Relationships between hallucinations, delusions, depression, suicide ideation, and plan among adults presenting with psychosis in psychiatric emergency care

ABSTRACT

Background

Suicide is a leading cause of preventable death among adults diagnosed with schizophrenia spectrum disorders. Fewer studies have examined suicide thoughts and behaviors among community populations of adults with psychosis symptoms. The current study examined the relationships between psychosis symptomatology, depression, and suicide ideation and plan among a sample of adults in psychiatric emergency care.

Methods

An Electronic Medical Record Search Engine was used to obtain data from Psychiatric Emergency Services (PES) of an academic healthcare system in the United States. Patients included 712 adults who presented to PES from 2013 to 2020 with one or more symptom of psychosis and either suicide ideation or a recent suicide attempt. Data were examined in SPSS27 using logistic regressions.

Results

Patients were twice as likely to experience suicidal ideation when hallucinations were present and eight times more likely when depression was present. Also, patients were twice as likely to have a suicide plan when hallucinations were present and three-times more likely when depression was present. Delusions did not significantly relate to suicide ideation or plan.

Discussion

Study findings suggest the importance of incorporating positive symptom evaluations into suicide risk assessments and the formulation of risk among patients with psychosis symptoms.

KEYWORDS:

• Psychosis symptoms
• psychiatric emergency services
• suicide ideation
• suicide plan

Acknowledgments

Research reported in this publication was supported by the National Cancer Institute of the National Institutes of Health under Award Numbers U24CA204863 and P30CA046592, as well as the National Center for Advancing Translational Sciences of the National Institutes of Health under Award Numbers UL1TR000433 and UL1TR002240. The content is solely the responsibility of the authors and does not necessarily represent the official views of the National Institutes of Health.

Disclosure of interest

All authors declare no conflict of interest.