), respectively. Respondents with 1 or more PEs had 2-fold increased odds of subsequent STBs after adjusting for antecedent or intervening mental disorders (suicidal ideation: odds ratio, 2.2; 95%CI, 1.8-2.6; suicide plans: odds ratio, 2.1; 95%CI, 1.7-2.6; and suicide attempts: odds ratio, 1.9; 95%CI, 1.5-2.5). There were significant dose-response relationships of number of PE types with subsequent STBs that persisted after adjustment for mental disorders. Although PEs were significant predictors of subsequent STB onset across all life stages, associations were strongest in individuals 12 years and younger. After adjustment for antecedent mental disorders, the overall population attributable risk proportions for lifetime suicidal ideation, plans, and attempts associated with temporally prior PEs were 5.3%, 5.7%, and 4.8%, respectively. Conclusions PEs are associated with elevated odds of subsequent STBs across the life-course that cannot be explained by antecedent mental disorders. These results highlight the importance of including information about PEs in screening instruments designed to predict STBs.

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Association of Psychotic Experiences With Subsequent Risk of Suicidal Ideation, Suicide Attempts, and Suicide Deaths

et al. 2019

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IMPORTANCE Recent research has highlighted that psychotic experiences are far more prevalent than psychotic disorders and associated with the full range of mental disorders. A particularly strong association between psychotic experiences and suicidal behavior has recently been noted. OBJECTIVE To provide a quantitative synthesis of the literature examining the longitudinal association between psychotic experiences and subsequent suicidal ideation, suicide attempts, and suicide deaths in the general population. DATA SOURCES We searched PubMed, Excerpta Medica Database, Cumulative Index to Nursing and Allied Health Literature, and PsycINFO from their inception until September 2017 for longitudinal population studies on psychotic experiences and subsequent suicidal ideation, suicide attempts, and suicide death. STUDY SELECTION Two authors searched for original articles that reported a prospective assessment of psychotic experiences and suicidal ideation, suicide attempts, or suicide death in general population samples, with at least 1 follow-up point. DATA EXTRACTION AND SYNTHESIS Two authors conducted independent data extraction. Authors of included studies were contacted for information where necessary. We assessed study quality using the Newcastle-Ottawa Quality Assessment Scale. We calculated pooled odds ratios using a random-effects model. A secondary analysis assessed the mediating role of co-occurring psychopathology. MAIN OUTCOMES AND MEASURES Psychotic experiences and subsequent suicidal ideation, suicide attempts, and suicide death. RESULTS Of a total of 2540 studies retrieved, 10 met inclusion criteria. These 10 studies reported on 84 285 participants from 12 different samples and 23 countries. Follow-up periods ranged from 1 month to 27 years. Individuals who reported psychotic experiences had an increase in the odds of future suicidal ideation (5 articles; n = 56 191; odds ratio [OR], 2.39 [95% CI,1.62-3.51]), future suicide attempt (8 articles; n = 66 967; OR, 3.15 [95% CI, 2.23-4.45]), and future suicide death (1 article; n = 15 049; OR, 4.39 [95% CI, 1.63-11.78]). Risk was increased in excess of that explained by co-occurring psychopathology: suicidal ideation (adjusted OR, 1.59 [95% CI, 1.09-2.32]) and suicide attempt (adjusted OR, 2.68 [95% CI, 1.71-4.21]). CONCLUSIONS AND RELEVANCE Individuals with psychotic experiences are at increased risk of suicidal ideation, suicide attempts, and suicide death. Psychotic experiences are important clinical markers of risk for future suicidal behavior.

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Psychotic experiences and risk of self-injurious behaviour in the general population: a systematic review and meta-analysis

Cited by 90 publications

References 65 publications

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

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

Association Between Psychotic Experiences and Subsequent Suicidal Thoughts and Behaviors

Association of Psychotic Experiences With Subsequent Risk of Suicidal Ideation, Suicide Attempts, and Suicide Deaths

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