The Relationship Between Suicidal Behavior, Neurocognitive Functions and Insight in Patients with Schizophrenia

Background: In schizophrenia, the relationship between suicide and cognition is unclear. We aimed to assess cognitive functions and insight in schizophrenia patients with and without suicide attempts.

Methods: In our study consisting of 77 patients, 36 of the patients had attempted suicide at least once in their lives, and the remaining 41 had never attempted suicide. Sociodemographic data scale, Beck Cognitive Insight Scale (BCIS) and Cambridge Neurophysiological Assessment Battery (CANTAB) were applied.

Results: In this study, patients with schizophrenia who attempted suicide had higher BCIS self-reflectiveness scores (p=0.004), lower BCIS self-certainty scores (p=0.040) and higher BCIS total score (p=0.004). Delay aversion (p=0.003) and risk taking scores (p=0.044) of CANTAB Cambridge Gambling Task (CGT) were higher in patients who attempted suicide. In logistic regression analysis, as independent factors, the number of hospitalizations increased the risk of suicide 1.5 times per hospitalization (p=0.021), CGT delay aversion increased the risk of suicide 8.4 times per score (p=0.044), and the BCIS self-certainty score was shown as the factor that decreased the risk of suicide by 0.78 times (p=0.024).

Conclusion: The causes of suicide attempts in schizophrenia still preserve its uncertain. Our results proposed a statistically significant relationship between cognitive insight and increased suicide attempts. This study also sustains that cognitive impulsivity is associated with suicidal behavior in patients with schizophrenia.

Cite this article as: Calli SY, Fidan Sever Y, Bestepe EE, Izci F. The relationship between suicidal behavior, neurocognitive functions, and insight in patients with schizophrenia. Psychiatry Clin Psychopharmacol. 2023;33(2):126-133.