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The role of demoralization in the relationship between insight and suicidality in schizophrenia

Eneman, M; Vanhee, L; Tang, E; Sabbe, B; Corveleyn, J; Luyten, P; (2020) The role of demoralization in the relationship between insight and suicidality in schizophrenia. Neurology, Psychiatry and Brain Research , 38 pp. 12-15. 10.1016/j.npbr.2020.08.002. Green open access

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Abstract

Background: The lifetime risk of suicide is significantly higher in patients with schizophrenia than in the general population. It has been suggested that insight is an important risk factor for suicidality in schizophrenia, but only in the presence of feelings of hopelessness and demoralization more generally. Methods: This study set out to investigate these assumptions in a sample of patients diagnosed with schizophrenia (n = 81) with the Structured Clinical Interview for DSM-IV Axis I. We hypothesized that there would be a positive association between insight in schizophrenia, measured by the Insight Scale for Psychosis, and suicidality among these patients, measured by the Beck Scale for Suicide Ideation. Furthermore, we expected demoralization, measured by the Demoralization Scale, to mediate the association between insight and suicidality. Results: With regard to the association between insight and suicidality, only the dimension awareness of illness was significantly positively associated with suicidality (r = .34, p ≤ .01**). Demoralization fully mediated the relationship between awareness of illness and suicidality (Sobel test z = 1.93, p < .05). Limitations: This was a cross-sectional study in a relatively small sample, based on self-report questionnaires only. Conclusions: This study emphasizes the importance of recognizing and treating demoralization features in schizophrenia.

Type: Article
Title: The role of demoralization in the relationship between insight and suicidality in schizophrenia
Open access status: An open access version is available from UCL Discovery
DOI: 10.1016/j.npbr.2020.08.002
Publisher version: https://doi.org/10.1016/j.npbr.2020.08.002
Language: English
Additional information: This version is the author accepted manuscript. For information on re-use, please refer to the publisher’s terms and conditions.
Keywords: demoralization, insignt, suicidality, schizophrenia
UCL classification: UCL
UCL > Provost and Vice Provost Offices
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Brain Sciences
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Brain Sciences > Div of Psychology and Lang Sciences
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Brain Sciences > Div of Psychology and Lang Sciences > Clinical, Edu and Hlth Psychology
URI: https://discovery.ucl.ac.uk/id/eprint/10107541
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