This article is more than 5 years old. Information may no longer be current.

Psychosis predicts suicide thoughts, plans, attempts

Psychotic experiences were significant predictors of subsequent suicidal thoughts, plans and attempts, regardless of mental health history, and particularly among children.

“Prior studies suggest that psychotic experiences are associated with an elevated risk of suicidal thoughts and behaviors,” Evelyn J. Bromet, PhD, of Stony Brook University School of Medicine, New York, and colleagues wrote. “Worryingly, prospective studies of school-aged children have reported strong associations between [psychotic experiences] and suicide attempts, with children with [psychotic experiences] having an approximately 11-fold increased odds of suicide attempts during the following 12 months compared with those without [psychotic experiences].”

To evaluate a temporal association between psychotic experiences and subsequent suicidal thoughts and behaviors, researchers analyzed data from WHO World Mental Health Surveys for 33,370 adult respondents from 19 countries. The cohort included 2,488 individuals with psychotic experiences.

Participants with psychotic experiences had lifetime prevalence of 28.5% for suicidal ideation 10.8% for suicidal plans; and 10.2% for suicide attempts.

After adjusting for previous or intervening mental disorders, participants with one or more psychotic experiences had 2-fold increased risk subsequent suicidal ideation (OR = 2.2; 95% CI, 1.8-2.6); plans (OR = 2.1; 95% CI, 1.7-2.6); and attempts (OR = 1.9; 95% CI, 1.5-2.5).

Researchers found significant dose-response relationships between number of psychotic experience types and subsequent suicidal ideation and behaviors. This remained after adjusting for mental disorders.

Psychotic experiences were significant predictors of subsequent suicidal ideation and behaviors, particularly among participants aged 12 years and younger.

After adjusting for previous mental disorders, temporally prior psychotic experiences were associated with overall population attributable risk proportions of 5.3% for lifetime suicidal ideation; 5.7% for lifetime suicidal plans; and 4.8% for lifetime suicide attempts.

“From a public health perspective, we speculate that the inclusion of [psychotic experience] items in routine screening tools could improve the prediction of suicide risk. Our study lends additional weight to the call for the routine inclusion of [psychotic experience] items when assessing [suicidal thoughts and behaviors] in both research and clinical settings,” the researchers concluded. – by Amanda Oldt

Disclosures: Bromet reports no relevant financial disclosures. Please see the study for a full list of relevant financial disclosures.