Abstract
Objective
Suicide is a major cause of death amongst individuals with schizophrenia spectrum disorders (SSD). Despite numerous risk factors being identified, accurate prediction of suicidality and provision of tailored and effective treatment is difficult. One factor that may warrant particular attention as a contributor to increased psychopathology and suicidality in SSD is disturbed sleep. Sleep disturbances have been reliably linked to greater levels of suicidal ideation and are highly prevalent amongst individuals with SSD. This study aimed to examine if reduced sleep duration and psychopathology are associated with increased suicidal ideation.
Method
One-hundred and eighteen adults with chronic SSD living within the community participated in this cross-sectional study. Psychosis symptoms were assessed using the Positive and Negative Syndrome Scale. Items 4 and 10 from the Montgomery-Asperg Depression Rating Scale and Item 2 from the Calgary Depression Scale for Schizophrenia were used to assess reduced sleep duration, current suicidal ideation, and hopelessness, respectively. All measures were rated concurrently.
Results
A hierarchical logistic regression revealed that greater acute sleep disturbances were associated with increased suicidal ideation and this relationship was found to be uniquely mediated by both positive symptom severity and hopelessness.
Conclusion
These results suggest that individuals with SSD who exhibited disrupted or disordered sleep, positive symptoms and/or hopelessness should be routinely screened for suicidal thinking. Furthermore, interventions that effectively target sleep disruptions may provide much-needed action against suicidal ideation.
Reduced sleep found to be associated with increased suicidal ideation
This was uniquely mediated by both hopelessness and positive symptoms
More regular screening of sleep problems in schizophrenia is needed
HIGHLIGHTS
ACKNOWLEDGEMENTS
The authors wish to acknowledge the contributions of study participants, staff at recruitment services, staff at the Centre for Mental Health, and staff at the Monash Alfred Psychiatry Research Centre (MAPrc), including Professor Jayashri Kulkarni.
DISCLOSURE STATEMENT
No potential conflict of interest was reported by the author(s).
Additional information
Funding
Notes on contributors
Sean P. Carruthers
Sean P. Carruthers and Stuart J. Lee, Centre for Mental Health, Swinburne University of Technology, Hawthorn, VIC, Australia.
Stuart J. Lee
Sean P. Carruthers and Stuart J. Lee, Centre for Mental Health, Swinburne University of Technology, Hawthorn, VIC, Australia.
Anoop Sankaranarayanan
Anoop Sankaranarayanan, Blacktown Mental Health Services, Western Sydney Mental Health Service, Sydney, NSW, Australia; School of Medicine and Translational Health Research Institute, Western Sydney University, Campbelltown, NSW, Australia.
Philip J. Sumner
Philip J. Sumner and Wei Lin Toh, Centre for Mental Health, Swinburne University of Technology, Hawthorn, VIC, Australia.
Wei Lin Toh
Philip J. Sumner and Wei Lin Toh, Centre for Mental Health, Swinburne University of Technology, Hawthorn, VIC, Australia.
Eric J. Tan
Eric J. Tan, Centre for Mental Health, Swinburne University of Technology, Hawthorn, VIC, Australia; Department of Psychiatry, St Vincent’s Hospital, Melbourne, VIC, Australia.
Erica Neill
Erica Neill, Centre for Mental Health, Swinburne University of Technology, Hawthorn, VIC, Australia; Department of Psychiatry, St Vincent’s Hospital, Melbourne, VIC, Australia; Department of Psychiatry, University of Melbourne, VIC, Australia.
Tamsyn E. Van Rheenen
Tamsyn E. Van Rheenen, Centre for Mental Health, Swinburne University of Technology, Hawthorn, VIC, Australia; Melbourne Neuropsychiatry Centre, Department of Psychiatry, The University of Melbourne and Melbourne Health, Victoria, Australia.
Caroline Gurvich
Caroline Gurvich, Centre for Mental Health, Swinburne University of Technology, Hawthorn, VIC, Australia; Monash Alfred Psychiatry Research Centre (MAPrc), Monash University Central Clinical School and The Alfred Hospital, Melbourne, Australia.
Susan L. Rossell
Susan L. Rossell, Centre for Mental Health, Swinburne University of Technology, Hawthorn, VIC, Australia; Department of Psychiatry, St Vincent’s Hospital, Melbourne, VIC, Australia.