Insight and suicidality in psychosis: A cross-sectional study

Area of Science:

• Psychiatry
• Clinical Psychology
• Neuroscience

Background:

• Psychotic disorders are associated with increased suicidality.
• The role of insight in understanding suicidality in psychosis requires further clarification.

Purpose of the Study:

• To investigate the association between specific dimensions of insight and suicidality in patients with schizophrenia spectrum disorders.
• To determine if awareness of mental illness, its consequences, or need for treatment predicts suicidality.

Main Methods:

• 143 patients with schizophrenia spectrum disorders were assessed for suicidality using the Calgary Depression Scale for Schizophrenia (CDSS).
• Insight was measured using the Scale of Unawareness of Mental Disorder (SUMD) and the Markova and Berrios Insight Scale.
• Bivariate analyses and multivariable logistic regression were employed.

Main Results:

• Awareness of mental illness and its social consequences correlated with higher suicidality scores.
• Specific domains of insight, including awareness of disturbed thinking and a vague feeling of something being wrong, were related to suicidality.
• Multivariable analysis revealed that depression and previous suicidal behavior, not insight dimensions, were significant predictors of suicidality.

Conclusions:

• While some insight dimensions show a link to suicidality in psychosis, these associations are mediated by depression and prior suicidal behavior.
• Depression and previous suicidal behavior are crucial factors in predicting suicidality in patients with psychotic disorders.