Suicidal ideation and behaviour in patients with persecutory delusions: Prevalence, symptom associations, and psychological correlates.


Journal

Comprehensive psychiatry
ISSN: 1532-8384
Titre abrégé: Compr Psychiatry
Pays: United States
ID NLM: 0372612

Informations de publication

Date de publication:
08 2019
Historique:
received: 23 03 2019
revised: 08 06 2019
accepted: 05 07 2019
pubmed: 19 7 2019
medline: 29 4 2020
entrez: 19 7 2019
Statut: ppublish

Résumé

To determine the prevalence of suicidal ideation and behaviour - and their correlates - in patients with persecutory delusions. 110 patients with persecutory delusions in the context of non-affective psychosis were assessed for suicidal thoughts and behaviours over the past month. Symptom and psychological assessments were also completed. The severity of suicidal ideation was: no suicidal ideation (n = 26, 23.6%); wish to be dead (n = 21, 19.1%); nonspecific active suicidal thoughts (n = 14, 12.7%); suicidal thoughts with methods but no intent (n = 29, 26.4%); suicidal thoughts with intent but no specific plan (n = 13, 11.8%); and suicidal intent with plan (n = 7, 6.4%). In the past month, five patients (4.5%) had made an actual, interrupted, or aborted suicide attempt. The severity of suicidal ideation was associated with higher levels of depression, paranoia, hallucinations, anger, insomnia, negative beliefs about the self and others, pessimism, worry, and delusion safety-seeking behaviours and lower levels of psychological well-being and reward responsiveness. Severity of ideation was not associated with cannabis or alcohol use, working memory, pain, or meaningful activity levels. Patients with persecutory delusions are typically in a severe state of psychological stress, and at risk of suicide, as indicated by very high levels of suicidal ideation. This exploratory study also identifies correlates of suicidal ideation that could be investigated in causal research designs.

Sections du résumé

BACKGROUND
To determine the prevalence of suicidal ideation and behaviour - and their correlates - in patients with persecutory delusions.
METHODS
110 patients with persecutory delusions in the context of non-affective psychosis were assessed for suicidal thoughts and behaviours over the past month. Symptom and psychological assessments were also completed.
RESULTS
The severity of suicidal ideation was: no suicidal ideation (n = 26, 23.6%); wish to be dead (n = 21, 19.1%); nonspecific active suicidal thoughts (n = 14, 12.7%); suicidal thoughts with methods but no intent (n = 29, 26.4%); suicidal thoughts with intent but no specific plan (n = 13, 11.8%); and suicidal intent with plan (n = 7, 6.4%). In the past month, five patients (4.5%) had made an actual, interrupted, or aborted suicide attempt. The severity of suicidal ideation was associated with higher levels of depression, paranoia, hallucinations, anger, insomnia, negative beliefs about the self and others, pessimism, worry, and delusion safety-seeking behaviours and lower levels of psychological well-being and reward responsiveness. Severity of ideation was not associated with cannabis or alcohol use, working memory, pain, or meaningful activity levels.
CONCLUSIONS
Patients with persecutory delusions are typically in a severe state of psychological stress, and at risk of suicide, as indicated by very high levels of suicidal ideation. This exploratory study also identifies correlates of suicidal ideation that could be investigated in causal research designs.

Identifiants

pubmed: 31319194
pii: S0010-440X(19)30031-8
doi: 10.1016/j.comppsych.2019.07.001
pii:
doi:

Types de publication

Journal Article Research Support, Non-U.S. Gov't

Langues

eng

Sous-ensembles de citation

IM

Pagination

41-47

Subventions

Organisme : Department of Health
ID : RP-2014-05-003
Pays : United Kingdom

Informations de copyright

Copyright © 2019 The Author(s). Published by Elsevier Inc. All rights reserved.

Auteurs

Daniel Freeman (D)

Department of Psychiatry, University of Oxford, UK; Oxford Health NHS Foundation Trust, UK. Electronic address: daniel.freeman@psych.ox.ac.uk.

Emily Bold (E)

Department of Psychiatry, University of Oxford, UK.

Eleanor Chadwick (E)

Department of Psychiatry, University of Oxford, UK.

Kathryn M Taylor (KM)

Department of Psychiatry, University of Oxford, UK.

Nicola Collett (N)

Department of Psychiatry, University of Oxford, UK; Oxford Health NHS Foundation Trust, UK.

Rowan Diamond (R)

Department of Psychiatry, University of Oxford, UK; Oxford Health NHS Foundation Trust, UK.

Emma Černis (E)

Department of Psychiatry, University of Oxford, UK; Oxford Health NHS Foundation Trust, UK.

Jessica C Bird (JC)

Department of Psychiatry, University of Oxford, UK; Oxford Health NHS Foundation Trust, UK.

Louise Isham (L)

Department of Psychiatry, University of Oxford, UK; Oxford Health NHS Foundation Trust, UK.

Ava Forkert (A)

Department of Psychiatry, University of Oxford, UK; Oxford Health NHS Foundation Trust, UK.

Lydia Carr (L)

Department of Psychiatry, University of Oxford, UK.

Chiara Causier (C)

Department of Psychiatry, University of Oxford, UK.

Felicity Waite (F)

Department of Psychiatry, University of Oxford, UK; Oxford Health NHS Foundation Trust, UK.

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