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Association of Psychache and Alexithymia With Suicide in Patients With Schizophrenia

Demirkol, Mehmet Emin MD*; Tamam, Lut MD*; Namli, Zeynep MD; Karaytuğ, Mahmut Onur MD; Uğur, Kerim MD§

The Journal of Nervous and Mental Disease: August 2019 - Volume 207 - Issue 8 - p 668–674
doi: 10.1097/NMD.0000000000001023
Original Articles

Suicide is a leading cause of death in patients with schizophrenia. Previous studies have mostly investigated the association between suicide and sociodemographics, positive and negative symptoms, and depressive symptoms. This study evaluated psychache and alexithymia in patients with schizophrenia, which have both been associated with suicide attempts and thoughts in patients with other psychiatric disorders. Positive and Negative Syndrome Scale (PANSS), Psychache Scale (PAS), Beck Scale for Suicidal Ideation (BSSI), Calgary Depression Scale for Schizophrenia (CDSS), and Toronto Alexithymia Scale (TAS) scores were obtained in 113 patients with schizophrenia, including 50 with suicide attempts. PANSS positive symptoms and general psychopathology subscale, CDSS, BSSI, TAS, and PAS scores were significantly higher in patients with suicide attempts. In multivariate logistic regression analysis, only the PAS score was an independent predictor of attempted suicide. Mediation analysis demonstrated that psychache (both directly and indirectly) and alexithymia (indirectly) might be associated with the risk of suicide in these patients.

*Department of Psychiatry, Çukurova University Medical School, Adana

Şanliurfa Mehmet Akif İnan State Hospital, Şanliurfa

Dr Ekrem Tok Hospital for Mental and Nervous Disease, Adana

§Malatya Training and Research Hospital, Malatya, Turkey.

Send reprint requests to Lut Tamam, MD, Department of Psychiatry, Çukurova University Medical School, Balcali Hospital, Mithat Ozsan St, 01330 Sariçam, Adana, Turkey. E-mail:

Online date: July 17, 2019

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