Abstract

Paranoia and suicidality seem to be common traits expressing in the general population to varying degrees. This study aims to explore the association between both and to identify determinants of comorbidity. We interviewed a representative sample of the population in Andalusia (n = 4507) and assessed paranoia and suicidality utilizing the Spanish Green’s Paranoid Thoughts Scale (S-GPTS) and the suicidality section of the MINI Neuropsychiatric Interview, respectively. We gathered data on socio-demographics, personality, substance abuse, social support, and environmental distress. We found that paranoia and suicidality were rather common with 6.4% (95% CI: 5.7–7.12) of the sample admitting to some (vs. none) level of suicidality. We also found a robust association between paranoia and suicidality, independent of age and sex (F:298.2; p =.0001; Eta²: .065); 0.5% (95% CI: 0.32–0.76) of the sample (n = 21) presented combinedly high levels of paranoia and some suicidality risk and were considered as having paranoia-suicidality comorbidity (PSC). We identified factors associating with PSC, including poor social support, childhood maltreatment, threatening life-events and increasing personality disorder, and nicotine dependence scores. Paranoia and suicidality are common traits in the general population and their comorbidity seems to associate with low social support, environmental adversity and disordered personality. Suicidality and paranoia are common traits present dimensionally in a representative nonclinical sample. Paranoia strongly and independently associates with suicidality risk in a large population-based study. Paranoia and suicidality comorbidity may be commonly determined by poor social support, disordered personality, previous childhood maltreatment, and exposure to threatening life-events.

摘要

偏执狂和自杀倾向似乎是普通人群不同程度地表现出来的共同特征。本研究旨在探讨两者之间的关联并确定合并症的决定因素。我们采访了安达卢西亚 (n = 4507) 人口的代表性样本，并分别利用西班牙格林的偏执思维量表 (S-GPTS) 和 MINI 神经精神病学访谈的自杀部分评估了偏执狂和自杀倾向。我们收集了有关社会人口统计、性格、药物滥用、社会支持和环境困境的数据。我们发现偏执狂和自杀相当普遍，有 6.4% (95% CI: 5.7–7.12) 的样本承认某些（与无）自杀水平。我们还发现偏执狂和自杀之间存在很强的关联，与年龄和性别无关 (F:298.2; p =.0001; Eta²: .065); 0.5% (95% CI: 0.32–0.76) 的样本 (n = 21) 表现出高水平的妄想症和一些自杀风险，并被认为患有妄想症-自杀合并症 (PSC)。我们确定了与 PSC 相关的因素，包括社会支持差、童年虐待、威胁生活事件和增加的人格障碍，以及尼古丁依赖评分。偏执狂和自杀是普通人群的共同特征，它们的合并症似乎与低社会支持、环境逆境和人格障碍有关。自杀和偏执是典型的非临床样本中存在的常见特征。在一项基于人群的大型研究中，偏执狂与自杀风险强烈且独立地相关。