Insight and risk of suicidal behaviour in two first-episode psychosis cohorts: Effects of previous suicide attempts and depression
The role of insight dimensions – illness recognition (IR), symptoms relabelling (SR), treatment compliance (TC) - in suicide risk in first-episode psychosis (FEP) remains unclear. The AESOP (n = 181) and GAP (n = 112) FEP cohorts were followed-up over 10- and 5 years. Survival analysis modelled time...
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| Veröffentlicht in: | Schizophrenia research 2019-02, Vol.204, p.80-89 |
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| creator | Lopez-Morinigo, Javier-David Di Forti, Marta Ajnakina, Olesja Wiffen, Benjamin D. Morgan, Kevin Doody, Gillian A. Jones, Peter B. Ayesa-Arriola, Rosa Canal-Rivero, Manuel Crespo-Facorro, Benedicto Murray, Robin M. Dazzan, Paola Morgan, Craig Dutta, Rina David, Anthony S. |
| description | The role of insight dimensions – illness recognition (IR), symptoms relabelling (SR), treatment compliance (TC) - in suicide risk in first-episode psychosis (FEP) remains unclear.
The AESOP (n = 181) and GAP (n = 112) FEP cohorts were followed-up over 10- and 5 years. Survival analysis modelled time to first suicidal event in relation to baseline scores on the Schedule for the Assessment of Insight, whilst adjusting for demographic, clinical, psychopathological and neuropsychological variables.
AESOP: those with previous suicide attempts scored higher on IR (7.6 ± 1.9 vs. 5.9 ± 3.0, p |
| doi_str_mv | 10.1016/j.schres.2018.09.016 |
| format | Article |
| fullrecord | <record><control><sourceid>proquest_cross</sourceid><recordid>TN_cdi_proquest_miscellaneous_2112612200</recordid><sourceformat>XML</sourceformat><sourcesystem>PC</sourcesystem><els_id>S0920996418305747</els_id><sourcerecordid>2112612200</sourcerecordid><originalsourceid>FETCH-LOGICAL-c408t-e273a988f3f7f18a55a6daf44a3f143e02544aad8fcab774c57e324049c5b6033</originalsourceid><addsrcrecordid>eNp9UEtvFDEMjhCILoV_gFCOXGZwHvPigISqQitV4gLnKJs4TJbdyRDPtuqVX05Gu3DsyZb9PeyPsbcCagGi_bCryY0ZqZYg-hqGugyfsY1oOlXJBobnbAODhGoYWn3BXhHtAEA00L1kFwpko_pBbdif24niz3HhdvI8R_rFU-B0jC56u-dbHO19TMfM48SXh8RDzLRUOEdKHvlMj25MFIm7NKa80Ed-HQK6hVaVOePKpbMccrsseJjLcvXyWPZEMU2v2Ytg94RvzvWS_fhy_f3qprr79vX26vNd5TT0xVR2yg59H1Toguht09jW26C1VUFoheWl0lvfB2e3Xadd06GSGvTgmm0LSl2y9yfdOaffR6TFHCI53O_thOVMI4WQrZASoED1CepyIsoYzJzjweZHI8Cs6ZudOaVv1vQNDKYMC-3d2eG4PaD_T_oXdwF8OgGw_HkfMReViJNDH3OJzfgUn3b4C_mAmrU</addsrcrecordid><sourcetype>Aggregation Database</sourcetype><iscdi>true</iscdi><recordtype>article</recordtype><pqid>2112612200</pqid></control><display><type>article</type><title>Insight and risk of suicidal behaviour in two first-episode psychosis cohorts: Effects of previous suicide attempts and depression</title><source>MEDLINE</source><source>Elsevier ScienceDirect Journals</source><creator>Lopez-Morinigo, Javier-David ; Di Forti, Marta ; Ajnakina, Olesja ; Wiffen, Benjamin D. ; Morgan, Kevin ; Doody, Gillian A. ; Jones, Peter B. ; Ayesa-Arriola, Rosa ; Canal-Rivero, Manuel ; Crespo-Facorro, Benedicto ; Murray, Robin M. ; Dazzan, Paola ; Morgan, Craig ; Dutta, Rina ; David, Anthony S.</creator><creatorcontrib>Lopez-Morinigo, Javier-David ; Di Forti, Marta ; Ajnakina, Olesja ; Wiffen, Benjamin D. ; Morgan, Kevin ; Doody, Gillian A. ; Jones, Peter B. ; Ayesa-Arriola, Rosa ; Canal-Rivero, Manuel ; Crespo-Facorro, Benedicto ; Murray, Robin M. ; Dazzan, Paola ; Morgan, Craig ; Dutta, Rina ; David, Anthony S.</creatorcontrib><description>The role of insight dimensions – illness recognition (IR), symptoms relabelling (SR), treatment compliance (TC) - in suicide risk in first-episode psychosis (FEP) remains unclear.
The AESOP (n = 181) and GAP (n = 112) FEP cohorts were followed-up over 10- and 5 years. Survival analysis modelled time to first suicidal event in relation to baseline scores on the Schedule for the Assessment of Insight, whilst adjusting for demographic, clinical, psychopathological and neuropsychological variables.
AESOP: those with previous suicide attempts scored higher on IR (7.6 ± 1.9 vs. 5.9 ± 3.0, p < 0.01) and total insight scores (TIS) (17.2 ± 5.0 vs. 13.4 ± 6.7, p = 0.03). IR (r = 0.23, p < 0.01), SR (r = 0.18, p = 0.04) and TC (r = 0.26, p < 0.01) correlated with depression. Univariable analyses: IR (HR = 1.14, 95% CI = 0.98–1.34, p = 0.09), TC (HR = 1.30, 95% CI = 0.99–1.71, p = 0.06) and TIS (HR = 1.06, 95% CI = 0.99–1.13, p = 0.08) were linked with suicidal behaviour. Multivariable regression models: depression (HR = 1.55, 95% CI = 1.22–1.97, p < 0.01) predicted suicidal behaviour.
GAP: SR (6.4 ± 3.1 vs. 4.5 ± 3.4, p = 0.03) and TIS (16.8 ± 6.4 vs. 12.8 ± 7.4, p = 0.03) were higher in those with suicidal antecedents. IR (r = 0.32, p < 0.01) and SR (r = 0.27, p = 0.01) correlated with depression. Univariable analyses: TC (HR = 1.36, 95% CI = 1.01–1.83, p = 0.04) and TIS (HR = 1.06, 95% CI = 0.99–1.14, p = 0.08) were associated with suicidal behaviour. Multivariable regression models: previous suicide attempts (HR 5.17, 95% CI 1.32–20.29, p = 0.02) and depression (HR 1.16, 95% CI = 1.00–1.35, p = 0.04) predicted suicidal behaviour.
Suicide attempts prior to FEP and depression at that point were associated with baseline insight levels and predicted risk of suicidal behaviour over the follow-up, which was not linked with insight. This may explain the apparent association of insight with suicidality in FEP.</description><identifier>ISSN: 0920-9964</identifier><identifier>EISSN: 1573-2509</identifier><identifier>DOI: 10.1016/j.schres.2018.09.016</identifier><identifier>PMID: 30253893</identifier><language>eng</language><publisher>Netherlands: Elsevier B.V</publisher><subject>Adult ; Awareness - physiology ; Depression ; Depression - epidemiology ; Depression - physiopathology ; Diagnostic Self Evaluation ; Female ; First-episode psychosis ; Follow-Up Studies ; Humans ; Insight ; Male ; Middle Aged ; Psychotic Disorders - epidemiology ; Psychotic Disorders - physiopathology ; Suicidal behaviour risk ; Suicide, Attempted - statistics & numerical data ; Young Adult</subject><ispartof>Schizophrenia research, 2019-02, Vol.204, p.80-89</ispartof><rights>2018</rights><rights>Copyright © 2018. Published by Elsevier B.V.</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c408t-e273a988f3f7f18a55a6daf44a3f143e02544aad8fcab774c57e324049c5b6033</citedby><cites>FETCH-LOGICAL-c408t-e273a988f3f7f18a55a6daf44a3f143e02544aad8fcab774c57e324049c5b6033</cites><orcidid>0000-0002-5818-5103 ; 0000-0003-0570-5352 ; 0000-0002-8427-3617</orcidid></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktohtml>$$Uhttps://www.sciencedirect.com/science/article/pii/S0920996418305747$$EHTML$$P50$$Gelsevier$$H</linktohtml><link.rule.ids>314,776,780,3537,27901,27902,65306</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/30253893$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Lopez-Morinigo, Javier-David</creatorcontrib><creatorcontrib>Di Forti, Marta</creatorcontrib><creatorcontrib>Ajnakina, Olesja</creatorcontrib><creatorcontrib>Wiffen, Benjamin D.</creatorcontrib><creatorcontrib>Morgan, Kevin</creatorcontrib><creatorcontrib>Doody, Gillian A.</creatorcontrib><creatorcontrib>Jones, Peter B.</creatorcontrib><creatorcontrib>Ayesa-Arriola, Rosa</creatorcontrib><creatorcontrib>Canal-Rivero, Manuel</creatorcontrib><creatorcontrib>Crespo-Facorro, Benedicto</creatorcontrib><creatorcontrib>Murray, Robin M.</creatorcontrib><creatorcontrib>Dazzan, Paola</creatorcontrib><creatorcontrib>Morgan, Craig</creatorcontrib><creatorcontrib>Dutta, Rina</creatorcontrib><creatorcontrib>David, Anthony S.</creatorcontrib><title>Insight and risk of suicidal behaviour in two first-episode psychosis cohorts: Effects of previous suicide attempts and depression</title><title>Schizophrenia research</title><addtitle>Schizophr Res</addtitle><description>The role of insight dimensions – illness recognition (IR), symptoms relabelling (SR), treatment compliance (TC) - in suicide risk in first-episode psychosis (FEP) remains unclear.
The AESOP (n = 181) and GAP (n = 112) FEP cohorts were followed-up over 10- and 5 years. Survival analysis modelled time to first suicidal event in relation to baseline scores on the Schedule for the Assessment of Insight, whilst adjusting for demographic, clinical, psychopathological and neuropsychological variables.
AESOP: those with previous suicide attempts scored higher on IR (7.6 ± 1.9 vs. 5.9 ± 3.0, p < 0.01) and total insight scores (TIS) (17.2 ± 5.0 vs. 13.4 ± 6.7, p = 0.03). IR (r = 0.23, p < 0.01), SR (r = 0.18, p = 0.04) and TC (r = 0.26, p < 0.01) correlated with depression. Univariable analyses: IR (HR = 1.14, 95% CI = 0.98–1.34, p = 0.09), TC (HR = 1.30, 95% CI = 0.99–1.71, p = 0.06) and TIS (HR = 1.06, 95% CI = 0.99–1.13, p = 0.08) were linked with suicidal behaviour. Multivariable regression models: depression (HR = 1.55, 95% CI = 1.22–1.97, p < 0.01) predicted suicidal behaviour.
GAP: SR (6.4 ± 3.1 vs. 4.5 ± 3.4, p = 0.03) and TIS (16.8 ± 6.4 vs. 12.8 ± 7.4, p = 0.03) were higher in those with suicidal antecedents. IR (r = 0.32, p < 0.01) and SR (r = 0.27, p = 0.01) correlated with depression. Univariable analyses: TC (HR = 1.36, 95% CI = 1.01–1.83, p = 0.04) and TIS (HR = 1.06, 95% CI = 0.99–1.14, p = 0.08) were associated with suicidal behaviour. Multivariable regression models: previous suicide attempts (HR 5.17, 95% CI 1.32–20.29, p = 0.02) and depression (HR 1.16, 95% CI = 1.00–1.35, p = 0.04) predicted suicidal behaviour.
Suicide attempts prior to FEP and depression at that point were associated with baseline insight levels and predicted risk of suicidal behaviour over the follow-up, which was not linked with insight. This may explain the apparent association of insight with suicidality in FEP.</description><subject>Adult</subject><subject>Awareness - physiology</subject><subject>Depression</subject><subject>Depression - epidemiology</subject><subject>Depression - physiopathology</subject><subject>Diagnostic Self Evaluation</subject><subject>Female</subject><subject>First-episode psychosis</subject><subject>Follow-Up Studies</subject><subject>Humans</subject><subject>Insight</subject><subject>Male</subject><subject>Middle Aged</subject><subject>Psychotic Disorders - epidemiology</subject><subject>Psychotic Disorders - physiopathology</subject><subject>Suicidal behaviour risk</subject><subject>Suicide, Attempted - statistics & numerical data</subject><subject>Young Adult</subject><issn>0920-9964</issn><issn>1573-2509</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2019</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNp9UEtvFDEMjhCILoV_gFCOXGZwHvPigISqQitV4gLnKJs4TJbdyRDPtuqVX05Gu3DsyZb9PeyPsbcCagGi_bCryY0ZqZYg-hqGugyfsY1oOlXJBobnbAODhGoYWn3BXhHtAEA00L1kFwpko_pBbdif24niz3HhdvI8R_rFU-B0jC56u-dbHO19TMfM48SXh8RDzLRUOEdKHvlMj25MFIm7NKa80Ed-HQK6hVaVOePKpbMccrsseJjLcvXyWPZEMU2v2Ytg94RvzvWS_fhy_f3qprr79vX26vNd5TT0xVR2yg59H1Toguht09jW26C1VUFoheWl0lvfB2e3Xadd06GSGvTgmm0LSl2y9yfdOaffR6TFHCI53O_thOVMI4WQrZASoED1CepyIsoYzJzjweZHI8Cs6ZudOaVv1vQNDKYMC-3d2eG4PaD_T_oXdwF8OgGw_HkfMReViJNDH3OJzfgUn3b4C_mAmrU</recordid><startdate>201902</startdate><enddate>201902</enddate><creator>Lopez-Morinigo, Javier-David</creator><creator>Di Forti, Marta</creator><creator>Ajnakina, Olesja</creator><creator>Wiffen, Benjamin D.</creator><creator>Morgan, Kevin</creator><creator>Doody, Gillian A.</creator><creator>Jones, Peter B.</creator><creator>Ayesa-Arriola, Rosa</creator><creator>Canal-Rivero, Manuel</creator><creator>Crespo-Facorro, Benedicto</creator><creator>Murray, Robin M.</creator><creator>Dazzan, Paola</creator><creator>Morgan, Craig</creator><creator>Dutta, Rina</creator><creator>David, Anthony S.</creator><general>Elsevier B.V</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7X8</scope><orcidid>https://orcid.org/0000-0002-5818-5103</orcidid><orcidid>https://orcid.org/0000-0003-0570-5352</orcidid><orcidid>https://orcid.org/0000-0002-8427-3617</orcidid></search><sort><creationdate>201902</creationdate><title>Insight and risk of suicidal behaviour in two first-episode psychosis cohorts: Effects of previous suicide attempts and depression</title><author>Lopez-Morinigo, Javier-David ; Di Forti, Marta ; Ajnakina, Olesja ; Wiffen, Benjamin D. ; Morgan, Kevin ; Doody, Gillian A. ; Jones, Peter B. ; Ayesa-Arriola, Rosa ; Canal-Rivero, Manuel ; Crespo-Facorro, Benedicto ; Murray, Robin M. ; Dazzan, Paola ; Morgan, Craig ; Dutta, Rina ; David, Anthony S.</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c408t-e273a988f3f7f18a55a6daf44a3f143e02544aad8fcab774c57e324049c5b6033</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2019</creationdate><topic>Adult</topic><topic>Awareness - physiology</topic><topic>Depression</topic><topic>Depression - epidemiology</topic><topic>Depression - physiopathology</topic><topic>Diagnostic Self Evaluation</topic><topic>Female</topic><topic>First-episode psychosis</topic><topic>Follow-Up Studies</topic><topic>Humans</topic><topic>Insight</topic><topic>Male</topic><topic>Middle Aged</topic><topic>Psychotic Disorders - epidemiology</topic><topic>Psychotic Disorders - physiopathology</topic><topic>Suicidal behaviour risk</topic><topic>Suicide, Attempted - statistics & numerical data</topic><topic>Young Adult</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Lopez-Morinigo, Javier-David</creatorcontrib><creatorcontrib>Di Forti, Marta</creatorcontrib><creatorcontrib>Ajnakina, Olesja</creatorcontrib><creatorcontrib>Wiffen, Benjamin D.</creatorcontrib><creatorcontrib>Morgan, Kevin</creatorcontrib><creatorcontrib>Doody, Gillian A.</creatorcontrib><creatorcontrib>Jones, Peter B.</creatorcontrib><creatorcontrib>Ayesa-Arriola, Rosa</creatorcontrib><creatorcontrib>Canal-Rivero, Manuel</creatorcontrib><creatorcontrib>Crespo-Facorro, Benedicto</creatorcontrib><creatorcontrib>Murray, Robin M.</creatorcontrib><creatorcontrib>Dazzan, Paola</creatorcontrib><creatorcontrib>Morgan, Craig</creatorcontrib><creatorcontrib>Dutta, Rina</creatorcontrib><creatorcontrib>David, Anthony S.</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>MEDLINE - Academic</collection><jtitle>Schizophrenia research</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Lopez-Morinigo, Javier-David</au><au>Di Forti, Marta</au><au>Ajnakina, Olesja</au><au>Wiffen, Benjamin D.</au><au>Morgan, Kevin</au><au>Doody, Gillian A.</au><au>Jones, Peter B.</au><au>Ayesa-Arriola, Rosa</au><au>Canal-Rivero, Manuel</au><au>Crespo-Facorro, Benedicto</au><au>Murray, Robin M.</au><au>Dazzan, Paola</au><au>Morgan, Craig</au><au>Dutta, Rina</au><au>David, Anthony S.</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Insight and risk of suicidal behaviour in two first-episode psychosis cohorts: Effects of previous suicide attempts and depression</atitle><jtitle>Schizophrenia research</jtitle><addtitle>Schizophr Res</addtitle><date>2019-02</date><risdate>2019</risdate><volume>204</volume><spage>80</spage><epage>89</epage><pages>80-89</pages><issn>0920-9964</issn><eissn>1573-2509</eissn><abstract>The role of insight dimensions – illness recognition (IR), symptoms relabelling (SR), treatment compliance (TC) - in suicide risk in first-episode psychosis (FEP) remains unclear.
The AESOP (n = 181) and GAP (n = 112) FEP cohorts were followed-up over 10- and 5 years. Survival analysis modelled time to first suicidal event in relation to baseline scores on the Schedule for the Assessment of Insight, whilst adjusting for demographic, clinical, psychopathological and neuropsychological variables.
AESOP: those with previous suicide attempts scored higher on IR (7.6 ± 1.9 vs. 5.9 ± 3.0, p < 0.01) and total insight scores (TIS) (17.2 ± 5.0 vs. 13.4 ± 6.7, p = 0.03). IR (r = 0.23, p < 0.01), SR (r = 0.18, p = 0.04) and TC (r = 0.26, p < 0.01) correlated with depression. Univariable analyses: IR (HR = 1.14, 95% CI = 0.98–1.34, p = 0.09), TC (HR = 1.30, 95% CI = 0.99–1.71, p = 0.06) and TIS (HR = 1.06, 95% CI = 0.99–1.13, p = 0.08) were linked with suicidal behaviour. Multivariable regression models: depression (HR = 1.55, 95% CI = 1.22–1.97, p < 0.01) predicted suicidal behaviour.
GAP: SR (6.4 ± 3.1 vs. 4.5 ± 3.4, p = 0.03) and TIS (16.8 ± 6.4 vs. 12.8 ± 7.4, p = 0.03) were higher in those with suicidal antecedents. IR (r = 0.32, p < 0.01) and SR (r = 0.27, p = 0.01) correlated with depression. Univariable analyses: TC (HR = 1.36, 95% CI = 1.01–1.83, p = 0.04) and TIS (HR = 1.06, 95% CI = 0.99–1.14, p = 0.08) were associated with suicidal behaviour. Multivariable regression models: previous suicide attempts (HR 5.17, 95% CI 1.32–20.29, p = 0.02) and depression (HR 1.16, 95% CI = 1.00–1.35, p = 0.04) predicted suicidal behaviour.
Suicide attempts prior to FEP and depression at that point were associated with baseline insight levels and predicted risk of suicidal behaviour over the follow-up, which was not linked with insight. This may explain the apparent association of insight with suicidality in FEP.</abstract><cop>Netherlands</cop><pub>Elsevier B.V</pub><pmid>30253893</pmid><doi>10.1016/j.schres.2018.09.016</doi><tpages>10</tpages><orcidid>https://orcid.org/0000-0002-5818-5103</orcidid><orcidid>https://orcid.org/0000-0003-0570-5352</orcidid><orcidid>https://orcid.org/0000-0002-8427-3617</orcidid><oa>free_for_read</oa></addata></record> |
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| subjects | Adult Awareness - physiology Depression Depression - epidemiology Depression - physiopathology Diagnostic Self Evaluation Female First-episode psychosis Follow-Up Studies Humans Insight Male Middle Aged Psychotic Disorders - epidemiology Psychotic Disorders - physiopathology Suicidal behaviour risk Suicide, Attempted - statistics & numerical data Young Adult |
| title | Insight and risk of suicidal behaviour in two first-episode psychosis cohorts: Effects of previous suicide attempts and depression |
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