Psychological pain and decision-making in schizophrenia: associations with lifetime suicide attempt history and suicidal ideation

作者：Aslan M, Bestepe EE · 发表于：Cognitive neuropsychiatry · 年份：2026 · DOI：10.1080/13546805.2026.2678597 · 研究领域：Cognitive functions、Iowa Gambling Task、decision-making、psychological pain、schizophrenia、suicide

Objective: This cross-sectional study aimed to evaluate the direct and indirect associations between psychological pain, decision-making and suicidality in patients with schizophrenia, with particular emphasis on lifetime suicide attempt history and current suicidal ideation severity. Methods: One hundred outpatients with schizophrenia (50 with and 50 without lifetime suicide attempt history) were assessed using the Positive and Negative Syndrome Scale, Calgary Depression Scale for Schizophrenia, Beck Suicide Ideation and Hopelessness Scales, Psychological Pain Scale, Iowa Gambling Task (IGT), Wisconsin Card Sorting Test, and Stroop Test. Multivariable logistic regression was used for lifetime suicide attempt history, and PROCESS Model 4 was used to test the indirect effect of IGT on suicidal ideation. Results: Higher psychological pain (OR = 1.075, 95% CI [1.026-1.127], p = 0.041), a greater number of lifetime psychiatric hospitalisations (OR = 1.300, 95%CI [1.065-1.586], p = 0.010), and lower IGT total score (OR = 0.932, 95%CI [0.887-0.979], p = 0.005) were independently associated with lifetime suicide attempt history. IGT also showed a significant indirect effect in the association between psychological pain and suicidal ideation (effect = 0.031, 95%CI [0.011-0.062]). Conclusion: Psychological pain and poorer decision-making performance were associated with suicidality-related outcomes in schizophrenia.