title: The association between anomalous self-experience and suicidality in first-episode schizophrenia seems mediated by depression.
abstract: BACKGROUND
  A recent hypothesis is that suicidality in schizophrenia may be linked to the patients' altered basic self-awareness or sense of self, termed self-disorders (SDs).
  
  
  OBJECTIVE
  The aim of the study was to investigate whether SDs in first-episode schizophrenia spectrum disorders are related to suicidality and whether this relationship is independent of or mediated by depression or other standard clinical measures.
  
  
  METHODS
  Self-disorders were assessed in 49 patients with first-episode schizophrenia by means of the Examination of Anomalous Self-Experience (EASE) instrument. Symptoms severity and functioning were assessed using the Structured Clinical Interview for the Positive and Negative Syndrome Scale, Calgary Depression Scale for Schizophrenia, and Global Assessment of Functioning-Split Version. Suicidality was measured by the Calgary Depression Scale for Schizophrenia item 8.
  
  
  RESULTS
  Analyses detected a significant association between current suicidality, current depression, and SDs as measured by the EASE. The effect of SDs on suicidal ideation appeared to be mediated by depression.
  
  
  CONCLUSIONS
  The interaction between anomalous self-experiences and depression could be a rational clinical target for the prevention of suicidality in the early phases of schizophrenia and supports the rationale for including assessment of SDs in early intervention efforts.
authors.affiliation: Division of Mental Health, Innlandet Hospital Trust, 2312 Ottestad, Norway. elisabeth.haug@sykehuset-innlandet.no
authors.forename: Elisabeth
authors.initials: E
authors.lastname: Haug
authors.forename: Ingrid
authors.initials: I
authors.lastname: Melle
authors.forename: Ole A
authors.initials: OA
authors.lastname: Andreassen
authors.forename: Andrea
authors.initials: A
authors.lastname: Raballo
authors.forename: Unni
authors.initials: U
authors.lastname: Bratlien
authors.forename: Merete
authors.initials: M
authors.lastname: Øie
authors.forename: Lars
authors.initials: L
authors.lastname: Lien
authors.forename: Paul
authors.initials: P
authors.lastname: Møller
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D015897:Comorbidity; D003430:Cross-Sectional Studies; D003866:Depressive Disorder / Q000453:epidemiology* / Q000523:psychology; D061345:Early Medical Intervention; D005260:Female; D006801:Humans; D016014:Linear Models; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D009664:Norway / Q000453:epidemiology; D012307:Risk Factors; D012559:Schizophrenia / Q000453:epidemiology*; D012565:Schizophrenic Psychology; D012649:Self Concept; D059020:Suicidal Ideation; D000092864:Suicide Prevention