Unraveling Suicidal Ideation and Behaviors in a Global Cohort of Individuals at Clinical High‐Risk for Psychosis: Multivariable Correlates and Subthreshold Psychotic Symptoms

作者：Stefano Damiani, Orlandi Marika, Umberto Provenzani, Elisa Bortolin, Margherita Rovida, Riccardo Stefanelli, Jean Addington, Luis Alameda, Celso Arango, Nicholas J. K. Breitborde, Matthew R. Broome, Kristin S. Cadenhead, Monica E. Calkins, Ricardo E. Carrión, Rolando I Castillo-Passi, Eric Yu Hai Chen, Jimmy Choi, Philippe Conus, Barbara A. Cornblatt, Covadonga Martínez Díaz-Caneja, Lauren M. Ellman, Abigayle Fogarty, Pablo A. Gaspar, Carla Gerber, Louise Birkedal Glenthøj, Leslie E. Horton, Christy Lai Ming Hui, Joseph P. Kambeitz, Lana Kambeitz‐Ilankovic, Matcheri S. Keshavan, Minah Kim, Sung‐Wan Kim, Nikolaos Koutsouleris, Zsüliet Kristóf, Jun Soo Kwon, Kerstin Langbein, Daniel Mamah, Daniel H. Mathalon, Vijay A. Mittal, Josh Nguyen, Merete Nordentoft, Godfrey D. Pearlson, Nora Penzel, Jesus Perez, Diana O. Perkins, Albert R. Powers, Jack C. Rogers, Fred W. Sabb, Jason Eric Schiffman, Jai L. Shah, Steven M. Silverstein, Stefan Smesny, William S. Stone, Gregory P. Strauss, Judy L. Thompson, Rachel Upthegrove, Swapna Kamal Verma, Cassandra M. J. Wannan, Jijun Wang, Heather M. Wastler, Daniel H. Wolf, Tianhong Zhang, Sylvain Bouix, Cheryl M. Corcoran, Tina Kapur, Ofer Pasternak, Carrie E. Bearden, Rene S. Kahn, John Michael Kane, Patrick D. McGorry, Barnaby Nelson, Martha E. Shenton, Scott W. Woods, Paolo Fusar‐Poli · 发表于：Acta Psychiatrica Scandinavica · 年份：2026 · DOI：10.1111/acps.70138 · 研究领域：Suicide and Self-Harm Studies、Schizophrenia research and treatment、Mental Health Treatment and Access

ABSTRACT Introduction Suicidal ideation and behaviors (SIB) are common among individuals at clinical high risk for psychosis (CHR‐P), but their relationship with the overall clinical profile remains unclear. This study aimed to identify sociodemographic/clinical factors associated with SIB in CHR‐P individuals and to examine whether subthreshold psychotic symptom severity increases with suicidal risk. Methods Data from the AMP SCZ initiative included 1443 CHR‐P participants aged 12–30 years. SIB were assessed using the Columbia Suicide Severity Rating Scale (C‐SSRS). Three Elastic Net regression models examined associations between suicidal ideation severity, intensity, and behaviors using 54 variables spanning sociodemographics, general psychopathology, subthreshold psychotic symptoms, and socio‐occupational functioning. Moreover, ANCOVA compared overall psychotic symptom severity across five groups defined by increasing severity on the C‐SSRS. Results Sixty‐eight percent of participants reported lifetime suicidal ideation, and 26% reported previous suicidal behaviors. Model performance was modest but significant (cross‐validated ideation severity: R 2 = 0.161, RMSE = 0.916; ideation intensity: R 2 = 0.193, RMSE = 0.898; suicidal behavior: accuracy = 0.685; AUC = 0.675; p < 0.001). Across all models, concurrent depressive symptoms, present/past diagnosis of depression, female sex at birth, cannabis use, visual/gustatory abnormalities, guilt, and lower role functioning were t...