The associations of suicidal ideation with psychopathology and inflammatory cytokines in patients with chronic schizophrenia
Bibliographic record
Abstract
BACKGROUND: Suicidal ideation (SI) is common in patients with chronic schizophrenia, but the exact mechanisms underlying its development are unclear. Therefore, this study aimed to initially assess the prevalence of SI and to thoroughly explore the potential associations between SI and general demographic factors, psychopathological characteristics, and inflammatory cytokines in patients with chronic schizophrenia. METHODS: From May to December 2018, 302 patients with chronic schizophrenia were included in this study. A self-administered questionnaire was used to collect general demographic data, and a series of scales were used to assess SI, psychotic symptoms, depression, insomnia, involuntary movements, extrapyramidal side effects, and akathisia symptoms, respectively. Additionally, plasma levels of inflammatory cytokines, including interleukin (IL)-1β, IL-6, IL-17 A and tumor necrosis factor-α (TNF-α) were measured. By logarithmic transformation with a base of 10, the values of Log IL-1β, Log IL-6, Log IL-17 A, and Log TNF-α were yielded. Among these, SI was designated as the dependent variable, with other psychopathological symptoms and inflammatory cytokines serving as independent variables, while general demographic factors were controlled for as potential confounders. Finally, multifactorial logistic stepwise regression analyses were performed to identify independent factors influencing SI in patients with chronic schizophrenia. Receiver operating characteristic (ROC) curve analyses were then used to assess the predictive value of each identified independent factor for SI. RESULTS: The prevalence of SI (lifetime) and SI (last week) in patients with chronic schizophrenia was 36.4% and 8.0%, respectively. After controlling for general demographic factors such as age, Body Mass Index (BMI), and years of education, regression analyses showed that being female, Calgary Depression Scale (CDSS) score and Log IL-1β were independent correlates of patients' SI (lifetime), while chlorpromazine equivalents, Positive and Negative Syndrome Scale (PANSS) score, CDSS score and Log IL-6 were independent correlates of SI (last week). Additionally, ROC curve analyses showed that the combination of both CDSS score and Log IL-1β items demonstrated better discriminative ability of SI (lifetime). And the four-item combination of chlorpromazine equivalents, PANSS score, CDSS score and Log IL-6 was a better predictor of SI (last week). CONCLUSION: There was higher overall risk of SI in patients with chronic schizophrenia. SI might be associated with psychotic symptoms, depression, insomnia, medication side effects, and increased levels of inflammatory cytokines. In clinical practice, doctors should take prompt preventive measures in patients combining suicidal risk factors.
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.001 | 0.002 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.000 | 0.000 |
| Bibliometrics | 0.001 | 0.001 |
| Science and technology studies | 0.000 | 0.000 |
| Scholarly communication | 0.000 | 0.000 |
| Open science | 0.000 | 0.000 |
| Research integrity | 0.000 | 0.001 |
| Insufficient payload (model declined to judge) | 0.001 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".