Insight in schizophrenia and risk of suicide: a systematic update

López-Moriñigo, Javier-David; Ramos-Ríos, Ramón; David, Anthony S.; Dutta, Rina

doi:10.1016/j.comppsych.2011.05.015

Cited by 63 publications

(45 citation statements)

References 55 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Further, this is in agreement with a recent systematic review carried by López-Moríñigo and coworkers 2 , who concluded that if any relationship exists between insight and suicidal behavior in psychotic patients, it may be related to other clinical variables, such as depressive symptoms.…”

Section: Discussionsupporting

confidence: 78%

See 1 more Smart Citation

Awareness of illness and suicidal behavior in delusional disorder patients

Molina-Andreu¹,

González-Rodríguez²,

Villanueva³

et al. 2014

Arc. Clin. Psychiatr.

View full text Add to dashboard Cite

Background:The relationship between insight and suicidal behavior among psychotic patients is poorly studied and possibly mediated by clinical variables. Objectives: Our goal was to investigate clinical differences in suicidal and non-suicidal delusional disorder (DD) patients, and to evaluate the relationship between insight, psychotic and depressive symptoms. Methods: Cross-sectional study in 64 consecutive DD patients. For assessment, we used the Positive and Negative Syndrome Scale (PANSS), the Hamilton Rating Scale for Depression (HRSD-17), the Columbia Suicide Severity Rating Scale (C-SSRS), the Personal and Social Performance Scale (PSP), and the first three items of the SUMD scale for insight. The sample was divided according to the presence of suicide attempts. To investigate psychopathological associations, bivariate correlation coefficients were used. Age at onset served as covariate in subsequent analyses. Results: Suicidal DD patients had higher depressive symptoms and were more frequently admitted than non-suicidal patients. A logistic regression model confirmed that insight, depressive symptoms and age at onset were predictors of suicidal behavior. Unawareness of the effects of medication was negatively related to depressive symptoms. After adjustment, depressive symptoms were weakly correlated to better insight into the effects of medication. No other statistically significant correlations were found. Discussion: Depressive symptoms, insight and age at onset of disease may be potential predictors of suicidal behavior in DD patients.

show abstract

Section: Discussionsupporting

confidence: 78%

“…The vast majority of scientific literature has defined insight as a multidimensional concept that includes awareness of a mental illness, recognition of the need for medication, awareness of the social consequences, and awareness of the presence of psychotic symptoms and the attribution of symptoms to the illness 2 .…”

Section: Introductionmentioning

confidence: 99%

Awareness of illness and suicidal behavior in delusional disorder patients

Molina-Andreu¹,

González-Rodríguez²,

Villanueva³

et al. 2014

Arc. Clin. Psychiatr.

View full text Add to dashboard Cite

show abstract

“…insight as a risk factor for suicide) and negative studies (i.e. insight behaving as a protective factor for suicide) (Lopez-Morinigo et al, 2012). Moreover, findings from a recent 1-year follow-up first-episode psychosis (FEP) study suggest that this relationship may change over the course of the illness.…”

Section: Introductionmentioning

confidence: 97%

“…the so-called demoralization syndrome Crumlish et al, 2005;Restifo et al, 2009). One possible explanation for these mixed findings may be related to the unidimensional approach to insight taken by some of these studies (Lopez-Morinigo et al, 2012) since over the last two decades insight has been demonstrated to be a multidimensional phenomenon (David et al, 1990;Amador et al, 1991;Amador and David, 2004), including: 1) awareness of having a mental disorder, 2) awareness of the effects of medication, 3) awareness of the social consequences of disorder, and 4) the ability to relabel psychotic experiences as abnormal. In keeping with this, two clinical rater-based scales to assess insight multidimensionally have been validated to date: the Scale of Unawareness of Mental Disorder (SUMD) (Amador et al, 1991) and the Scale for Assessment of Insight (SAI) (David, 1990) and its expanded version (SAI-E) (Kemp and David, 1997).…”

Section: Introductionmentioning

confidence: 99%

Insight and suicidality in psychosis: A cross-sectional study

Massons

López-Moriñigo

Pousa

et al. 2017

Psychiatry Research

Self Cite

View full text Add to dashboard Cite

Insight and suicidality in psychosis: A crosssectional study, Psychiatry Research, http://dx.doi.org/10.1016Research, http://dx.doi.org/10. /j.psychres.2017 This is a PDF file of an unedited manuscript that has been accepted for publication. As a service to our customers we are providing this early version of the manuscript. The manuscript will undergo copyediting, typesetting, and review of the resulting galley proof before it is published in its final citable form. Please note that during the production process errors may be discovered which could affect the content, and all legal disclaimers that apply to the journal pertain. Insight scale total score and two specific domains (awareness of "disturbed thinking and loss of control over the situation" and "having a vague feeling that something is wrong") were related to suicidality. However, no insight dimensions survived the multivariable regression model, which found depression and previous suicidal behaviour to predict suicidality. Conclusions: Suicidality in psychosis was linked with some insight dimensions: awareness of mental illness and awareness of social consequences, but not compliance. Depression and previous suicidal behaviour mediated the associations with insight; thus, predicting suicidality.

show abstract

“…These include increased thought disorder (Bakst et al, 2010), increased insight into illness (Barrett, Sundet, Faerden, Agartz, et al, 2010;Lopez-Morinigo, Ramos-Rios, David, & Dutta, 2012;Robinson et al, 2009), longer duration of untreated illness (Altamura, Bassetti, Bignotti, Pioli, & Mundo, 2003), and negative beliefs about psychosis (Barrett, Sundet, Faerden, Agartz, et al, 2010). Research conducted into suicide risk in the very early stages of psychosis prior to first presentation to services has found that, in addition to the above-mentioned risk factors, younger age at onset and longer duration of untreated psychosis are associated with increased risk of DSH and suicidal ideation before first presentation (Altamura et al, 2003;Barrett, Sundet, Faerden, Nesvag, et al, 2010;Clarke et al, 2006;Harvey et al, 2008).…”

Section: Risk Factors For Suicidementioning

confidence: 99%

Future‐directed thinking in first‐episode psychosis

Goodby

MacLeod

2015

British J Clinic Psychol

View full text Add to dashboard Cite

ObjectivesThis study employed the Future Thinking Task (MacLeod et al., 2005, Br. J. Clin. Psychol., 44, 495) to investigate whether future‐directed thinking in first‐episode psychosis is significantly different from that of matched controls, and to identify its correlates in this patient group.DesignCross‐sectional, mixed‐model, case–control design.MethodParticipants were 30 patients with first‐episode psychosis and 27 matched controls. The Future Thinking Task was used to assess future‐directed thinking in both groups. Anxiety and depression were also measured as well as self‐report measures of hopelessness, suicide ideation and a measure of negative symptoms.ResultsIndividuals with psychosis were impaired in future‐directed thinking in both positive and negative domains, particularly with respect to the coming year. Increased self‐reported hopelessness was associated with reduced positive future thinking and increased negative future thinking. Increased positive future thinking was also associated with reduced severity of negative symptoms, whilst negative future thinking was associated with suicide ideation.ConclusionsIndividuals with first‐episode psychosis show a reduction in positive future thinking in line with that seen in other clinical groups, but this is accompanied by an unexpected reduction in negative future thinking. The findings suggest a general disengagement with the future in this group that may affect recovery and functioning.Practitioner points Individuals with first‐episode psychosis may benefit from interventions to help them engage with their future, in particular in the mid‐range, up to 1 year. The Future Thinking Task may be a helpful addition to the assessment of suicide risk in those with first‐episode psychosis. Decreased positive future thinking was associated with increased severity of negative symptoms, indicating a potential new treatment angle for this resistant aspect of psychosis. The cross‐sectional design of this study does not allow for conclusions about the causal relationship between psychosis and future‐directed thinking. This study investigated future‐directed thinking in individuals with a range of psychotic illnesses employing a trans‐diagnostic approach; therefore, conclusions cannot be drawn about the nature of future‐directed thinking in individual psychotic disorders.

show abstract

Insight in schizophrenia and risk of suicide: a systematic update

Cited by 63 publications

References 55 publications

Awareness of illness and suicidal behavior in delusional disorder patients

Awareness of illness and suicidal behavior in delusional disorder patients

Insight and suicidality in psychosis: A cross-sectional study

Future‐directed thinking in first‐episode psychosis

Contact Info

Product

Resources

About