The subjective perception of the association between psychotic experiences and suicidal behavior among young adults

Psychotic experiences such as hallucinations and delusions are reported by approximately 7.2% of the general population, even in the absence of a psychotic disorder. Individuals who report such psychotic experiences are significantly more likely to endorse suicidal ideation and behavior across several large epidemiological samples. This study aimed to determine whether individuals who reported psychotic experiences and suicidal behavior would subjectively endorse a causal relationship between these two clinical phenomena.

Five open-ended questions were asked via online survey to 12 college students who had previously reported both hallucination-like experiences and suicidal behavior in a quantitative survey. Thematic analysis was used to analyze open-ended responses.

The majority of respondents, n (%) = 11 (91.6), did not endorse a notable subjective relationship between psychosis and suicidal ideation or suicide attempts. However, respondents did spontaneously report that stigma and fear may drive suicidal ideation among people who report psychotic experiences and other symptoms of psychological distress.

These findings are generally inconsistent with the hypothesis that psychotic experiences are directly related to suicidal behavior, and are consistent with the alternative hypothesis that both psychotic experiences and suicidal behavior are indicators of common underlying factors such as general psychological distress, potentially exacerbated by stigma.