“Psychotic experiences are reported by 5% to 8% of the general adult population,” wrote Kathryn Yates, M.Sc., of the Department of Psychiatry at the Royal College of Surgeons in Ireland and colleagues. “While initial research focused on an increased risk for psychotic disorder in individuals who report PEs [psychotic experiences], much subsequent research has demonstrated that PEs are associated with high risk for a broad range of mental disorders and poor mental health outcomes in general.”
Yates and colleagues conducted a systematic review and meta-analysis of 10 longitudinal population studies that examined the association between psychotic experiences and subsequent suicidal ideation, suicide attempts, and/or death by suicide. The studies included 84,285 people from 23 countries. The follow-up periods for the studies ranged from one month to 27 years.
The researchers found that individuals who reported psychotic experiences had an increase in the odds of future suicidal ideation (odds ratio, 2.39), future suicide attempt (odds ratio, 3.15), and future death by suicide (odds ratio, 4.39).
To investigate whether co-occurring psychopathology fully mediated the association between psychotic experiences and suicidal behaviors, Yates and colleagues conducted a secondary analysis of three studies on the association between psychotic experiences and suicidal ideation. In these three studies, the authors reported adjusted odds ratios for co-occurring psychopathology; the pooled odds ratio was 1.59. Yates and colleagues also analyzed data from five studies on the association between psychotic experiences and suicide attempt. In these five studies, the authors reported adjusted odds ratios for co-occurring psychopathology; the pooled odds ratio was 2.68.
“Our findings suggest that there is a psychosis-associated subtype of suicidal behavior that extends well beyond the previously established association between psychotic disorder and suicidal behavior,” the researchers wrote. “Further research is necessary to understand whether specific types of PEs (for example, perceptual abnormalities versus unusual thought content) are more closely associated with suicidal behavior, whether suicidal behavior is a risk factor for later PEs (in addition to PEs being a risk marker for later suicidal behavior), and the interplay between the many potential mechanisms that contribute to the PE-suicidality association.”
For related information, see the Psychiatric News article “Hallucinations Can Be Marker for Variety of Psychiatric Disorders in Youth.”