Are sleep disturbances a risk factor for suicidal behavior in the first episode of psychosis? Evidence from a systematic review

IF 3.7 2区医学 Q1 PSYCHIATRY

Journal of psychiatric research Pub Date : 2025-03-27 DOI:10.1016/j.jpsychires.2025.03.053

Valentina Baldini , Martina Gnazzo , Giulia Santangelo , Armando D'Agostino , Giorgia Varallo , Maristella Scorza , Giovanni Ostuzzi , Gian Maria Galeazzi , Diana De Ronchi , Giuseppe Plazzi

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引用次数: 0

Abstract

Sleep disturbances are common in individuals with first-episode psychosis (FEP) and have been identified as potential contributors to an increased risk of suicidal behavior. This systematic review aims to synthesize the existing evidence on the association between sleep disturbances and suicidal behavior in individuals experiencing FEP, a critical period for early intervention.

In accordance with the guidelines established by PRISMA, this systematic review was duly registered in PROSPERO (CRD42024598203) prior to its initiation. A comprehensive search was conducted across databases including PubMed, Web of Science, EMBASE, and PsycINFO, encompassing studies from their inception through February 2025. The review specifically included observational studies that investigated the association between sleep disturbances and suicidal behaviors, which include suicidal ideation, attempts, or completed suicides, among individuals with FEP. The inclusion criteria required that all studies featured adult participants aged 18 years and older, employed validated measures for both sleep disturbances and suicidality, and concentrated on populations with FEP. Reviews, case reports, and studies not published in English were systematically excluded. The selection of studies, extraction of data, and assessment of quality were conducted independently by two reviewers.

Seven studies met the inclusion criteria, with sample sizes ranging from 118 to 688 participants. The findings indicate that sleep disturbances, especially insomnia, are significantly linked to an increased risk of suicidal ideation and behavior in individuals with FEP. The strength of these associations varied among the studies, with some reporting moderate to strong effect sizes. However, there was noted methodological heterogeneity, including variations in sleep assessment tools.

This systematic review highlights sleep disturbances as a key modifiable risk factor for suicidal behavior in individuals with FEP. Future research should prioritize longitudinal designs and standardized sleep assessments to better characterize this relationship and guide targeted interventions.

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睡眠障碍是精神病首发自杀行为的危险因素吗？来自系统评价的证据

睡眠障碍在首发精神病（FEP）患者中很常见，并且已被确定为增加自杀行为风险的潜在因素。本系统综述旨在综合现有证据，在经历FEP的个体中，睡眠障碍与自杀行为之间的关系，这是早期干预的关键时期。根据PRISMA制定的指南，该系统评价在开始之前已在PROSPERO （CRD42024598203）正式注册。在PubMed、Web of Science、EMBASE和PsycINFO等数据库中进行了全面的搜索，涵盖了从研究开始到2025年2月的研究。该综述特别纳入了调查睡眠障碍与自杀行为之间关系的观察性研究，包括FEP患者的自杀意念、自杀企图或自杀完成。纳入标准要求所有研究以18岁及以上的成年参与者为特征，采用有效的睡眠障碍和自杀测量方法，并集中于FEP人群。系统地排除了非英文发表的综述、病例报告和研究。研究的选择、数据的提取和质量的评估由两位审稿人独立进行。7项研究符合纳入标准，样本量从118到688人不等。研究结果表明，睡眠障碍，尤其是失眠，与FEP患者自杀意念和行为风险的增加有着显著的联系。这些关联的强度在不同的研究中有所不同，有些研究报告了中等到强烈的效应量。然而，研究方法存在异质性，包括睡眠评估工具的差异。本系统综述强调睡眠障碍是FEP患者自杀行为的关键可改变风险因素。未来的研究应该优先考虑纵向设计和标准化的睡眠评估，以更好地描述这种关系并指导有针对性的干预措施。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Journal of psychiatric research 医学-精神病学

CiteScore

7.30

自引率

2.10%

发文量

622

审稿时长

130 days

期刊介绍： Founded in 1961 to report on the latest work in psychiatry and cognate disciplines, the Journal of Psychiatric Research is dedicated to innovative and timely studies of four important areas of research: (1) clinical studies of all disciplines relating to psychiatric illness, as well as normal human behaviour, including biochemical, physiological, genetic, environmental, social, psychological and epidemiological factors; (2) basic studies pertaining to psychiatry in such fields as neuropsychopharmacology, neuroendocrinology, electrophysiology, genetics, experimental psychology and epidemiology; (3) the growing application of clinical laboratory techniques in psychiatry, including imagery and spectroscopy of the brain, molecular biology and computer sciences;