Affiliation:
1. Medical College of Georgia, Augusta University , Augusta , GA , USA
2. Department of Psychiatry, Augusta University , Augusta , GA , USA
Abstract
Abstract
Background and Hypothesis
Insomnia occurs frequently in the clinical course of schizophrenia. A growing literature has found associations between insomnia, suicidal ideation and behavior, and psychopathology in schizophrenia. We explored associations between sleep problems, suicidal ideation, and psychopathology in a cohort of patients with first-episode psychosis.
Study Design
We performed a secondary analysis of data for n = 403 subjects with data from the Recovery After an Initial Schizophrenia Episode study using regression models.
Study Results
The prevalence of sleep problems and suicidal ideation at baseline was 57% and 15%, respectively. After controlling for potential confounders, in the study baseline sleep problems were associated with increased odds of suicidal ideation with evidence of a dose-dependent relationship (OR = 2.25, 95% CI 1.15–4.41, P = .018). Over 24 months, sleep problems at any time point were associated with an over 3-fold increased odds of concurrent suicidal ideation (OR = 3.21, 95% CI 1.45–7.14, P = .004). Subjects with persistent sleep problems were almost 14 times more likely to endorse suicidal ideation at least once over the study than those without sleep problems (OR = 13.8, 95% CI 6.5–53.4, P < .001). Sleep problems were also a predictor of higher Positive and Negative Syndrome Scale total (β = 0.13–0.22), positive (β = 0.14–0.25), and general (β = 0.16–0.27) subscale scores at baseline and multiple follow-up visits (P < .01 for each).
Conclusions
Sleep problems are highly prevalent and associated with suicidal ideation and greater psychopathology in first-episode psychosis. Formal assessment and treatment of insomnia appear relevant to the clinical care of patients with psychosis as a predictor of suicidal ideation and symptom severity.
Funder
National Institute of Mental Health
Stanley Medical Research Institute
Publisher
Oxford University Press (OUP)
Subject
Psychiatry and Mental health
Cited by
2 articles.
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