Suicidality in Schizophrenia Spectrum Disorders: The Relationship to Hallucinations and Persecutory Delusions

Kjelby, Eirik; Sinkeviciute, Igne; Gjestad, Rolf; Kroken, Rune A.; Løberg, Else‐Marie; Jørgensen, Hugo A.; Hugdahl, Kenneth; Johnsen, Erik

doi:10.1016/j.eurpsy.2015.07.003

Cited by 80 publications

(48 citation statements)

References 57 publications

(75 reference statements)

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“…Specifically, hallucinations and delusions play an important role in suicidal ideation (Bornheimer and Jaccard, 2016). Although there have been mixed findings with respect to positive symptoms affecting suicidal behavior, several authors opined that hallucinations predicted suicidal plans and ideation (Kjelbyet al, 2015), (Bertelsen et al, 2007). Hallucinations-delusions accounted for increased percentage of suicide attempts (Koeda et al, 2012), (Ishii et al, 2014).…”

Section: Discussionmentioning

confidence: 99%

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Self-harm and suicide attempts in Schizophrenia

Jakhar

Beniwal

Bhatia

et al. 2017

Asian Journal of Psychiatry

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Background The risk of suicide among persons with schizophrenia (SZ) is higher than in general population, with multiple contributory factors. We assessed the prevalence of risk of deliberate self-harm and suicide attempts, along with associated socio-demographic and clinical factors in a group of SZ outpatients (n=61) as part of a larger study on overall schizophrenia-associated risks. Aims To investigate factors associated with risk of deliberate self-harm and suicide among persons with schizophrenia. Method Out of 270 SZ participants evaluated for various risks using Ram Manohar Lohia Risk Assessment Interview (RML-RAI), 61 reported risk of self-harm including suicide attempt/s. The factors associated with this risk were further evaluated on clinical details and Diagnostic Interview for Genetic Studies. Results Risk of reported self-harm was 22.59%. Among them, 10% had attempted suicide at least once. Current age and past month Global Assessment of Functioning score from DIGS (GAF) were significantly correlated with suicide attempt. Attempters had significantly lower current GAF score, indicating poorer functioning. Among 27 attempters, 9 attempted at the onset of illness while 6 others attempted suicide within one year. Most common method of attempt was ingestion of insecticides or overdose of medication, followed by hanging or jumping from height. Conclusion In our hospital-based sample of suicide attempters, 10% had attempted suicide, among them over 55% within first year of illness. Attempters were significantly older than non-attempters and suffered from significantly more severe illness than non-attempters. Positive symptoms were significantly associated with attempt, irrespective of time at which suicide was attempted.

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Section: Discussionmentioning

confidence: 99%

“…Suicidal ideation is a strong predictor of suicide and the basis of suicide prevention in schizophrenia (Chung et al, 2014). Additionally, self-harm increases the likelihood of eventual death by suicide (50–100 times more than general population over 12-months (Kjelby et al, 2015). …”

Section: Introductionmentioning

confidence: 99%

Self-harm and suicide attempts in Schizophrenia

Jakhar

Beniwal

Bhatia

et al. 2017

Asian Journal of Psychiatry

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“…The experience of such hallucinations is often disturbing, interferes with cognitive performance, and may lead to impaired performance of daily activities. Some individuals engage in acts of self‐harm in response to voices (Kjelby et al, ), and some engage in violent acts in response to command auditory hallucinations (Bucci et al, ). Understanding the mechanism of auditory verbal hallucinations is essential for the better management of these adverse outcomes.…”

Section: The Value Of Hallucination Researchmentioning

confidence: 99%

Studies of auditory verbal hallucinations

Heckers

2016

Psychophysiology

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Neuroscientists have been exploring the mechanism of auditory verbal hallucinations. In this commentary, I review studies by Judy Ford, who employed a vocalization paradigm to test the hypothesis of impaired corollary discharge in psychotic patients who experience auditory verbal hallucinations. I highlight the strengths of this research program and reflect on the challenge of reducing a complex clinical feature to an abnormality of basic cognitive processes, such as language and memory.

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“…This may subsequently result in negative emotional and behavioral reactions such as low mood, hopelessness, or suicidal thoughts and behaviors (Chadwick and Birchwood, 1994; Iqbal and Birchwood, 2006). A potential mechanism of influence between suicide and hallucinations are command auditory hallucinations (Kjelby et al, 2015). Epidemiologic data show that 50–66% of individuals diagnosed with schizophrenia hear auditory hallucinations (Resnick, 2015; Simms et al, 2007) and 18–50% of which report hallucinations to be command in nature (Harkavy-Friedman et al, 2003; Zisook et al, 1995).…”

Section: Introductionmentioning

confidence: 99%

Moderating effects of positive symptoms of psychosis in suicidal ideation among adults diagnosed with schizophrenia

Bornheimer

2016

Schizophrenia Research

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Background Suicide is among the leading causes of death for adults diagnosed with schizophrenia, with risk estimates being over eight folds greater than the general population. While the majority of research to date focuses on the role of symptoms of depression in suicide risk, there is a lack of consensus and understanding of the relationship between positive symptoms of psychosis and both suicidal ideation and attempt. The current study examined pathways of influence between symptoms of depression, positive symptoms of psychosis (i.e. hallucinations and delusions), hopelessness, and suicidal ideation among a population of adults diagnosed with schizophrenia. Methods Data were obtained from the Clinical Antipsychotic Trials of Intervention Effectiveness (CATIE; n = 1460) at baseline. Suicidal ideation, hopelessness, and symptoms of depression were measured by the Calgary Depression Scale (CDRS) and hallucinations and delusions by the Positive and Negative Syndrome Scale (PANSS). Data were analyzed with Structural Equation Modeling (SEM) using Mplus 7. Results Symptoms of depression, positive symptoms of psychosis, and hopelessness independently predicted suicidal ideation. Hopelessness significantly mediated the relationship between symptoms of depression and suicidal ideation. Lastly, positive symptoms of psychosis were found to moderate the relationship between symptoms of depression and suicidal ideation. Conclusions The current study provides evidence for the role that positive symptoms of psychosis (specifically hallucinations and delusions) play in suicidal ideation, pointing towards the implication that beyond symptoms of depression, positive symptoms must be evaluated for and treated.

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Suicidality in Schizophrenia Spectrum Disorders: The Relationship to Hallucinations and Persecutory Delusions

Abstract: ClinicalTrials.gov ID; URL: http://www.clinicaltrials.gov/NCT00932529.

Cited by 80 publications

References 57 publications

Self-harm and suicide attempts in Schizophrenia

Self-harm and suicide attempts in Schizophrenia

Studies of auditory verbal hallucinations

Moderating effects of positive symptoms of psychosis in suicidal ideation among adults diagnosed with schizophrenia

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