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Clinical and neuropsychological aspects of non-fatal self-harm in schizophrenia

Published online by Cambridge University Press:  15 April 2020

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Abstract

Purpose:

To investigate demographic, clinical and neuropsychological aspects of self-harm in schizophrenia and identify which are independently predictive of and therefore the most relevant to clinical intervention.

Subjects and methods:

Eighty-seven patients with schizophrenia were interviewed regarding substance misuse, depression, hopelessness, negative/positive symptoms and illness insight. Neuropsychological assessment included premorbid IQ, continuous performance test, cognitive-motor and trait impulsivity. A prospective three-month review of medical records was also undertaken.

Results:

Fifty-nine patients (68%) reported past self-harm (including attempted suicide). Those with past self-harm, compared to those without, were significantly more likely to report depression, hopelessness, impulsivity, a family history of self-harm, polysubstance abuse and had higher premorbid IQ. Logistic regression revealed that depression, higher premorbid IQ and polysubstance abuse were independently linked to self-harm. Five participants attempted self-harm during the 3-month prospective follow-up period. These all had a history of past self-harm and were significantly more likely to have been depressed at the initial interview than those who did not go on to self-harm.

Discussion and conclusions:

Independent predictors of self-harm in schizophrenia are premorbid IQ and polysubstance abuse. In addition, depression was both independently associated with past self-harm and predictive of self-harm in the follow-up period.

Type
Original article
Copyright
Copyright © European Psychiatric Association

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References

Addington, DAddington, JMatickatyndale, EAssessing depression in schizophrenia – the Calgary Depression Scale. Brit J Psychiatry 1993;163:3944.CrossRefGoogle Scholar
Agerbo, EHigh income, employment, postgraduate education, and marriage: a suicidal cocktail among psychiatric patients. Arch Gen Psychiatry 2007;64:13771384.CrossRefGoogle ScholarPubMed
Alati, RGunnell, DNajman, JWilliams, GLawlor, DIs IQ in childhood associated with suicidal thoughts and attempts? Findings from the Mater University Study of Pregnancy and its outcomes. Suicide Life Threat Behav 2009;39:282293.CrossRefGoogle ScholarPubMed
American Psychiatric Association. DSM-IV-TR: diagnostic and statistical manual of mental disorders. Washinton: American Psychiatric Press Inc; 1994.Google Scholar
Andreassen, NCScale for the Assessment of Negative Symptoms (SANS). Iowa City, IA: University of Iowa; 1983.Google Scholar
Andreassen, NCScale for the Assessment of Positive Symptoms (SAPS). University of Iowa; 1984.Google Scholar
Barrett, EASundet, KSimonsen, CAgartz, ILorentzen, SMehlum, L, et al.Neurocognitive functioning and suicidality in schizophrenia spectrum disorders. Compr Psychiatry 2011;52:156163.CrossRefGoogle ScholarPubMed
Beck, ATSteer, RABeck hopelessness scale manual. San Antonio: The Psychological Corporation; 1993.Google Scholar
Bertelsen, MJeppesen, PPetersen, LThorup, AOhlenschlaeger, Jle Quach, P, et al.Suicidal behaviour and mortality in first-episode psychosis: the OPUS trial. Brit J Psychiatry 2007;51:s140s146.CrossRefGoogle ScholarPubMed
Cohen, JA power primer. Psychol Bull 1992;112:155159.CrossRefGoogle ScholarPubMed
David, ASInsight and psychosis. Brit J Psychiatry 1990;156:798808.CrossRefGoogle ScholarPubMed
Donohoe, GCorvin, ARobertson, IHAre the cognitive deficits associated with impaired insight in schizophrenia specific to executive task performance?. J Nerv Ment Dis 2005;193:803808.CrossRefGoogle ScholarPubMed
Dutta, RMurray, RMAllardyce, JJones, PBBoydell, JEarly risk factors for suicide in an epidemiological first episode psychosis cohort. Schizophr Res 2011;126:1119.CrossRefGoogle Scholar
Dutta, RMurray, RMHotopf, MAllardyce, JJones, PBBoydell, JReassessing the long-term risk of suicide after a first episode of psychosis. Arch Gen Psychiatry 2010;67:12301237.CrossRefGoogle ScholarPubMed
Fliege, HLee, JRGrimm, AKlapp, BFRisk factors and correlates of deliberate self-harm behavior: a systematic review. J Psychosom Res 2009;66:477493.CrossRefGoogle ScholarPubMed
Gratz, KLMeasurement of deliberate self-harm: preliminary data on the deliberate self-harm inventory. J Psychopathol Behav 2001;23:253263.CrossRefGoogle Scholar
Haro, JMNovick, DBertsch, JKaragianis, JDossenbach, MJones, PBCross-national clinical and functional remission rates: worldwide schizophrenia outpatient health outcomes (W-SOHO) study. Br J Psychiatry 2011;199:194201.CrossRefGoogle ScholarPubMed
Harvey, SBDean, KMorgan, CWalsh, EDemjaha, ADazzan, P, et al.Self-harm in first-episode psychosis. Brit J Psychiatry 2008;192:178184.CrossRefGoogle ScholarPubMed
Haw, CHawton, KHouston, KTownsend, EPsychiatric and personality disorders in deliberate self-harm patients. Br J Psychiatry 2001;178:4854.CrossRefGoogle ScholarPubMed
Haw, CHawton, KSutton, LSinclair, JDeeks, JSchizophrenia and deliberate self-harm: a systematic review of risk factors. Suicide Life Threat Behav 2005;35:5062.CrossRefGoogle ScholarPubMed
Hawton, KRodham, KEvans, EWeatherall, RDeliberate self-harm in adolescents: self-report survey in schools in England. BMJ 2002;325:12071211.CrossRefGoogle ScholarPubMed
Hawton, KSutton, LHaw, CSinclair, JDeeks, JJSchizophrenia and suicide: systematic review of risk factors. Brit J Psychiatry 2005;187:920.CrossRefGoogle ScholarPubMed
Hor, KTaylor, MSuicide and schizophrenia: a systematic review of rates and risk factors. J Psychopharmacol 2010;24:8190.CrossRefGoogle ScholarPubMed
Iancu, IBodner, ERoitman, SPiccone, SAPoreh, AKotler, MImpulsivity, aggression and suicide risk among male schizophrenia patients. Psychopathology 2010;43:223229.CrossRefGoogle ScholarPubMed
Jiang, GXRasmussen, FWasserman, DShort stature and poor psychological performance: risk factors for attempted suicide among Swedish male conscripts. Acta Psychiatr Scand 1999;100:433440.CrossRefGoogle ScholarPubMed
Klonsky, EDOltmanns, TFTurkheimer, EDeliberate self-harm in a nonclinical population: prevalence and psychological correlates. Am J Psychiatry 2003;160:15011508.CrossRefGoogle Scholar
Lee, KHHarris, AWLoughland, CMWilliams, LMThe five symptom dimensions and depression in schizophrenia. Psychopathology 2003;36:226233.CrossRefGoogle Scholar
Lee, KHTsoi, DTKhokhar, WASwalli, JSGee, KPluck, G, et al.CPT performance under parametric increase of working memory load in schizophrenia. Psychiatry Res 2012;197:350352.CrossRefGoogle Scholar
Limosin, FLoze, JYPhilippe, ACasadebaig, FRouillon, FTen-year prospective follow-up study of the mortality by suicide in schizophrenic patients. Schizophr Res 2007;94:2328.CrossRefGoogle ScholarPubMed
Madsen, TAgerbo, EMortensen, PBNordentoft, MPredictors of psychiatric inpatient suicide: a national prospective register-based study. J Clin Psychiatry 2012;73:144151.CrossRefGoogle ScholarPubMed
McGirr, ATurecki, GWhat is specific to suicide in schizophrenia disorder? Demographic, clinical and behavioural dimensions. Schizophr Res 2008;98:217224.CrossRefGoogle ScholarPubMed
McGrath, JSaha, SWelham, JEl Saadi, OMacCauley, CChant, DA systematic review of the incidence of schizophrenia: the distribution of rates and the influence of sex, urbanicity, migrant status and methodology. BMC Med 2004;2:13.CrossRefGoogle ScholarPubMed
Nangle, JMClarke, SMorris, DWSchwaiger, SMcGhee, KAKenny, N, et al.Neurocognition and suicidal behaviour in an Irish population with major psychotic disorders. Schizophr Res 2006;85:196200.CrossRefGoogle Scholar
Nelson, HENational adult reading test: test manual, 2nd editionWindsor, UK: NFER-NELSON; 1991.Google Scholar
NICE. The Short-term physical and psychological management and secondary prevention of self-harm in primary and secondary care. Clinical Guidance 16 London: National Institute for Clinical Excellence; 2004.Google Scholar
Nordentoft, MMortensen, PBPedersen, CBAbsolute risk of suicide after first hospital contact in mental disorder. Arch Gen Psychiatry 2011;68:10581064.CrossRefGoogle ScholarPubMed
Nyman, AKJonsson, HPatterns of self-destructive behaviour in schizophrenia. Acta Psychiatr Scand 1986;73:252262.CrossRefGoogle Scholar
Osler, MNybo Andersen, AMNordentoft, MImpaired childhood development and suicidal behaviour in a cohort of Danish men born in 1953. J Epidemiol Community Health 2008;62:2328.CrossRefGoogle Scholar
Palmer, BAPankratz, VSBostwick, JMThe lifetime risk of suicide in schizophrenia: a reexamination. Arch Gen Psychiatry 2005;62:247253.CrossRefGoogle ScholarPubMed
Patton, JHStanford, MSBarratt, ESFactor structure of the Barratt Impulsiveness Scale. J Clin Psychol 1995;51:768774.3.0.CO;2-1>CrossRefGoogle ScholarPubMed
Reitan, RMValidity of the Trail Making test as an indicator of organic brain damage. Percept Mot Skills 1958;8:271276.CrossRefGoogle Scholar
Reutfors, JBrandt, LJonsson, EGEkbom, ASparen, POsby, URisk factors for suicide in schizophrenia: findings from a Swedish population-based case-control study. Schizophr Res 2009;108:231237.CrossRefGoogle ScholarPubMed
Roy-Byrne, PPSherbourne, CDCraske, MGStein, MBKaton, WSullivan, G, et al.Moving treatment research from clinical trials to the real world. Psychiatr Serv 2003;54:327332.CrossRefGoogle ScholarPubMed
Schneider, BSchnabel, AWetterling, TBartusch, BWeber, BGeorgi, KHow do personality disorders modify suicide risk?. J Personal Disord 2008;22:233245.CrossRefGoogle ScholarPubMed
Schwartz, RCInsight and suicidality in schizophrenia: a replication study. J Nerv Ment Dis 2000;188:235237.CrossRefGoogle ScholarPubMed
Steblaj, ATavcar, RDernovsek, MZPredictors of suicide in psychiatric hospital. Acta Psychiatr Scand 1999;100:383388.CrossRefGoogle ScholarPubMed
Swann, ACDougherty, DMPazzaglia, PJPham, MSteinberg, JLMoeller, FGIncreased impulsivity associated with severity of suicide attempt history in patients with bipolar disorder. Am J Psychiatry 2005;162:16801687.CrossRefGoogle ScholarPubMed
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