Association Between Psychopathology and Suicidal Behavior In Schizophrenia

Jovanović, Nikolina; Podlešek, Anja; Medved, Vesna; Grubišin, Jasmina; Mihaljević-Peleš, Alma; Tošić, Goran; Lovretić, Vanja

doi:10.1027/0227-5910/a000211

Cited by 18 publications

(12 citation statements)

References 31 publications

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“…However, we noted previously with a larger sample (Pluck, Lekka, 2012), that neither severities of positive nor negative symptoms were linked to self-harm. A recent study of 509 schizophrenia patients has also reported that positive and negative symptoms are not predictive of suicide attempts (Jovanovic et al , 2013). Similarly, severity of positive and negative symptoms were not associated with any self-harm related brain activations in our study.…”

Section: Discussionsupporting

confidence: 37%

Self-harm in schizophrenia is associated with dorsolateral prefrontal and posterior cingulate activity

Lee¹,

Pluck²,

Lekka³

et al. 2015

Progress in Neuro-Psychopharmacology and Biological Psychiatry

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Article available under the terms of the CC-BY-NC-ND licence (https://creativecommons.org/licenses/by-nc-nd/4.0/) eprints@whiterose.ac.uk https://eprints.whiterose.ac.uk/ Reuse Unless indicated otherwise, fulltext items are protected by copyright with all rights reserved. The copyright exception in section 29 of the Copyright, Designs and Patents Act 1988 allows the making of a single copy solely for the purpose of non-commercial research or private study within the limits of fair dealing. The publisher or other rights-holder may allow further reproduction and re-use of this version -refer to the White Rose Research Online record for this item. Where records identify the publisher as the copyright holder, users can verify any specific terms of use on the publisher's website. TakedownIf you consider content in White Rose Research Online to be in breach of UK law, please notify us by emailing eprints@whiterose.ac.uk including the URL of the record and the reason for the withdrawal request. AbstractSelf-harm, such as self-cutting, self-poisoning or jumping from height, regardless of intentions, is common among people with schizophrenia. We wished to investigate brain activations relating to self-harm, in order to test whether these activations could differentiate between schizophrenia patients with self-harm and those without. We used event-related functional MRI with a go/nogo response inhibition paradigm. Fourteen schizophrenia patients, with a history of self-harm, were compared with 14 schizophrenia patients without a history of self-harm and 17 healthy control participants. In addition, we used standard clinical measures and neuropsychological tests to assess risk factors associated with self-harm. The right dorsolateral prefrontal cortex (DLPFC) and the left posterior cingulate cortex differentiated all three groups; brain activation in these regions being greatest in the control group, and the self-harm patient group being greater than in the non -self-harm patient group. In the self-harm patient group, right DLPFC activity was positively correlated with severity of suicidal thinking. In addition, both patient groups showed less activation in the right orbitofrontal cortex, left ventral anterior cingulate cortex and right thalamus. This is the first study to report right DLPFC activation in association with self-harm and suicidal thinking in patients with schizophrenia. This area could be a target for future neuromodulation studies to treat suicidal thinking and self-harm behaviors in patients with schizophrenia.3

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Section: Discussionsupporting

confidence: 37%

Self-harm in schizophrenia is associated with dorsolateral prefrontal and posterior cingulate activity

Lee¹,

Pluck²,

Lekka³

et al. 2015

Progress in Neuro-Psychopharmacology and Biological Psychiatry

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“…Identified correlates of SI in this population have included mood variability, negative symptoms, and depressive symptoms (Fialko et. al., 2006; Hocaoglu and Babuc, 2009; Jovanovic et al, 2013; Kontaxakis et al, 2004; Palmier-Claus et al, 2013), as well as positive symptoms (Taylor et al, 2010). We have previously examined the prevalence of SI in young people at clinical high-risk for psychosis (CHR), finding that 55% reported having suicidal thoughts (DeVylder et al, 2012), a prevalence replicated in other cohorts (Hutton et al, 2011).…”

Section: Introductionmentioning

confidence: 99%

Assessing suicidal ideation in individuals at clinical high risk for psychosis

Gill

Quintero

Poe

et al. 2015

Schizophrenia Research

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Background The majority of individuals with schizophrenia and other psychotic illnesses have had suicidal ideation at some point during the illness. However, little is known about the variation in level and intensity of suicidal ideation and symptoms in the attenuated stage of psychotic illness. Our aims were to assess prevalence of suicidal ideation in this at risk group, and to examine the severity and intensity of suicidal ideation, and their relation to symptoms. Methods Suicidal ideation was assessed in 42 clinical high-risk participants using the Columbia Suicide Severity Rating Scale (C-SSRS). We hypothesized prevalence rates would be similar to what was found in previous studies, and individuals with suicidal ideation would have higher positive and negative symptoms, with poorer functioning. We assessed levels of severity and intensity of suicidal ideation related to these symptoms, and examined how depressive symptoms affected these relationships. Results Nearly half (42.9%) of participants reported having current suicidal ideation. We found no relationship to positive symptoms. However, severity and intensity of suicidal ideation was found to be related to negative symptoms and level of functioning. When controlling for depressive symptoms during exploratory analysis, this relationship still emerged. Conclusions This study adds to the literature demonstrating the complex nature of suicidal ideation in psychotic illness. The C-SSRS has shown to be helpful in determining relationships between severity and intensity in suicidal ideation in relation to specific symptoms in a research setting.

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“…While anxiety has been linked to suicide risk in schizophrenia (e.g., Hor and Taylor, 2010; Jovanovic et al, 2013; Lyu and Zhang, 2014), the effect is generally not as strong as the effect of depression. Our findings may be due to the smaller range on depressive symptoms in this sample, as one of the depression subscale items (i.e., suicide ideation) was removed prior to analysis.…”

Section: Discussionmentioning

confidence: 99%

“…Covariates were selected based on significant correlations with the outcome variable, as well as previous research establishing depression and anxiety as important risk factors for suicide ideation (e.g., Jovanovic et al, 2013; Yan et al, 2013). Because the BSI suicide ideation item evidenced substantial right skew, a Poisson regression was used (Coxe et al, 2008).…”

Section: Methodsmentioning

confidence: 99%

“…Jovanovic et al (2013) found that anxiety was associated increased suicide risk, defined as previous suicide attempts and/or current suicide ideation. Depressive symptoms have also been associated with suicide risk (Jovanovic et al, 2013), as well as previous suicide attempts (Umut et al, 2013) and suicide ideation (Umut et al, 2013; Yan et al, 2013) separately. Therefore, it is important to account for psychiatric symptoms such as depression and anxiety when examining predictors of suicide risk in individuals with schizophrenia.…”

Section: Introductionmentioning

confidence: 99%

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Personal Recovery as a Protective Factor Against Suicide Ideation in Individuals With Schizophrenia

et al. 2016

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Suicide rates are elevated in individuals with schizophrenia, yet evidence is mixed regarding the roles of positive and negative symptoms as risk factors for suicide in this population, suggesting that there may be other influential variables. One such variable may be personal recovery. Therefore, the purpose of this study was to test the hypothesis that personal recovery would moderate the relationship between symptoms of schizophrenia and suicide ideation. This hypothesis was tested in sample of 169 individuals diagnosed with schizophrenia or schizoaffective disorder using a Poisson regression model. Results suggested that there was no significant interaction between recovery and symptoms of schizophrenia. However, recovery was a significant predictor of suicide ideation after controlling for psychiatric symptoms. These findings indicate that recovery is associated with lower suicide ideation and thus may protect against it. Thus, recovery should be assessed, and potentially intervened upon, to reduce suicide risk in individuals with schizophrenia.

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Association Between Psychopathology and Suicidal Behavior In Schizophrenia

Abstract: The results indicate that clinicians should look for depression, anxiety, and guilt feelings, while positive and negative symptoms seem to be less relevant for suicide assessment in schizophrenia.

Cited by 18 publications

References 31 publications

Self-harm in schizophrenia is associated with dorsolateral prefrontal and posterior cingulate activity

Self-harm in schizophrenia is associated with dorsolateral prefrontal and posterior cingulate activity

Assessing suicidal ideation in individuals at clinical high risk for psychosis

Personal Recovery as a Protective Factor Against Suicide Ideation in Individuals With Schizophrenia

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