Association between childhood maltreatment and suicidal ideation among Chinese patients with chronic schizophrenia: the mediating role of insomnia
Yuzhu Hao,
Pu Peng,
Qianjin Wang,
Yanan Zhou,
Shubao Chen,
Qiuxia Wu,
Tieqiao Liu,
Xiangyang Zhang
Affiliations
Yuzhu Hao
Department of Psychiatry, National Clinical Research Centre for Mental Disorders, and National Centre for Mental Disorders, The Second Xiangya Hospital of Central South University, Changsha, China
Department of Psychiatry, National Clinical Research Centre for Mental Disorders, and National Centre for Mental Disorders, The Second Xiangya Hospital of Central South University, Changsha, China
Department of Psychiatry, National Clinical Research Centre for Mental Disorders, and National Centre for Mental Disorders, The Second Xiangya Hospital of Central South University, Changsha, China
Department of Psychiatry, Hunan Brain Hospital (Hunan Second People's Hospital), Changsha, China
Shubao Chen
Department of Psychiatry, National Clinical Research Centre for Mental Disorders, and National Centre for Mental Disorders, The Second Xiangya Hospital of Central South University, Changsha, China
Qiuxia Wu
Department of Psychiatry, National Clinical Research Centre for Mental Disorders, and National Centre for Mental Disorders, The Second Xiangya Hospital of Central South University, Changsha, China
Department of Psychiatry, National Clinical Research Centre for Mental Disorders, and National Centre for Mental Disorders, The Second Xiangya Hospital of Central South University, Changsha, China
CAS Key Laboratory of Mental Health, Institute of Psychology, Chinese Academy of Sciences, Beijing, China Department of Psychology, University of Chinese Academy of Sciences, Beijing, China
Background Childhood maltreatment is a well-established transdiagnostic risk factor for suicidal ideation; however, previous studies on their association in schizophrenia have produced highly varied results. Moreover, the mechanism linking childhood maltreatment and suicide ideation remains unclear in schizophrenia. Aims This cross-sectional study aimed to investigate the association between childhood maltreatment and suicide ideation in people with schizophrenia and tested whether insomnia mediated this relationship. Method Positive and Negative Syndrome Scale (PANSS), Insomnia Severity Index (ISI), Childhood Trauma Questionnaire – Short Form and Beck Suicidal Ideation Inventory were employed. Logistic regression and mediation analysis were performed. Results (a) The prevalence of suicide ideation, insomnia, sexual abuse, emotional neglect, emotional abuse, physical abuse and physical neglect was 10% (n = 61), 18% (n = 111), 11% (n = 68), 25% (n = 153), 6.3% (n = 39), 17% (n = 106) and 39% (n = 239), respectively. In all, 52% (n = 320) reported childhood maltreatment; (b) patients with suicide ideation demonstrated higher insomnia and childhood maltreatment. PANSS depression factor, ISI, lifetime suicidal attempts and emotional abuse were independently associated with suicide ideation; (c) insomnia partially mediated the effects of emotional abuse and emotional neglect on suicide ideation, and insomnia completely mediated the effects of physical neglect and physical abuse on suicide ideation. Conclusion Our study calls for formal assessments for childhood maltreatment and insomnia in schizophrenia, which might help identify suicide ideation early. In addition, interventions targeting insomnia might help reduce suicide ideation among people with schizophrenia who experience childhood maltreatment.
