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Schizophr Res. 2015 Jul;165(2-3):152-6. doi: 10.1016/j.schres.2015.04.022. Epub 2015 May 7.

Assessing suicidal ideation in individuals at clinical high risk for psychosis.

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Department of Psychiatry at Columbia University Medical Center, New York, NY, United States; Department of Psychology at The Catholic University of America, Washington, DC, United States. Electronic address:
Department of Psychiatry at Columbia University Medical Center, New York, NY, United States.



The majority of individuals with schizophrenia and other psychotic illnesses have had suicidal ideation at some point during the illness. However, little is known about the variation in level and intensity of suicidal ideation and symptoms in the attenuated stage of psychotic illness. Our aims were to assess prevalence of suicidal ideation in this at risk group, and to examine the severity and intensity of suicidal ideation, and their relation to symptoms.


Suicidal ideation was assessed in 42 clinical high-risk participants using the Columbia Suicide Severity Rating Scale (C-SSRS). We hypothesized that prevalence rates would be similar to what was found in previous studies, and individuals with suicidal ideation would have higher positive and negative symptoms, with poorer functioning. We assessed levels of severity and intensity of suicidal ideation related to these symptoms, and examined how depressive symptoms affected these relationships.


Nearly half (42.9%) of participants reported having current suicidal ideation. We found no relationship to positive symptoms. However, severity and intensity of suicidal ideation were found to be related to negative symptoms and level of functioning. When controlling for depressive symptoms during exploratory analysis, this relationship still emerged.


This study adds to the literature demonstrating the complex nature of suicidal ideation in psychotic illness. The C-SSRS has shown to be helpful in determining relationships between severity and intensity in suicidal ideation in relation to specific symptoms in a research setting.


Clinical high risk; Functioning; Psychosis; Schizophrenia; Suicidal ideation

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