The Role of Family Function in Reducing Suicidal Ideation Mediated by COVID-Related Stress and Psychotic-Like Experiences Among Adolescents

Abstract

Background: The COVID-19 pandemic has increased perceived psychological stress among adolescents, who experienced the lockdown period with their family. We investigated the role of family function (FF) in the interrelation between perceived stress (PS), psychotic-like experiences (PLEs) and suicidal ideation (SI) during this pandemic.Methods: 4807 adolescents completed this cross-sectional survey between May 14th and June 6th, 2020 in Hunan Province, China. We measured PS with Perceived stress scale (PSS-10), PLEs with the 8-item version of Community Assessment of Psychic Experiences (CAPE), SI with the suicidal item from the Mental Health Inventory of Middle School Students (MMHI-60), and FF with Family APGAR scale. Spearman’s correlation, mediation and moderated mediation analysis were utilized as statistical methods, adjusting for age and sex.Findings: Adolescents with high PS had higher PLEs (r = 0·51) as well as SI (r = 0·48); higher PLEs were related to more SI (r = 0·46). FF was lower in adolescents with higher PS (r = -0·34), PLEs (r = -0·29) and SI (r = -0·32) [All above p Interpretation: Our findings indicate that interventions to improve family function could reduce the stress-induced psychotic-like experiences and suicidal ideation during enforced social isolation.Funding Statement: This work was supported by the China Precision Medicine Initiative (2016YFC0906300 to ZL), the National Natural Science Foundation of China (82071506 to ZL). LP acknowledges support from the Tanna Schulich Chair of Neuroscience and Mental Health.Declaration of Interests: LP reports personal fees from Janssen Canada, Otsuka Canada, SPMM Course Limited, UK, Canadian Psychiatric Association; book royalties from Oxford University Press; investigator-initiated educational grants from Janssen Canada, Sunovion and Otsuka Canada outside the submitted work. All other authors report no relevant conflicts.Ethics Approval Statement: Our study was approved by the Ethics Committees of the Second Xiangya Hospital of Central South University.