The relation of current suicidal ideation with life events, problem solving skills and cognitive functions in psychotic disorder patients

Aim: Life events are among the major risk factors for suicide. However, individuals may not be affected at the same level to worrying life events. In patients with a psychotic disorder, the effects of coping with life events, problem solving skills and cognitive functions on suicidal ideation were not adequately investigated. The aim of this study is to study the relation of current suicidal ideation, past suicide attempts, and current psychopathologies of psychotic disorder patients on their problem-solving skills, life events and cognitive functions. Method: 101 healthy controls and 101 patients at the Adnan Menderes University, Faculty of Medicine Research and Training Hospital, Department of Psychiatry polyclinic in stable conditions or clinically in remission treated as outpatients for psychotic disorder diagnosed according to DSM-IV diagnostic classification for schizophrenia,schizoaffective disorder, delusional disorder were enrolled in the current study. Both patients and healthy controls were applied demographic data form, the SCID-I, Beck Depression Inventory, the Beck Hopelessness Scale, Beck Depression Inventory, the Suicidal Ideation Questionnaire, Barratt Impulsivity Scale-11, Worrying Experiences List, Problem Solving Scale and the Wisconsin Card Sorting Test. Moreover, PANSS and Calgary Depression Scale were administered to the patients.Findings : 52.5% (n = 53) of the patients with psychosis were determined to have a currently active suicidal ideation (ASI), respectively. Past suicides attempt histories were significantly higher in the ASI group compared to the patients without ASI. There was no statistically significant difference between patients with and without ASI, with regard to the suicide attempt history of a family member, psychotic disorder history in the family, average illness duration, PANSS positive, PANSS general psychopathology and PANSS total scores. PANSS negative scores of ASI patients were significantly lower than the non ASI group. Major depression diagnosis in ASI in patients was with (58.5%, n = 31) significantly higher than the patients without ASI (18.8%, n = 9). Life events were determined to be in ASI patients statistically more significant than non ASI -patients and healthy controls. In psychotic patients one or more life events increased ASI prevalence 43approximately 1.4 times (risk ratio: 1.391). On comparing the problem-solving skills ofASI patients and non ASI patients, there were no differences between both groups; yet compared with the healthy controls, these were lower in the ASI group. On evaluating problem-solving skills according to sub-scales; although there were no differences between patients and controls in positive problem orientation and rational problem-solving style, the negative problem-solving orientation of the patients were lower and impulsive / careless problem-solving and avoiding problem-solving scores were significantly higher. There was no statistically meaningful relation between patients problem-solving skills and PANSS values. On comparing the preservative error percentages determined with Wisconsin Card Sorting Test, there was no statistically significant difference between patients with and without ASI. WCST preservative error percentages of ASI and non ASI patients were significantly higher than the control group. Results: There was no relation between the presence of active suicidal thoughts (ideation) in patients with psychosis and the variables of age, gender, disease duration, suicide attempt and mental illness history in the family, PANSS positive, general psychopathology, total scores, problem solving skills and preservative error percentages measured with WCST. However, a relation between the presence of major depression in patients and PANSS negative symptom scores, life events, past suicide attempts, and the presence of active suicidal ideation.Key words: Schizophrenia, Psychosis, Suicide, Wisconsin Card Sorting Test, Life Events, Problem Solving