Is Suicidal Ideation Always a Symptom of a Psychiatric Disorder?

Comprehensive Psychiatry, 2000

Schizophrenia Research, 2015

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

Comprehensive Psychiatry, 1994

10% of schizophrenics commit suicide, little is known about the clinical correlates of this behavior. This study investigated the relationships between suicidal ideation, anxiety, and psychosis in a group of schizophrenic and schizoaffective patients with operationally defined cases of postpsy-chotic depression. Psychosis contributed to the variance in suicidal ideation over and above the effects of depression and anxiety. Treatment and research implications of this finding are discussed.

Clinical psychology & psychotherapy, 2016

Although suicide is one of the leading causes of death worldwide, there is a need for studies to identify variables that can differentiate patients with suicide ideation at risk of transitioning to an attempt. In this study, we assessed suicide ideation and attempts, non-suicidal self-injury (NSSI), hopelessness, borderline symptoms and meaning in life in a sample of 348 patients with different diagnoses of mental disorders. We divided the sample into four subgroups: patients without suicide ideation or suicide attempts; patients with current suicide ideation; patients with lifetime suicide attempts and patients with a suicide attempt in the previous year. The group with suicide attempts in the previous year showed higher levels of hopelessness, borderline symptoms and NSSI, and lower levels of meaning in life than the other groups. Groups were composed of unequal numbers of patients, and in some of them, the sample size was small. The sample was composed mainly of women with eating...

Eastern Journal of Psychiatry

Mental illness has been reported as one of the major factors associated with suicide. Present the study was conducted to assess the prevalence and nature of suicidal ideation among hospitalized psychiatric patients. This is a center based prevalence study, conducted in Ranchi Institute of Neuro-Psychiatry and Allied Sciences, Ranchi. Adult Suicidal Ideation Questionnaire and Brief Psychiatric Rating Scale were administered to 300 hospitalized psychiatric patients who were able to comprehend instruction of scales. Findings show that 16.4% patients had suicidal ideation. Among socio-demographic and clinical correlates only psychopathology was significantly correlated with suicidal ideation. Majority of patients having suicidal ideation had mood disorder.

Journal of affective disorders, 2012

BACKGROUND: Suicidal ideation is common in depression, but only moderately related to depression severity - in part because certain clusters of symptoms, such as those related to core mood disturbance, have a differential relationship to suicidal thinking. METHODS: 400 medication free participants with current major depression were assessed with either or both the Hamilton Depression Rating Scale (HDRS, n=396) and Beck Depression Inventory (BDI, n=366), and the Scale for Suicide Ideation (SSI). Depression rating scales were decomposed into symptoms clusters previously reported (Grunebaum et al., 2005), in order to evaluate their association to suicidal thinking. RESULTS: Correlations between overall depression severity ratings and the measure of suicidal ideation were modest, and reduced when specific items assessing suicidal thinking on these depression scales were removed. Symptom clusters assessing Psychic Depression (HDRS), Subjective Depression (BDI), and Self-Blame (BDI) were ...

Psychiatric Services, 2018

Objective-People with psychotic disorders are at high risk for suicidal behavior. We evaluated whether response to item 9 of the Patient Health Questionnaire or PHQ9 (regarding thoughts of death or self-harm) predicts subsequent suicidal behavior in outpatients with diagnoses of psychotic disorders. Methods-Electronic health records from seven large integrated health systems were used to identify all outpatient visits by adults with a diagnosis of schizophrenia-spectrum psychosis or unspecified psychosis between 1/1/2009 and 6/30/2015 during which a PHQ9 depression questionnaire was completed (n=32,982 visits by 5947 patients). Suicide attempts over the 90 days following each visit were ascertained from EHRs and insurance claims. Suicide deaths were ascertained by linkage to state death certificate files. Results-Risk of suicide attempt within 90 days of an outpatient visit increased from 0.8% among those reporting thoughts of death or self-harm "not at all" to 3.5% among those reporting such thoughts "nearly every day". Over 90 days of follow-up, 47% of suicide attempts occurred among those reporting any recent thoughts of death or self-harm at the sampled visit. 59% of suicide attempts occurred among those reporting thoughts of death or self-harm at the index visit or any visit in the prior year. The number of suicide deaths within 90 days (n=10) was too small to accurately assess the relationship between response to PHQ9 item 9 and subsequent suicide death.

2000

The present study examined the relative contribution of diagnostic and psychosocial factors to the prediction of severity of suicidal ideation in a sample of 78 college students. Using hierarchical regression analyses to control for each set of factors, psychosocial variables were found to consistently predict level of suicidal ideation. In contrast, diagnostic variables including diagnosis of substance abuse and composite scores for depression and anxiety were unrelated to level of suicidality. An examination of individual diagnoses revealed no predictable relationships with severity of suicidality in this population. The results were discussed from several methodological viewpoints.

Schizophrenia Bulletin, 1998

The objective of this study was to predict suicidality in people with schizophrenia. Ninety-six patients with recent-onset schizophrenia were rated every 2 weeks for 1 year to examine (1) the temporal course of suicidal ideation and suicide attempts and (2) the extent to which anxiety, depression, and mild suicidal ideation were followed by significant suicidal ideation or a suicide attempt. The severity of suicidality changed rapidly. Low levels of suicidal ideation increased the risk for significant suicidal ideation or a suicide attempt during the subsequent 3 months. Depression was moderately correlated with concurrent suicidality, but not independently associated with future suicidality. Therefore, low levels of suicidal ideation may predict future suicidal ideation or behavior better than depressed mood in individuals with schizophrenia.

Research Square (Research Square), 2022

Introduction : Although the risk of suicide is high in rst-episode psychosis (FEP), little is known about the course of suicidal ideation and its relation with suicide attempts. Therefore, we aimed to identify ve-year trajectories of suicidal ideation and associated factors in FEP and compare how suicide attempts were distributed across these identi ed trajectories. Methods This ve-year prospective study assessed suicidal ideation, suicide attempts and potentially associated factors through research interviews, chart review and coroners' reports in 382 FEP patients [mean age = 23.53(SD = 3.61)] admitted to two ve-year early psychosis services in Montreal, Canada. Trajectories were identi ed using a semiparametric mixture model, and associated factors with multinomial logistic regression. Results Three suicidal ideation trajectories were identi ed: low and decreasing (85.08%); early decline, then increasing (7.85%), and persistent suicidal ideation (7.07%). Suicidal ideation prior to admission (OR = 2.85,p < 0.05) and cocaine use disorder (OR = 6.78,p < 0.05) were associated with the early decline, then increasing suicidal ideation trajectory. Persons with prior suicide ideation (OR = 4.33,p < 0.05) and attempts (OR = 8.18,p < 0.001) and alcohol use disorder (OR = 3.63, p < 0.05) were more likely to belong to the persistent suicidal ideation trajectory, and to attempt suicide during follow-up. Conclusion Our study highlights heterogeneity in the course of suicidal ideation over ve years and the importance of ongoing assessment of suicidal risk in FEP patients, particularly during periods of transition to other services and for patients who persistently report suicidal ideation, as they are likelier to engage in suicide attempts. Patients with factors associated with increased or persistent suicidal ideation trajectories should be targeted for suicide prevention interventions.