The Relationship Between Suicide Attempts and Ideation with Depression, Insight, and Internalized Stigmatization in Schizophrenia
Yıl: 2022 Cilt: 23 Sayı: 1 Sayfa Aralığı: 18 - 25 Metin Dili: İngilizce DOI: 10.5152/alphapsychiatry.2021.21216 İndeks Tarihi: 24-06-2022
The Relationship Between Suicide Attempts and Ideation with Depression, Insight, and Internalized Stigmatization in Schizophrenia
Öz: Background: Suicidal behavior is quite common in schizophrenia and various risk factors
for suicide have been reported. The aim of this study was to examine the relationship
between suicide attempts and ideation with depression, insight, and internalized stigmatization in patients with schizophrenia.
Method: Thirty-six patients with a history of suicide attempts and 52 patients without
suicide attempts who were diagnosed as schizophrenia according to DSM-5 diagnostic
criteria were included in this study. According to the score which they obtained from the
eighth item of the Calgary Depression Scale for Schizophrenia, patients were divided into
two groups: not suicidal ideations (zero points) and suicidal ideations (one, two, or three
points). Sociodemographic information form, Positive and Negative Syndrome Scale,
Calgary Schizophrenia Depression Scale, Schedule for Assessing the Three-Component
of Insight, The Internalized Stigma of Mental Illness Scale, and The Suicide Ideation Scale
were applied to all of the patients who participated in the study.
Results: Patients with suicide attempts were more likely to be single and had higher the
Internalized Stigma of Mental Illness Scale scores compared to patients without suicide
attempts. Patients with suicidal ideation had higher Positive and Negative Syndrome
Scale total scores, higher Calgary Schizophrenia Depression Scale scores, and higher the
Internalized Stigma of Mental Illness Scale scores than those without suicidal ideation.
There was a strong, positive correlation between the Suicide Ideation Scale and Calgary
Schizophrenia Depression Scale, as well as there was a moderate, positive correlation
between Positive and Negative Syndrome Scale, the Internalized Stigma of Mental Illness
Scale, and the Suicide Ideation Scale in the suicidal ideation group. In regression analysis,
depression was found to be a predictor of suicidal ideation.
Conclusion: Depression and internalized stigma were risk factors for suicide in schizophrenia. Risk factors need to be carefully assessed to prevent suicide in schizophrenia.
Anahtar Kelime: Belge Türü: Makale Makale Türü: Araştırma Makalesi Erişim Türü: Erişime Açık
- 1. Bushe CJ, Taylor M, Haukka J. Mortality in schizophrenia: a measurable clinical endpoint. J Psychopharmacol. 2010;24(suppl 4):17-25. [CrossRef]
- 2. Palmer BA, Pankratz VS, Bostwick JM. The lifetime risk of suicide in schizophrenia: a reexamination. Arch Gen Psychiatry. 2005;62(3):247-253. [CrossRef]
- 3. Montross LP, Zisook S, Kasckow J. Suicide among patients with schizophrenia: a consideration of risk and protective factors. Ann Clin Psychiatry. 2005;17(3):173-182. [CrossRef]
- 4. Pompili M, Amador XF, Girardi P, et al. Suicide risk in schizophrenia: learning from the past to change the future. Ann Gen Psychiatry. 2007;6(1):10. [CrossRef]
- 5. Popovic D, Benabarre A, Crespo JM, et al. Risk factors for suicide in schizophrenia: systematic review and clinical recommendations. Acta Psychiatr Scand. 2014;130(6):418-426. [CrossRef]
- 6. Mauri MC, Paletta S, Maffini M, Moliterno D, Altamura AC. Suicide attempts in schizophrenic patients: clinical variables. Asian J Psychiatr. 2013;6(5):421-427. [CrossRef]
- 7. Bornheimer LA. Moderating effects of positive symptoms of psychosis in suicidal ideation among adults diagnosed with schizophrenia. Schizophr Res. 2016;176(2-3):364-370. [CrossRef]
- 8. Siris SG. Suicide and schizophrenia. J Psychopharmacol. 2001;15(2):127- 135. [CrossRef]
- 9. Harkavy-Friedman JM, Nelson EA, Venarde DF, Mann JJ. Suicidal behavior in schizophrenia and schizoaffective disorder: examining the role of depression. Suicide Life Threat Behav. 2004;34(1):66-76. [CrossRef]
- 10. Aki H, Tomotake M, Kaneda Y, et al. Subjective and objective quality of life, levels of life skills, and their clinical determinants in outpatients with schizophrenia. Psychiatry Res. 2008;158(1):19-25. [CrossRef]
- 11. Bertelsen M, Jeppesen P, Petersen L, et al. Suicidal behaviour and mortality in first-episode psychosis: the OPUS trial. Br J Psychiatry Suppl. 2007;51(suppl 51):s140-s146. [CrossRef]
- 12. Lincoln TM, Lüllmann E, Rief W. Correlates and long-term consequences of poor insight in patients with schizophrenia: a systematic review. Schizophr Bull. 2007;33(6):1324-1342. [CrossRef]
- 13. Saravanan B, Jacob KS, Johnson S, et al. Outcome of first-episode schizophrenia in India: longitudinal study of effect of insight and psychopathology. Br J Psychiatry. 2010;196(6):454-459. [CrossRef]
- 14. Belvederi Murri MB, Respino M, Innamorati M, et al. Is good insight associated with depression among patients with schizophrenia? Systematic review and meta-analysis. Schizophr Res. 2015;162(1-3):234-247. [CrossRef]
- 15. Crumlish N, Whitty P, Kamali M, et al. Early insight predicts depression and attempted suicide after 4 years in first‐episode schizophrenia and schizophreniform disorder. Acta Psychiatr Scand. 2005;112(6):449-455. [CrossRef]
- 16. López-Moríñigo JD, Ramos-Ríos R, David AS, Dutta R. Insight in schizophrenia and risk of suicide: a systematic update. Compr Psychiatry. 2012;53(4):313-322. [CrossRef]
- 17. Corrigan PW. The impact of stigma on severe mental illness. Cogn Behav Pract. 1998;5(2):201-222. [CrossRef]
- 18. Yanos PT, Roe D, Markus K, Lysaker PH. Pathways between internalized stigma and outcomes related to recovery in schizophrenia spectrum disorders. Psychiatr Serv. 2008;59(12):1437-1442. [CrossRef]
- 19. Yanos PT, Lysaker PH, Roe D. Internalized stigma as a barrier to improvement in vocational functioning among people with schizophrenia-spectrum disorders. Psychiatry Res. 2010;178(1):211-213. [CrossRef]
- 20. Yoo T, Kim SW, Kim SY, et al. Relationship between suicidality and low self-esteem in patients with schizophrenia. Clin Psychopharmacol Neurosci. 2015;13(3):296-301. [CrossRef]
- 21. Touriño R, Acosta FJ, Giráldez A, et al. Suicidal risk, hopelessness and depression in patients with schizophrenia and internalized stigma. Actas Esp Psiquiatr. 2018;46(2):33-41.
- 22. Kay SR, Fiszbein A, Opler LA. The Positive and Negative Syndrome Scale (PANSS) for schizophrenia. Schizophr Bull. 1987;13(2):261-276. [CrossRef]
- 23. Kostakoğlu A, Batur S, Tiryaki A, Göğüş A. Pozitif ve negatif sendrom ölçeğinin (PANSS) Türkçe uyarlamasının geçerlilik ve güvenilirliği. Türk Psikhol Derg. 1999;14(44):23-32.
- 24. Addington D, Addington J, Maticka-Tyndale E. Specificity of the Calgary Depression Scale for schizophrenics. Schizophr Res. 1994;11(3):239-244. [CrossRef]
- 25. Aydemir Ö, Esen Danacı A, Deveci A, İçelli İ. Calgary Şizofrenide Depresyon Ölçeği’nin Türkçe versiyonunun güvenilirliği ve geçerliliği. Nöropsikiyatri Ars. 2000;37(1):82-86.
- 26. David A, Buchanan A, Reed A, Almeida O. The assessment of insight in psychosis. Br J Psychiatry. 1992;161(5):599-602. [CrossRef]
- 27. Aslan S, Karakılıç H, Işıklı S, Coşar B, Işık E. İçgörünün üç bileşenini değerlendirme ölçeği:güvenirlik ve geçerlik çalışması. Türkiye’de Psikiyatri. 2001;3(1):17-24.
- 28. Ritsher JB, Otilingam PG, Grajales M. Internalized stigma of mental illness: psychometric properties of a new measure. Psychiatry Res. 2003;121(1):31-49. [CrossRef]
- 29. Ersoy MA, Varan A. Ruhsal hastalıklarda içselleştirilmiş damgalanma ölçeği Türkçe formu’nun güvenilirlik ve geçerlik çalışması. Turk Psikiyatri Derg. 2007;18(2):163-171.
- 30. Levine S, Ancill RJ, Roberts AP. Assessment of suicide risk by computer‐ delivered self‐rating questionnaire: preliminary findings. Acta Psychiatr Scand. 1989;80(3):216-220. [CrossRef]
- 31. Dilbaz N, Holat H, Bayam G, Tüzer T. İntihar düşüncesi ölçeğinin geçerlilik ve güvenirliği. Ulusal Psikiyatri Bilimler Kongresi Bilimsel Çalışma Kitabı. 1995;31:40-41.
- 32. Hawton K, Sutton L, Haw C, Sinclair J, Deeks JJ. Schizophrenia and suicide: systematic review of risk factors. Br J Psychiatry. 2005;187(1):9-20. [CrossRef]
- 33. Reutfors J, Brandt L, Jönsson EG, et al. Risk factors for suicide in schizophrenia: findings from a Swedish population-based case-control study. Schizophr Res. 2009;108(1-3):231-237. [CrossRef]
- 34. Sharaf AY, Ossman LH, Lachine OA. A cross-sectional study of the relationships between illness insight, internalized stigma, and suicide risk in individuals with schizophrenia. Int J Nurs Stud. 2012;49(12):1512-1520. [CrossRef]
- 35. Pompili M, Lester D, Grispini A, et al. Completed suicide in schizophrenia: evidence from a case-control study. Psychiatry Res. 2009;167(3):251-257. [CrossRef]
- 36. Wong Z, Öngür D, Cohen B, et al. Command hallucinations and clinical characteristics of suicidality in patients with psychotic spectrum disorders. Compr Psychiatry. 2013;54(6):611-617. [CrossRef]
- 37. Harkavy-Friedman JM, Kimhy D, Nelson EA, et al. Suicide attempts in schizophrenia: the role of command auditory hallucinations for suicide. J Clin Psychiatry. 2003;64(8):871-874. [CrossRef]
- 38. Kocatürk BK, Eşsizoğlu A, Aksaray G, Akarsu FÖ, Musmul A. Relationship suicide, cognitive functions, and depression in patients with schizophrenia. Nöro Psikiyatr Ars. 2015;52(2):169-173. [CrossRef]
- 39. Hor K, Taylor M. Suicide and schizophrenia: a systematic review of rates and risk factors. J Psychopharmacol. 2010;24(suppl 4):81-90. [CrossRef]
- 40. McGirr A, Tousignant M, Routhier D, et al. Risk factors for completed suicide in schizophrenia and other chronic psychotic disorders: a case–control study. Schizophr Res. 2006;84(1):132-143. [CrossRef]
- 41. Restifo K, Harkavy-Friedman JM, Shrout PE. Suicidal behavior in schizophrenia: a test of the demoralization hypothesis. J Nerv Ment Dis. 2009;197(3):147-153. [CrossRef]
- 42. Barrett EA, Mork E, Færden A, et al. The development of insight and its relationship with suicidality over one year follow-up in patients with first episode psychosis. Schizophr Res. 2015;162(1-3):97-102. [CrossRef]
- 43. Massons C, Lopez-Morinigo JD, Pousa E, et al. Insight and suicidality in psychosis: a cross-sectional study. Psychiatry Res. 2017;252:147-153. [CrossRef]
- 44. Vrbova K, Prasko J, Ociskova M, et al. Suicidality, self-stigma, social anxiety and personality traits in stabilized schizophrenia patients: a crosssectional study. Neuropsychiatr Dis Treat. 2018;14:1415-1424. [CrossRef]
- 45. Clement S, Schauman O, Graham T, et al. What is the impact of mental health-related stigma on help-seeking? A systematic review of quantitative and qualitative studies. Psychol Med. 2015;45(1):11-27. [CrossRef]
- 46. Lien YJ, Chang HA, Kao YC, et al. Self‐stigma mediates the impact of insight on current suicide ideation in suicide attempters with schizophrenia: results of a moderated mediation approach. Suicide Life Threat Behav. 2018;48(6):661-676. [CrossRef]
| APA | BILGIN KOCAK M, SAHIN A, Özyıldız Güz H, Böke Ö, Sarısoy G, Karabekiroğlu A (2022). The Relationship Between Suicide Attempts and Ideation with Depression, Insight, and Internalized Stigmatization in Schizophrenia. , 18 - 25. 10.5152/alphapsychiatry.2021.21216 |
| Chicago | BILGIN KOCAK MERVE,SAHIN AHMET RIFAT,Özyıldız Güz Hatice,Böke Ömer,Sarısoy Gökhan,Karabekiroğlu Aytül The Relationship Between Suicide Attempts and Ideation with Depression, Insight, and Internalized Stigmatization in Schizophrenia. (2022): 18 - 25. 10.5152/alphapsychiatry.2021.21216 |
| MLA | BILGIN KOCAK MERVE,SAHIN AHMET RIFAT,Özyıldız Güz Hatice,Böke Ömer,Sarısoy Gökhan,Karabekiroğlu Aytül The Relationship Between Suicide Attempts and Ideation with Depression, Insight, and Internalized Stigmatization in Schizophrenia. , 2022, ss.18 - 25. 10.5152/alphapsychiatry.2021.21216 |
| AMA | BILGIN KOCAK M,SAHIN A,Özyıldız Güz H,Böke Ö,Sarısoy G,Karabekiroğlu A The Relationship Between Suicide Attempts and Ideation with Depression, Insight, and Internalized Stigmatization in Schizophrenia. . 2022; 18 - 25. 10.5152/alphapsychiatry.2021.21216 |
| Vancouver | BILGIN KOCAK M,SAHIN A,Özyıldız Güz H,Böke Ö,Sarısoy G,Karabekiroğlu A The Relationship Between Suicide Attempts and Ideation with Depression, Insight, and Internalized Stigmatization in Schizophrenia. . 2022; 18 - 25. 10.5152/alphapsychiatry.2021.21216 |
| IEEE | BILGIN KOCAK M,SAHIN A,Özyıldız Güz H,Böke Ö,Sarısoy G,Karabekiroğlu A "The Relationship Between Suicide Attempts and Ideation with Depression, Insight, and Internalized Stigmatization in Schizophrenia." , ss.18 - 25, 2022. 10.5152/alphapsychiatry.2021.21216 |
| ISNAD | BILGIN KOCAK, MERVE vd. "The Relationship Between Suicide Attempts and Ideation with Depression, Insight, and Internalized Stigmatization in Schizophrenia". (2022), 18-25. https://doi.org/10.5152/alphapsychiatry.2021.21216 |
| APA | BILGIN KOCAK M, SAHIN A, Özyıldız Güz H, Böke Ö, Sarısoy G, Karabekiroğlu A (2022). The Relationship Between Suicide Attempts and Ideation with Depression, Insight, and Internalized Stigmatization in Schizophrenia. Alpha psychiatry (Online), 23(1), 18 - 25. 10.5152/alphapsychiatry.2021.21216 |
| Chicago | BILGIN KOCAK MERVE,SAHIN AHMET RIFAT,Özyıldız Güz Hatice,Böke Ömer,Sarısoy Gökhan,Karabekiroğlu Aytül The Relationship Between Suicide Attempts and Ideation with Depression, Insight, and Internalized Stigmatization in Schizophrenia. Alpha psychiatry (Online) 23, no.1 (2022): 18 - 25. 10.5152/alphapsychiatry.2021.21216 |
| MLA | BILGIN KOCAK MERVE,SAHIN AHMET RIFAT,Özyıldız Güz Hatice,Böke Ömer,Sarısoy Gökhan,Karabekiroğlu Aytül The Relationship Between Suicide Attempts and Ideation with Depression, Insight, and Internalized Stigmatization in Schizophrenia. Alpha psychiatry (Online), vol.23, no.1, 2022, ss.18 - 25. 10.5152/alphapsychiatry.2021.21216 |
| AMA | BILGIN KOCAK M,SAHIN A,Özyıldız Güz H,Böke Ö,Sarısoy G,Karabekiroğlu A The Relationship Between Suicide Attempts and Ideation with Depression, Insight, and Internalized Stigmatization in Schizophrenia. Alpha psychiatry (Online). 2022; 23(1): 18 - 25. 10.5152/alphapsychiatry.2021.21216 |
| Vancouver | BILGIN KOCAK M,SAHIN A,Özyıldız Güz H,Böke Ö,Sarısoy G,Karabekiroğlu A The Relationship Between Suicide Attempts and Ideation with Depression, Insight, and Internalized Stigmatization in Schizophrenia. Alpha psychiatry (Online). 2022; 23(1): 18 - 25. 10.5152/alphapsychiatry.2021.21216 |
| IEEE | BILGIN KOCAK M,SAHIN A,Özyıldız Güz H,Böke Ö,Sarısoy G,Karabekiroğlu A "The Relationship Between Suicide Attempts and Ideation with Depression, Insight, and Internalized Stigmatization in Schizophrenia." Alpha psychiatry (Online), 23, ss.18 - 25, 2022. 10.5152/alphapsychiatry.2021.21216 |
| ISNAD | BILGIN KOCAK, MERVE vd. "The Relationship Between Suicide Attempts and Ideation with Depression, Insight, and Internalized Stigmatization in Schizophrenia". Alpha psychiatry (Online) 23/1 (2022), 18-25. https://doi.org/10.5152/alphapsychiatry.2021.21216 |
