Understanding suicidal ideation in psychosis: findings from the Psychological Prevention of Relapse in Psychosis (PRP) Trial

L. Fialko, D. Freeman, P. E. Bebbington, E. Kuipers, P. A. Garety, G. Dunn, D. G. Fowler

Research output: Contribution to journalArticlepeer-review

113 Citations (Scopus)


Objective: To examine the clinically important phenomenon of suicidal ideation in psychosis in relation to affective processes and the multidimensional nature of hallucinations and delusions.

Method: In a cross-sectional study of 290 individuals with psychosis, the associations between level of suicidal ideation, affective processes, positive symptoms, clinical and demographic variables were examined.

Results: Forty-one per cent of participants expressed current suicidal ideation. Suicidal ideation was associated with depressed mood, anxiety, low self-esteem, negative illness perceptions, negative evaluative beliefs about the self and others and daily alcohol consumption. Frequency of auditory hallucinations and preoccupation with delusions were not associated with suicidal ideation; however, positive symptom distress did relate to suicidal thoughts.

Conclusion: Affective dysfunction, including distress in response to hallucinations and delusions, was a key factor associated with suicidal ideation in individuals with psychotic relapse. Suicidal ideation in psychosis appears to be an understandable, mood-driven process, rather than being of irrational or ‘psychotic’ origin.
Original languageEnglish
Pages (from-to)177-186
Number of pages10
JournalActa Physiologica Scandinavica
Issue number3
Publication statusPublished - Sep 2006

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