@article{ref1,
title="Insight and risk of suicidal behaviour in two first-episode psychosis cohorts: effects of previous suicide attempts and depression",
journal="Schizophrenia Research",
year="2019",
author="Lopez-Morinigo, Javier-David and Di Forti, Marta and Ajnakina, Olesya and Wiffen, Benjamin D. and Morgan, Kevin and Doody, Gillian A. and Jones, Peter B. and Ayesa-Arriola, Rosa and Canal-Rivero, Manuel and Crespo-Facorro, Benedicto and Murray, Robin M. and Dazzan, Paola and Morgan, Craig and Dutta, Rina and David, Anthony S.",
volume="204",
number="",
pages="80-89",
abstract="BACKGROUND: The role of insight dimensions - illness recognition (IR), symptoms relabelling (SR), treatment compliance (TC) - in suicide risk in first-episode psychosis (FEP) remains unclear. <br><br>METHOD: The AESOP (n = 181) and GAP (n = 112) FEP cohorts were followed-up over 10- and 5 years. Survival analysis modelled time to first suicidal event in relation to baseline scores on the Schedule for the Assessment of Insight, whilst adjusting for demographic, clinical, psychopathological and neuropsychological variables. <br><br>RESULTS: AESOP: those with previous suicide attempts scored higher on IR (7.6 ± 1.9 vs. 5.9 ± 3.0, p < 0.01) and total insight scores (TIS) (17.2 ± 5.0 vs. 13.4 ± 6.7, p = 0.03). IR (r = 0.23, p < 0.01), SR (r = 0.18, p = 0.04) and TC (r = 0.26, p < 0.01) correlated with depression. Univariable analyses: IR (HR = 1.14, 95% CI = 0.98-1.34, p = 0.09), TC (HR = 1.30, 95% CI = 0.99-1.71, p = 0.06) and TIS (HR = 1.06, 95% CI = 0.99-1.13, p = 0.08) were linked with suicidal behaviour. Multivariable regression models: depression (HR = 1.55, 95% CI = 1.22-1.97, p < 0.01) predicted suicidal behaviour. GAP: SR (6.4 ± 3.1 vs. 4.5 ± 3.4, p = 0.03) and TIS (16.8 ± 6.4 vs. 12.8 ± 7.4, p = 0.03) were higher in those with suicidal antecedents. IR (r = 0.32, p < 0.01) and SR (r = 0.27, p = 0.01) correlated with depression. Univariable analyses: TC (HR = 1.36, 95% CI = 1.01-1.83, p = 0.04) and TIS (HR = 1.06, 95% CI = 0.99-1.14, p = 0.08) were associated with suicidal behaviour. Multivariable regression models: previous suicide attempts (HR 5.17, 95% CI 1.32-20.29, p = 0.02) and depression (HR 1.16, 95% CI = 1.00-1.35, p = 0.04) predicted suicidal behaviour. <br><br>CONCLUSIONS: Suicide attempts prior to FEP and depression at that point were associated with baseline insight levels and predicted risk of suicidal behaviour over the follow-up, which was not linked with insight. This may explain the apparent association of insight with suicidality in FEP.<br><br>Copyright © 2018. Published by Elsevier B.V.<p /> <p>Language: en</p>",
language="en",
issn="0920-9964",
doi="10.1016/j.schres.2018.09.016",
url="http://dx.doi.org/10.1016/j.schres.2018.09.016"
}