The effect of impoverishment of thought in early psychosis: Influence on suicide risk via depression and aggression
Bibliographic record
Abstract
Objective: Suicide is a leading cause of premature mortality among individuals with psychosis, particularly during its early stages. This study aimed to examine the direct and indirect effects of formal thought disorders (FTDs) on suicidal ideation and behavior in early psychosis, while also evaluating the roles of depressive symptoms and social functionality as both independent contributors to suicide risk and potential mediators of the relationship between FTDs and suicidality. Method: The study included 64 patients diagnosed with early psychosis (≤12 months since initial treatment), 30 of whom had recently attempted suicide. Participants were assessed using the Columbia Suicide Severity Rating Scale (C-SSRS), Thought and Language Index (TLI), Personal and Social Performance Scale (PSP), Calgary Depression Scale for Schizophrenia (CDSS), and the Positive and Negative Syndrome Scale (PANSS). Results: Patients with a history of suicide attempts scored significantly lower on the TLI-Impoverishment of Thought Subscale (TLI-ITS) (p=0.001), and significantly higher on the TLI-Disorganization Subscale (p=0.036), the CDSS (p<0.001), and the PANSS Positive Subscale (p=0.003). They also had significantly lower total PSP scores (p<0.001). Mediation analysis revealed that the effect of TLI-ITS on suicide attempts was negative and significantly mediated through both CDSS and the Personal and Social Performance Scale - Dysfunction subscale (PSP-D). Lower TLI-ITS scores were associated with higher CDSS scores and lower PSP-D scores, each of which contributed to an increased risk of suicide attempts (p<0.001 and p=0.026, respectively). Conclusion: The prominence of impoverishment of thought may be associated with lower levels of depressive symptoms and increased disruptive and aggressive behaviors, which, in turn, could be linked to a reduced risk of suicidal thoughts and attempts. These findings could serve as an important point of consideration for clinicians when assessing suicidal ideation and behavior in early psychosis.
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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 | 0.000 | 0.003 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.000 | 0.000 |
| Bibliometrics | 0.000 | 0.000 |
| Science and technology studies | 0.000 | 0.000 |
| Scholarly communication | 0.001 | 0.000 |
| Open science | 0.000 | 0.001 |
| Research integrity | 0.000 | 0.001 |
| Insufficient payload (model declined to judge) | 0.002 | 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".