TY - JOUR
T1 - Insomnia, Suicidal Ideation, and Suicide Attempts in the Clinical Antipsychotic Trials of Intervention Effectiveness
AU - Miller, Brian J
AU - McEvoy, Joseph P
AU - McCall, William V
N1 - Funding Information:
Submitted: March 11, 2020; accepted September patients: prevalence and quality of life. Int J ideation during a depression clinical trial. Sleep 28, 2020. Environ Res Public Health. 2020;17(4):E1350.PubMed CrossRef Med. 2010;11(9):822–827.PubMed CrossRef Publishedonline:March 23, 2021. 2. Hou CL, Li Y, Cai MY, et al. Prevalence of 9. Lu L, Dong M, Zhang L, et al. Prevalence of Potential conflicts of interest:DrMillerhas insomnia and clinical and quality of life suicide attempts in individuals with nothing to disclose for the present work. In the correlates in chinese patients with schizophrenia: a meta-analysis of observational past12months, he received research support schizophrenia treated in primary care. Perspect studies. Epidemiol Psychiatr Sci. 2019;29:e39.PubMed CrossRef from Alkermes, Augusta University,NARSAD, PsychiatrCare.2017;53(2):80–86.PubMedCrossRef Hor K, Taylor M. Suicide and schizophrenia: a the National Institute of Mental Health, and the 3. Palmese LB, DeGeorge PC, Ratliff JC, et al. systematic review of rates and risk factors. StanleyMedicalResearchInstituteandhonoraria Insomnia is frequent in schizophrenia and J Psychopharmacol. 2010;24(4 suppl):81–90.PubMed CrossRef from PsychiatricTimes. Dr McEvoyhasnothing associated with night eating and obesity. Andriopoulos I, Ellul J, Skokou M, et al. to disclose for the present work. In the past12 Schizophr Res. 2011;133(1–3):238–243.PubMed CrossRef Suicidality in the “prodromal” phase of months, he participated in advisory boards for 4. Monti JM, BaHammam AS, Pandi-Perumal SR, schizophrenia. Compr Psychiatry. Otsuka, Merck, Forum, and Ameritox and has et al. Sleep and circadian rhythm dysregulation 2011;52(5):479–485.PubMed CrossRef received research grants from Otsuka, Avenir, in schizophrenia. Prog Neuropsychopharmacol Freeman D, Bold E, Chadwick E, et al. Suicidal Auspex, and Alkermes. Dr McCall has nothing to Biol Psychiatry. 2013;43:209–216.PubMed CrossRef ideation and behaviour in patients with disclose for the work under consideration. In the Wulff K, Dijk DJ, Middleton B, et al. Sleep and persecutory delusions: prevalence, symptom past 12 months, he has received research support circadian rhythm disruption in schizophrenia. associations, and psychological correlates. from PCORI, Merck, Vistagen, and the MECTA Br J Psychiatry. 2012;200(4):308–316.PubMedCrossRef ComprPsychiatry. 2019;93:41–47.PubMedCrossRef Corporation; has been a consultant for Anthem Davies G, Haddock G, Yung AR, et al. A Li SX, Lam SP, Zhang J, et al. Sleep disturbances Insurance, Jazz, Sage, and Janssen; has been a paid systematic review of the nature and correlates and suicide risk in an 8-year longitudinal study CME speaker for CME Outfitters; and has received of sleep disturbance in early psychosis. Sleep of schizophrenia-spectrum disorders. Sleep. royalties from Wolters Kluwer. Med Rev. 2017;31:25–38.PubMed CrossRef 2016;39(6):1275–1282.PubMed CrossRef Funding/support: No direct funding was provided Malik S, Kanwar A, Sim LA, et al. The association Miller BJ, Parker CB, Rapaport MH, et al. for this research. between sleep disturbances and suicidal Insomnia and suicidal ideation in nonaffective behaviors in patients with psychiatric psychosis. Sleep. 2019;42(2).PubMed CrossRef diagnoses: a systematic review and meta-Pompili M, Lester D, Grispini A, et al. analysis. Syst Rev. 2014;3(1):18.PubMed CrossRef Completed suicide in schizophrenia: evidence 1. Batalla-MartínD,Belzunegui-ErasoA,Miralles McCall WV, Blocker JN, D’Agostino R Jr, et al. from a case-control study. PsychiatryRes. Garijo E, et al. Insomnia in schizophrenia Insomnia severity is an indicator of suicidal 2009;167(3):251–257.PubMed CrossRef
Publisher Copyright:
Copyright © 2021 Physicians Postgraduate Press, Inc.
PY - 2021/5
Y1 - 2021/5
N2 - Objective: Insomnia occurs frequently in the clinical course of schizophrenia. There is a robust association between insomnia and suicide in other psychiatric disorders. Several previous studies found associations between insomnia and suicidal ideation, suicide attempt, and psychopathology in schizophrenia. We explored these associations in a cross-sectional study of a large sample of patients with schizophrenia. Methods: In February 2020, we investigated relationships between current insomnia, suicidal ideation over the past 2 weeks, suicide attempt in the past 6 months (assessed by either the Calgary Depression Scale for Schizophrenia or self-report), and current psychopathology for subjects with baseline data from the Clinical Antipsychotic Trials of Intervention Effectiveness (DSM-IV schizophrenia trial conducted 2001-2004) using regression models. Results: After controlling for multiple potential confounding factors, terminal insomnia was associated with significant, 2.7-fold increased odds of current suicidal ideation (OR = 2.7, 95% CI = 2.0-3.6, P < .001). Initial/middle insomnia was associated with a significant, 5.5-fold increased odds of suicide attempt in the past 6 months (OR = 5.5, 95% CI = 1.4- 21.1, P = .013). Terminal insomnia was also a significant indicator of higher Positive and Negative Syndrome Scale total (β = 0.12, P < .001), positive subscale (β = 0.11, P <.001), and general psychopathology subscale (β = 0.14, P < .001) scores. There were no other significant associations between insomnia, suicidal thinking or behavior, and psychopathology. Conclusions: Insomnia is associated with suicidal ideation, recent suicide attempt, and greater psychopathology in schizophrenia. Findings provide additional evidence that formal assessment of insomnia is relevant to the clinical care of patients with schizophrenia as an indicator of suicidal ideation and behavior, as well as symptom severity.
AB - Objective: Insomnia occurs frequently in the clinical course of schizophrenia. There is a robust association between insomnia and suicide in other psychiatric disorders. Several previous studies found associations between insomnia and suicidal ideation, suicide attempt, and psychopathology in schizophrenia. We explored these associations in a cross-sectional study of a large sample of patients with schizophrenia. Methods: In February 2020, we investigated relationships between current insomnia, suicidal ideation over the past 2 weeks, suicide attempt in the past 6 months (assessed by either the Calgary Depression Scale for Schizophrenia or self-report), and current psychopathology for subjects with baseline data from the Clinical Antipsychotic Trials of Intervention Effectiveness (DSM-IV schizophrenia trial conducted 2001-2004) using regression models. Results: After controlling for multiple potential confounding factors, terminal insomnia was associated with significant, 2.7-fold increased odds of current suicidal ideation (OR = 2.7, 95% CI = 2.0-3.6, P < .001). Initial/middle insomnia was associated with a significant, 5.5-fold increased odds of suicide attempt in the past 6 months (OR = 5.5, 95% CI = 1.4- 21.1, P = .013). Terminal insomnia was also a significant indicator of higher Positive and Negative Syndrome Scale total (β = 0.12, P < .001), positive subscale (β = 0.11, P <.001), and general psychopathology subscale (β = 0.14, P < .001) scores. There were no other significant associations between insomnia, suicidal thinking or behavior, and psychopathology. Conclusions: Insomnia is associated with suicidal ideation, recent suicide attempt, and greater psychopathology in schizophrenia. Findings provide additional evidence that formal assessment of insomnia is relevant to the clinical care of patients with schizophrenia as an indicator of suicidal ideation and behavior, as well as symptom severity.
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U2 - 10.4088/JCP.20m13338
DO - 10.4088/JCP.20m13338
M3 - Article
C2 - 34033271
SN - 0160-6689
VL - 82
JO - Diseases of the Nervous System
JF - Diseases of the Nervous System
IS - 3
M1 - 20M13338
ER -
