Tuesday, March 10, 2015

Psychotic Experiences Appear to Predict Suicidal Behavior, Study Shows

Individuals with psychiatric disorders reporting psychotic experiences are more likely to report concurrent suicidal ideation and suicide attempts than those who do not report psychotic experiences, according to a study that appears online in JAMA Psychiatry.

Psychotic experiences were especially prevalent among individuals reporting severe attempts and may account for nearly one-third of attempts with intent to die in the United States annually, according to the report.

Researchers from Columbia University, the New York State Psychiatric Institute, and the University of Maryland School of Social Work examined the association between 12-month suicidality and 12-month psychotic experiences. Cross-sectional survey data were drawn from a large general population-based sample of adult household residents (n=11,716) in the United States identified through the Collaborative Psychiatric Epidemiology Surveys (2001-2003). The statistical analysis was adjusted for potential demographic confounders and co-occurring DSM-IV mental health conditions.

The researchers found that individuals reporting psychotic experiences were approximately five times more likely to report suicidal ideation and nearly 10 times more likely to report a suicide attempt during a 12-month period. The mean 12-month prevalence of suicide attempts among individuals reporting ideation and psychotic experiences and meeting criteria for any psychiatric disorder was 47.4 percent compared with 18.9 percent among those with just ideation and a disorder.

In contrast, depressive, anxiety, and substance use disorders did not reliably identify those at risk for attempts among respondents with suicidal ideation.

In comments to Psychiatric News, immediate past APA President Jeffrey Lieberman, M.D., a coauthor of the study, noted that the increased risk for suicidal ideation and suicide attempts was especially high among people aged 18 to 29, whether or not these young people had a primary diagnosis of psychotic disorder. The fact that they reported psychotic experiences even in the context of such disorders as anxiety, depression, and substance abuse (as opposed to schizophrenia and bipolar disorder) indicates that this is a significant risk factor in and of itself. 

“This study of a community-based epidemiological sample identified psychotic experience as a predictor of suicidal behavior in young people in particular,” he said. “This finding can be considered an important risk factor for suicide in youth in the context of a wide range of mental disorders and can be applied in clinical practice."

For more information see the Psychiatric News article, "Teens' Psychotic Symptoms Strongly Associated With Suicidal Behavior."

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