title: Subclinical psychosis and suicidal behavior in England: Findings from the 2007 Adult Psychiatric Morbidity Survey.
abstract: BACKGROUND
  Psychotic disorders have been associated with suicidality but information on the association between subclinical psychosis and suicidality in the general adult population is scarce.
  
  
  METHODS
  Data from the 2007 Adult Psychiatric Morbidity Survey (n=7403) were analyzed. This was a nationally representative survey of the English adult household population (aged ≥16years). Five types of psychotic symptoms (hypomania, thought control, paranoia, strange experience, auditory hallucination) occurring in the past 12months were assessed with the Psychosis Screening Questionnaire. Participants with probable or definite psychosis were excluded. Logistic regression analysis was used to assess the association between psychotic symptoms and suicidal ideation and suicide attempt in the past 12months.
  
  
  RESULTS
  The prevalence of at least one psychotic symptom was 5.4%. After adjusting for potential confounders including mental disorders, each individual psychotic symptom was significantly associated with suicidal ideation with odds ratios (ORs) ranging from 3.22 to 4.20. With the exception of thought control, all symptoms were also associated with significantly higher odds for suicide attempt (ORs 3.95 to 10.23). Having at least one psychotic symptom was associated with ORs of 3.13 (95%CI 2.09-4.68) and 3.84 (95%CI 1.67-8.83) for suicidal ideation and suicide attempt respectively. In addition, a greater number of psychotic symptoms was associated with higher odds for suicidal ideation and suicide attempt.
  
  
  CONCLUSIONS
  Psychotic symptoms, regardless of the type, were independently associated with higher odds for suicidal ideation and suicide attempt. Assessment and management of suicide risk in individuals with psychotic symptoms may be important for suicide prevention.
authors.affiliation: Parc Sanitari Sant Joan de Déu, Universitat de Barcelona, Fundació Sant Joan de Déu, Dr Antoni Pujades, 42, Sant Boi de Llobregat, Barcelona 08830, Spain; Instituto de Salud Carlos III, Centro de Investigación Biomédica en Red de Salud Mental, CIBERSAM, Monforte de Lemos 3-5 Pabellón 11, Madrid 28029, Spain. Electronic address: a.koyanagi@pssjd.org.
authors.forename: Ai
authors.initials: A
authors.lastname: Koyanagi
authors.affiliation: The Stockholm Centre for Health and Social Change (SCOHOST), Södertörn University, Huddinge 141 89, Sweden; Department of Human Ecology, Graduate School of Medicine, The University of Tokyo, 7-3-1 Hongo, Bunkyo-ku, Tokyo 113-0033, Japan; Department of Child and Adolescent Mental Health, National Institute of Mental Health, National Center of Neurology and Psychiatry, 4-1-1 Ogawa-Higashi, Kodaira, Tokyo 187-8553, Japan. Electronic address: andrew.stickley@sh.se.
authors.forename: Andrew
authors.initials: A
authors.lastname: Stickley
authors.affiliation: Parc Sanitari Sant Joan de Déu, Universitat de Barcelona, Fundació Sant Joan de Déu, Dr Antoni Pujades, 42, Sant Boi de Llobregat, Barcelona 08830, Spain; Instituto de Salud Carlos III, Centro de Investigación Biomédica en Red de Salud Mental, CIBERSAM, Monforte de Lemos 3-5 Pabellón 11, Madrid 28029, Spain. Electronic address: jmharo@pssjd.org.
authors.forename: Josep Maria
authors.initials: JM
authors.lastname: Haro
mesh_terms: D000293:Adolescent; D000328:Adult; D000367:Age Factors; D000368:Aged; D004739:England / Q000453:epidemiology; D005260:Female; D005500:Follow-Up Studies; D006306:Health Surveys; D006801:Humans; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D009017:Morbidity; D011569:Psychiatric Status Rating Scales; D011618:Psychotic Disorders / Q000453:epidemiology* / Q000523:psychology*; D012189:Retrospective Studies; D059020:Suicidal Ideation; D013406:Suicide, Attempted / Q000706:statistics & numerical data*; D011795:Surveys and Questionnaires; D055815:Young Adult
keywords: Epidemiology; Psychotic symptom; Suicidal behavior; Suicide