Abstract

Objective

Suicide is a major cause of death amongst individuals with schizophrenia spectrum disorders (SSD). Despite numerous risk factors being identified, accurate prediction of suicidality and provision of tailored and effective treatment is difficult. One factor that may warrant particular attention as a contributor to increased psychopathology and suicidality in SSD is disturbed sleep. Sleep disturbances have been reliably linked to greater levels of suicidal ideation and are highly prevalent amongst individuals with SSD. This study aimed to examine if reduced sleep duration and psychopathology are associated with increased suicidal ideation.

Method

One-hundred and eighteen adults with chronic SSD living within the community participated in this cross-sectional study. Psychosis symptoms were assessed using the Positive and Negative Syndrome Scale. Items 4 and 10 from the Montgomery-Asperg Depression Rating Scale and Item 2 from the Calgary Depression Scale for Schizophrenia were used to assess reduced sleep duration, current suicidal ideation, and hopelessness, respectively. All measures were rated concurrently.

Results

A hierarchical logistic regression revealed that greater acute sleep disturbances were associated with increased suicidal ideation and this relationship was found to be uniquely mediated by both positive symptom severity and hopelessness.

Conclusion

These results suggest that individuals with SSD who exhibited disrupted or disordered sleep, positive symptoms and/or hopelessness should be routinely screened for suicidal thinking. Furthermore, interventions that effectively target sleep disruptions may provide much-needed action against suicidal ideation.

• HIGHLIGHTS

• Reduced sleep found to be associated with increased suicidal ideation

• This was uniquely mediated by both hopelessness and positive symptoms

• More regular screening of sleep problems in schizophrenia is needed

中文翻译：

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精神病和绝望介导了精神分裂症谱系障碍患者睡眠减少与自杀意念之间的关系

摘要

客观的

自杀是精神分裂症谱系障碍 (SSD) 患者死亡的主要原因。尽管确定了许多风险因素，但准确预测自杀倾向并提供量身定制的有效治疗仍然很困难。作为导致 SSD 精神病理学和自杀倾向增加的一个因素，可能需要特别注意的一个因素是睡眠障碍。睡眠障碍与更高水平的自杀意念可靠相关，并且在 SSD 患者中非常普遍。这项研究旨在检查睡眠时间减少和精神病理学是否与自杀意念增加有关。

方法

居住在社区内的 118 名患有慢性 SSD 的成年人参与了这项横断面研究。使用阳性和阴性症状量表评估精神病症状。蒙哥马利-阿斯伯格抑郁量表的第 4 项和第 10 项以及精神分裂症卡尔加里抑郁量表的第 2 项分别用于评估睡眠时间缩短、当前自杀意念和绝望程度。同时对所有措施进行评级。

结果

分层逻辑回归显示，严重的急性睡眠障碍与自杀意念的增加有关，并且发现这种关系是由阳性症状的严重程度和绝望感独特地介导的。

结论

这些结果表明，表现出睡眠中断或紊乱、阳性症状和/或绝望的 SSD 患者应定期筛查自杀念头。此外，有效针对睡眠中断的干预措施可能会提供针对自杀意念的急需行动。

• 强调

• 发现睡眠减少与自杀意念增加有关

• 这是由绝望和阳性症状独特介导的

• 需要更定期地筛查精神分裂症患者的睡眠问题