title: Understanding suicidal ideation in psychosis: findings from the Psychological Prevention of Relapse in Psychosis (PRP) trial.
abstract: OBJECTIVE
  To examine the clinically important phenomenon of suicidal ideation in psychosis in relation to affective processes and the multidimensional nature of hallucinations and delusions.
  
  
  METHODS
  In a cross-sectional study of 290 individuals with psychosis, the associations between level of suicidal ideation, affective processes, positive symptoms, clinical and demographic variables were examined.
  
  
  RESULTS
  Forty-one per cent of participants expressed current suicidal ideation. Suicidal ideation was associated with depressed mood, anxiety, low self-esteem, negative illness perceptions, negative evaluative beliefs about the self and others and daily alcohol consumption. Frequency of auditory hallucinations and preoccupation with delusions were not associated with suicidal ideation; however, positive symptom distress did relate to suicidal thoughts.
  
  
  CONCLUSIONS
  Affective dysfunction, including distress in response to hallucinations and delusions, was a key factor associated with suicidal ideation in individuals with psychotic relapse. Suicidal ideation in psychosis appears to be an understandable, mood-driven process, rather than being of irrational or 'psychotic' origin.
authors.affiliation: Department of Psychology, Institute of Psychiatry, King's College London, University of London, London, UK. l.fialko@iop.kcl.ac.uk
authors.forename: L
authors.initials: L
authors.lastname: Fialko
authors.forename: D
authors.initials: D
authors.lastname: Freeman
authors.forename: P E
authors.initials: PE
authors.lastname: Bebbington
authors.forename: E
authors.initials: E
authors.lastname: Kuipers
authors.forename: P A
authors.initials: PA
authors.lastname: Garety
authors.forename: G
authors.initials: G
authors.lastname: Dunn
authors.forename: D
authors.initials: D
authors.lastname: Fowler
mesh_terms: D000328:Adult; D001008:Anxiety Disorders / Q000175:diagnosis / Q000523:psychology / Q000628:therapy; D015928:Cognitive Behavioral Therapy; D003131:Combined Modality Therapy; D015897:Comorbidity; D003469:Culture; D003702:Delusions / Q000175:diagnosis / Q000523:psychology / Q000628:therapy; D003866:Depressive Disorder / Q000175:diagnosis / Q000523:psychology / Q000628:therapy; D004739:England; D005196:Family Therapy; D005260:Female; D006212:Hallucinations / Q000175:diagnosis / Q000523:psychology / Q000628:therapy; D006801:Humans; D008297:Male; D008875:Middle Aged; D018187:Personal Construct Theory; D010555:Personality Inventory; D011569:Psychiatric Status Rating Scales; D011618:Psychotic Disorders / Q000175:diagnosis / Q000523:psychology* / Q000628:therapy*; D012307:Risk Factors; D012559:Schizophrenia / Q000175:diagnosis / Q000628:therapy*; D055502:Secondary Prevention; D012649:Self Concept; D012803:Sick Role; D013405:Suicide / Q000523:psychology*; D000092864:Suicide Prevention