Association between Multimorbidity and Suicidal Behaviors among People with Psychotic Disorders

Suicide and poor health conditions are the leading causes of premature mortality in psychotic disorders. People with psychotic disorders have an increased risk of multimorbidity (≥2 chronic conditions) which could contribute to higher rates of suicidal ideation and suicide behaviors. The aim of the present study was to determine the association between multimorbidity and suicidal behaviors in people with psychotic disorders.

Cross-sectional study using data from the Signature Biobank and including people with clinical diagnoses of psychotic disorders. Sociodemographic information, lifestyle habits, 22 chronic conditions, suicidal ideation (PHQ-9), and suicidal behaviors (SBQ-R) scores were gathered. Logistic regressions were performed across three models with different levels of adjustment: sociodemographics (M1), M1 adjusted for psychotic symptoms (M2), and M2 with further adjustments for lifestyle habits (M3). Sensitivity analyses were done on a subgroup of individuals with early psychosis (≤30 years old).

A sample of 748 participants with diagnosis of psychotic disorder (69% male; age: 39.5 ± 14.1; 35.2% with schizophrenia was recruited. Among them, 407 participants (54%) had multimorbidity, and 44% had physical multimorbidity. After adjustment for covariates, individuals with multimorbidity were more likely to report suicidal ideations (OR 2.31, 95%CI [1.61-3.32]) and suicidal behaviors (OR 1.84, 95%CI [1.15-2.97]) than their counterparts. Similar results were found for the young psychosis subgroup (<30 years old), as for physical multimorbidity.

Results confirmed an association between multimorbidity and higher rates of suicidal behaviors among our sample, supporting the importance of interventions to prevent the development of chronic conditions.