title: Suicidality in schizophrenia spectrum disorders: the relationship to hallucinations and persecutory delusions.
abstract: BACKGROUND
  Assessment of suicide risk is crucial in schizophrenia and results concerning risk contributed by hallucinations and persecutory delusions are inconsistent. We aimed to determine factors associated with suicidal ideation and plans at the time of acute admission in patients suffering from schizophrenia spectrum disorders.
  
  
  METHODS
  One hundred and twenty-four patients older than 18 years admitted to an acute psychiatric ward due to psychosis were consecutively included. Predictors of suicidal ideation and suicide plans at the time of admission were examined with multinominal logistic regression and structural equation modelling (SEM). The study design was pragmatic, thus entailing a clinically relevant representation.
  
  
  RESULTS
  Depression Odds Ratio (OR) 12.9, Drug use OR 4.07, Hallucinations OR 2.55 and Negative symptoms OR 0.88 significantly predicted Suicidal ideation. Suspiciousness/ Persecution did not. Only Depression and Hallucinations significantly predicted Suicide plans. In the SEM-model Anxiety, Depression and Hopelessness connected Suspiciousness/Persecution, Hallucinations and Lack of insight with Suicidal ideation and Suicide plans.
  
  
  CONCLUSIONS
  The study contributes to an increasing evidence base supporting an association between hallucinations and suicide risk. We want to emphasise the importance of treating depression and hallucinations in psychotic disorders, reducing hopelessness while working with insight and reducing drug abuse in order to lower suicide risk.
  
  
  BACKGROUND
  ClinicalTrials.gov ID; URL: http://www.clinicaltrials.gov/NCT00932529.
authors.affiliation: Division of Psychiatry, Haukeland University Hospital, Bergen, Norway. Electronic address: eirik.kjelby@helse-bergen.no.
authors.forename: E
authors.initials: E
authors.lastname: Kjelby
authors.affiliation: Division of Psychiatry, Haukeland University Hospital, Bergen, Norway.
authors.forename: I
authors.initials: I
authors.lastname: Sinkeviciute
authors.affiliation: Division of Psychiatry, Haukeland University Hospital, Bergen, Norway.
authors.forename: R
authors.initials: R
authors.lastname: Gjestad
authors.affiliation: Division of Psychiatry, Haukeland University Hospital, Bergen, Norway; Department of Clinical Medicine, Section of Psychiatry, Faculty of Medicine and Dentistry, University of Bergen, Norway.
authors.forename: R A
authors.initials: RA
authors.lastname: Kroken
authors.affiliation: Division of Psychiatry, Haukeland University Hospital, Bergen, Norway; Department of Clinical Psychology, University of Bergen, Norway.
authors.forename: E-M
authors.initials: EM
authors.lastname: Løberg
authors.affiliation: Department of Clinical Medicine, Section of Psychiatry, Faculty of Medicine and Dentistry, University of Bergen, Norway.
authors.forename: H A
authors.initials: HA
authors.lastname: Jørgensen
authors.affiliation: Division of Psychiatry, Haukeland University Hospital, Bergen, Norway; Department of Biological and Medical Psychology, University of Bergen, Norway; NORMENT Centre of Excellence, University of Oslo, Norway.
authors.forename: K
authors.initials: K
authors.lastname: Hugdahl
authors.affiliation: Division of Psychiatry, Haukeland University Hospital, Bergen, Norway; Department of Clinical Medicine, Section of Psychiatry, Faculty of Medicine and Dentistry, University of Bergen, Norway.
authors.forename: E
authors.initials: E
authors.lastname: Johnsen
mesh_terms: D000328:Adult; D003702:Delusions / Q000175:diagnosis / Q000209:etiology / Q000628:therapy*; D003863:Depression / Q000175:diagnosis / Q000209:etiology / Q000628:therapy*; D005260:Female; D006212:Hallucinations / Q000175:diagnosis / Q000209:etiology / Q000628:therapy*; D006801:Humans; D008297:Male; D008875:Middle Aged; D011567:Psychiatric Department, Hospital; D011618:Psychotic Disorders / Q000150:complications* / Q000175:diagnosis / Q000628:therapy*; D012307:Risk Factors; D012559:Schizophrenia / Q000175:diagnosis; D019966:Substance-Related Disorders / Q000150:complications; D059020:Suicidal Ideation; D013405:Suicide / Q000523:psychology*; D000092864:Suicide Prevention
keywords: Psychiatry in Europe; Schizophrenia and psychosis; Suicide