Relationship between lifetime suicide attempts and schizotypal traits in patients with schizophrenia.

Toshiya Teraishi,Junko Matsuo,Miho Ota,Shintaro Ogawa,Hiroaki Hori,Hiroshi Kunugi,Anna Nagashima,Daimei Sasayama,Ikki Ishida,Yukiko Kinoshita,Kotaro Hattori,Kenji Hashimoto

doi:10.1371/journal.pone.0107739

Toshiya Teraishi, Junko Matsuo + Show 10 more

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https://doi.org/10.1371/journal.pone.0107739

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Journal: PloS one	Publication Date: Sep 16, 2014
Citations: 54	License type: CC BY 4.0

Affiliation: National Center of Neurology and Psychiatry

Abstract

Patients with schizophrenia are at increased risk for suicide. Various risk factors for suicide have been reported in schizophrenia; however, few studies have examined the association between personality traits and suicidal behavior. We administered the Schizotypal Personality Questionnaire (SPQ) to 87 Japanese patients with schizophrenia (49 males; mean age 38.1±10.6 years) with and without a history of suicide attempts (SA and nSA groups, respectively), and 322 controls (158 males; mean age 40.8±13.9 years). As expected, an analysis of covariance (ANCOVA) controlling for age and sex showed that all SPQ indices (total SPQ score and all three factors, i.e., cognitive-perceptual, interpersonal, and disorganized) were significantly higher in patients with schizophrenia (SA+nSA groups), than controls (p<0.001 for all comparisons). Furthermore, there were significant differences in the total score and the interpersonal and disorganized factors between the SA and nSA groups (nSA<SA, p<0.01 for all comparisons). Receiver operating characteristic analysis showed that a total SPQ score of 33.5 was the optimal cut-off value to discriminate the SA group from the nSA group (χ2[1] = 10.6, p = 0.002, odds ratio: 4.7, 95% confidence interval: 1.8–12.1, sensitivity: 0.70, specificity: 0.67). These results suggest that high schizotypy is associated with lifetime suicide attempts, and that the total SPQ score might be useful to assess the risk of suicide attempt in patients with schizophrenia.

Highlights

Suicide in patients with schizophrenia has long been a major topic of research because the suicide mortality rate is higher in this group than in the general population
Significant differences in the Schizotypal Personality Questionnaire (SPQ) total score and interpersonal and disorganized factors were found between the Suicide attempt (SA) and No suicide attempt (nSA) groups
Few studies have examined schizotypal traits assessed by the SPQ in patients with schizophrenia [22,25,26], and to our knowledge, this is the first report showing significant differences on the total score and interpersonal and disorganized factors of the SPQ between schizophrenia patients with and without suicide attempts

Summary

Introduction

Suicide in patients with schizophrenia has long been a major topic of research because the suicide mortality rate is higher in this group than in the general population. Reported suicide risk factors among schizophrenic individuals are male gender, poor adherence to treatment, greater insight into the illness, depressive episodes, substance abuse/dependence, and previous suicide attempts [4,5,6]. Protective factors such as defect state at an early stage and having daily activities have been reported [5]. The risk factors for suicide attempts in patients with schizophrenia are depressive episodes, hopelessness, insight into the illness [9], and alcohol abuse/ dependence [10]. A large epidemiological study revealed that higher education, female gender and single marital status were associated with suicide attempts in patients with first-episode schizophrenia [12]

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