Exploring the relation between psychosis‐like experiences and suicidal ideation, plans, and attempts among college students in the United States

Aim The suicide rate among college students is particularly high, with evidence that psychosis‐like experiences (PLEs) put these individuals at greater risk. The current study explored whether there are differential relations between four subtypes of PLEs and three suicide outcomes. Methods We analysed a large sample of college students from the Fall semester cohort of the 2020 Healthy Minds Study (HMS) (weighted N = 36727). PLEs and suicide outcomes were assessed using binary variables from the World Health Organization Composite International Diagnostic Interview. Results Findings revealed that reporting any of the subtypes of PLEs was associated with greater odds of suicidal ideation (SI), a suicide plan (SP) and a suicide attempt (SA) (signficant a ORs ranging from 1.30 to 3.30). For college students who endorsed SI or a SP in the past year, experiencing delusional mood (aOR [95% CI] = 1.30 [1.02–1.65]), suspiciousness (aOR [95% CI] = 1.31 [1.00–1.71]) and hallucinatory experiences (aOR [95% CI] = 2.76 [2.05–3.71]) in their lifetime increased their odds of reporting a SA in the past year. There was also evidence of a dose‐dependent relation between the number of PLEs endorsed and all three suicide outcomes. Conclusions Certain subtypes of PLEs including delusional mood, suspiciousness and hallucinatory experiences may contribute to an elevated risk of suicide outcomes in college students. Moreover, the odds of reporting suicide outcomes were greater for individuals who endorsed a greater number of PLEs. It may be helpful to assess for indicated subtypes when determining suicide risk among college students and to be particularly mindful of those who report three or more PLEs.