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Psychotic experiences predict risk for future suicidal behavior

Results from a systematic review and meta-analysis of longitudinal population studies revealed that individuals with psychotic experiences were at higher risk for future suicidal ideation, suicide attempts and suicide death.

“A striking finding in recent research on [psychotic experiences] has been the strong association with suicidal behavior,” Kathryn Yates, MSc, from the department of psychiatry, Royal College of Surgeons in Ireland, and colleagues wrote in JAMA Psychiatry. “In the past 5 years, there have been many studies to investigate the risk of suicidal behavior in individuals who report having [psychotic experiences].”

Researchers conducted a systematic review and meta-analysis of longitudinal prospective studies on psychotic experiences and subsequent suicidal ideation, suicide attempts and suicide death in general population samples with at least one follow-up point. They calculated pooled ORs using a random-effects model and examined the mediating role of co-occurring psychopathology in a secondary analysis.

In total, 10 studies encompassing 84,285 participants from 12 different samples and 23 countries with follow-up periods ranging from 1 month to 27 years were included in analysis.

Yates and colleagues found that people in the general population who reported psychotic experiences had more than a twofold increased risk for future suicidal ideation (n = 56,191; OR = 2.39 [95% CI, 1.62-3.51]). Individuals with psychotic experiences were at more than three times the risk for future suicide attempt (n = 66,967; OR = 3.15 [95%CI, 2.23-4.45]), and more than four times the risk for future suicide death (n = 15,049; OR = 4.39 [95% CI, 1.63-11.78]).

When examining psychopathology as a mediator of the association between psychotic experiences and risk for suicidal behavior, the investigators found that this increased risk was more than that explained by co-occurring psychopathology for suicidal ideation (adjusted OR = 1.59; 95% CI, 1.09-2.32) and suicide attempt (adjusted OR = 2.68; 95% CI, 1.71-4.21).

Yates and colleagues concluded that further research is needed to understand:

• if any specific type of psychotic experiences may be more closely tied to suicidal behavior;
• whether suicidal behavior is a risk factor for subsequent psychotic experiences; and
• how potential mechanisms contribute to the psychotic experience/suicidality relationship. – by Savannah Demko

Disclosure: The authors report no relevant financial disclosures.