The Relationship Between Suicidal Behaviour and Metacognition: A Study of First Year Psychosis

The present study aimed at investigating the relationship between suicidal behaviour and metacognition in first-year psychosis.

Sixty-eight patients (n = 34 with suicidal behaviour, n = 34 without suicidal behaviour) were included in this cross-sectional study. Data was collected using a sociodemographic and clinical data form, the Positive and Negative Syndrome Scale (PANSS), the Colombia Suicide Severity Rating Scale (C-SSRS), the Calgary Depression Scale (CDSS), the Metacognition Questionnaire-30 (MCQ-30), the Beck Cognitive Insight Scale (BCIS), the Beck Hopelessness Scale (BHS).

Patients with suicidal behaviour had a higher rate of pathological metacognitive beliefs. Whilst a significant difference was noted in all subscales of metacognition in comparing those with and without suicidal behaviour, there was no significant difference in insight and hopelessness factors in both groups. It was concluded that metacognition had a direct effect on suicidal behaviour, and this effect was not mediated and not influenced by the factors of hopelessness and insight. The study demonstrated that the risk of suicide increases as the pathological metacognitive beliefs increase.

This study was the first to examine the effect of metacognition on suicidal behaviour and the first one to analyse how this effect is related to insight and hopelessness in first-year patients with psychotic disorders. The results indicate that pathological metacognitive beliefs increase suicidal behaviour in patients with psychotic disorders. In order to understand this relationship better and to expose the factors that mediate the relationship, longitudinal follow-up studies in patients as well as studies with larger sample groups are needed.