Suicidal ideation in individuals at ultra‐high risk for psychosis and its association with suspiciousness independent of depression

Bang, Minji; Park, Jin Y.; Kim, Kyung Ran; Lee, Su Young; Song, Yoo Sung; Kang, Jee In; Lee, Eun; An, Suk Kyoon

doi:10.1111/eip.12517

Cited by 19 publications

(24 citation statements)

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“…In this regard, positive correlations were found between BDI‐II item 9 score and three main psychopathological features: (1) depression severity (both in its cognitive and somatic‐affective components), (2) some specific items of the CAARMS related to Huber's basic symptoms (BS) (i.e., subjective emotional disturbance, subjective complaints of impaired autonomic functioning, and subjective tolerance to normal stress), and (3) CAARMS factor 1 (“Negative‐interpersonal dimension”). Differently from some previous studies (Bang et al., ; Gill et al., ; Niendam et al., ), this pattern coheres with findings of a previous study (Gill et al., ), who showed higher depression severity in UHR individuals with suicidal ideation in comparison with those without suicidal ideation. Moreover, in the current study, more severe levels of depressive symptoms correctly were the single most important psychopathological factor that predicted suicidal ideation in UHR+ adolescents (75% of correct dichotomized BDI‐II item 9 ascription in the logistic regression model).…”

Section: Discussionsupporting

confidence: 84%

“…Differently, Bang et al. () recently found that suicidal thinking severity in UHR subjects was significantly associated with experiences of suspiciousness, as measured in the Structured Interview for Psychosis‐risk Syndromes (SIPS) (McGlashan et al., ), independent of depressive symptoms.…”

Section: Discussionmentioning

confidence: 99%

“…Obviously, understanding suicidality in adolescents at UHR (as compared to FEP and generic help‐seeking) is important to rationalize service provision and optimize targeted youth mental health (Raballo, Poletti, & McGorry, ; Taylor et al., ). Indeed, identifying a heightened risk for suicide might be more urgent than the risk of developing full‐blown psychosis at first psychiatric contact (Bang et al., ).…”

mentioning

confidence: 99%

“…(2) Brief Limited Intermittent Psychotic Symptoms (BLIPS), which are transient psychotic symptoms that spontaneously remit within 1 week; and (3) Genetic Risk and Functioning Deterioration Syndrome (GRFD), a trait/state risk condition in which the individual has a family history of psychosis (in first-degree relatives) or manifests schizotypal personality disorder along with low functioning sustained for ≤ 1 month (Yung et al, 2005). These UHR subgroups present distinct meta-analytical prevalences and longitudinal risk of transition to psychosis (Fusar-Poli et al, 2016), although evidence is less robust in children and adolescents.…”

mentioning

confidence: 99%

“…Assessing suicidality in this population is crucial because psychotic experiences are associated with increased longitudinal rates of suicidal thoughts and behaviors (Bromet et al, 2017), and suicide risk is known to be clinically relevant in first-episode psychosis (FEP) (Pompili et al, 2011), with a meta-analytical estimation of 4.9% of lifetime suicide rate in schizophrenic subjects (Palmer, Pankratz, & Bostwick, 2005). A recent meta-analysis on suicide in UHR individuals reported a previous 2-week prevalence of 66.08%, a lifetime prevalence of 48.61% and a lifetime suicide attempt prevalence of 17.74% (Taylor, Hutton, & Wood, 2015).…”

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confidence: 99%

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Suicidal Thinking and Behavior in Adolescents at Ultra‐High Risk of Psychosis: A Two‐year Longitudinal Study

Pelizza

Poletti

Azzali

et al. 2019

Suicide & Life Threat Behav

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Objective Suicide risk in subjects at Ultra‐High Risk of psychosis (UHR) has been rarely assessed in adolescence, but it is of obvious importance for prognostic and clinical care reasons. In this study, we aimed to prospectively assess suicide risk and behaviors in UHR adolescents. Method We examined 112 help‐seeking adolescents (13–18 years, 50% males, 83.9% Caucasian) that were enrolled in the Reggio Emilia At‐Risk Mental States (ReARMS) project and followed up for 2 years. Specific items derived from the Comprehensive Assessment of At‐Risk Mental States (CAARMS) and the Beck Depression Inventory‐II (BDI‐II) were used to assess suicide risk. Suicide attempts and completed suicides were also recorded. Results Baseline assessment detected 40 UHR adolescents, 32 FEP (first‐episode psychosis), and 40 non‐UHR/FEP. We found that 67.5% of UHR adolescents had suicidal ideation, and 18.5% to severe degree. Attempted suicide before enrollment was higher in the UHR group than in non‐UHR/FEP peers (17.5% vs. 2.5%). BDI‐II suicidal ideation severity was stable at 12‐month follow‐up and decreased at 24‐month follow‐up. Conclusions A high prevalence of suicidal ideation among UHR adolescents was found and supports the routine monitoring of risk of self‐injurious thinking and behavior in this at‐risk population.

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Section: Discussionsupporting

confidence: 84%

Section: Discussionmentioning

confidence: 99%

mentioning

confidence: 99%

mentioning

confidence: 99%

mentioning

confidence: 99%

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Suicidal Thinking and Behavior in Adolescents at Ultra‐High Risk of Psychosis: A Two‐year Longitudinal Study

Pelizza

Poletti

Azzali

et al. 2019

Suicide & Life Threat Behav

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Lifetime Suicide Attempts in Otherwise Psychiatrically Healthy Individuals

Oquendo,

Wall,

Wang

et al. 2024

JAMA Psychiatry

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ImportanceNot all people who die by suicide have a psychiatric diagnosis; yet, little is known about the percentage and demographics of individuals with lifetime suicide attempts who are apparently psychiatrically healthy. If such suicide attempts are common, there are implications for suicide risk screening, research, policy, and nosology.ObjectiveTo estimate the percentage of people with lifetime suicide attempts whose first attempt occurred prior to onset of any psychiatric disorder.Design, Setting, and ParticipantsThis cross-sectional study used data from the US National Epidemiologic Study of Addictions and Related Conditions III (NESARC-III), a cross-sectional face-to-face survey conducted with a nationally representative sample of the US civilian noninstitutionalized population, and included persons with lifetime suicide attempts who were aged 20 to 65 years at survey administration (April 2012 to June 2013). Data from the NESARC, Wave 2 survey from August 2004 to September 2005 were used for replication. Analyses were performed from April to August 2023.ExposureLifetime suicide attempts.Main Outcomes and MeasuresThe main outcome was presence or absence of a psychiatric disorder before the first lifetime suicide attempt. Among persons with lifetime suicide attempts, the percentage and 95% CI of those whose first suicide attempt occurred before the onset of any apparent psychiatric disorders was calculated, weighted by NESARC sampling and nonresponse weights. Separate analyses were performed for males, females, and 3 age groups (20 to &lt;35, 35-50, and &gt;50 to 65 years).ResultsIn the total sample of 36 309 respondents, 1948 persons had lifetime suicide attempts; 66.8% (95% CI, 64.1%-69.4%) were female, and 6.2% (95% CI, 4.9%-7.4%) had no apparent lifetime psychiatric diagnoses when surveyed. In addition, 13.4% (95% CI, 11.6%-15.2%) made their first suicide attempt prior to psychiatric disorder onset. Thus, an estimated 19.6% of respondents first attempted suicide without an antecedent psychiatric disorder. No significant age or sex differences were detected in the percentage of those with lifetime suicide attempts absent psychiatric disorders, although females were more likely than males to attempt suicide in the year of psychiatric disorder onset (14.9% [95% CI, 12.5%-17.3%] vs 8.6% [95% CI, 6.0%-11.2%]; P &lt; .001), and attempts were less frequent among those older than 50 to 65 years (3.9% [95% CI, 3.5%-4.4%] vs 6.1% [95% CI, 5.4%-6.8%] for 35-50 years and 6.2% [95% CI, 5.6%-6.9%] for 20 to &lt;35 years; P &lt; .001).Conclusions and RelevanceIn this study, an estimated 19.6% of individuals who attempted suicide did so despite not meeting criteria for an antecedent psychiatric disorder. This finding challenges clinical notions of who is at risk for suicidal behavior and raises questions about the safety of limiting suicide risk screening to psychiatric populations.

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Reliability, Validity, Epidemiology, and Cultural Variation of the Structured Interview for Psychosis-Risk Syndromes (SIPS) and the Scale of Psychosis-Risk Symptoms (SOPS)

Woods

Walsh

PowersIII

et al. 2019

Handbook of Attenuated Psychosis Syndrome Across Cultures

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Suicidal ideation in individuals at ultra‐high risk for psychosis and its association with suspiciousness independent of depression

Cited by 19 publications

References 50 publications

Suicidal Thinking and Behavior in Adolescents at Ultra‐High Risk of Psychosis: A Two‐year Longitudinal Study

Suicidal Thinking and Behavior in Adolescents at Ultra‐High Risk of Psychosis: A Two‐year Longitudinal Study

Lifetime Suicide Attempts in Otherwise Psychiatrically Healthy Individuals

Reliability, Validity, Epidemiology, and Cultural Variation of the Structured Interview for Psychosis-Risk Syndromes (SIPS) and the Scale of Psychosis-Risk Symptoms (SOPS)

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