Abstract
The full text of this article is freely and openly accessible from the following repository: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7965071/
Subclinical risk markers for schizophrenia predict suicidality, but little is known about the nature of the relationship. Suicidal ideation is often considered homogenous, but distinguishing passive from active ideation (i.e. thoughts of death vs thoughts of killing oneself) and different temporal patterns may further understanding of risk factors. We tested whether schizotypy and psychotic experiences (PE) in early adolescence predict subsequent growth trajectories of suicidal ideation and suicide attempt outcomes. Participants were 1037 members of the population-representative Dunedin Study cohort. PE was measured at 11 years; schizotypy at 13 and 15 years. Outcomes were passive and active suicidal ideation, and suicide attempt, measured at 18, 21, 26, 32, and 38 years. Passive ideation was best represented by two trajectories, including persistent and transient ideation classes. Schizotypy predicted membership in the smaller persistent class (OR = 1.21, p = .041), whereas PE was not associated with class membership. Probability of suicide attempt was 13.8% in the persistent ideation class, compared to 1.8% in the transient class. Active ideation was best represented by a one-class model, the intercept of which was predicted by schizotypy (OR = 1.23, p = .015). Suicide attempts were predicted by schizotypy (OR = 1.53, p = .040) and PE (OR = 3.42, p = .046), and this was partially mediated by indirect effects via the active ideation trajectory. Findings indicate adolescent schizotypy and PE are related to subsequent suicidal ideation and attempts. Suicidal ideation is heterogenous, and schizotypy is specifically related to a persistent passive ideation subgroup.