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Article

Modeling the Longitudinal Effects of Insight on Depression, Quality of Life and Suicidality in Schizophrenia Spectrum Disorders: Results from the FACE-SZ Cohort

by
Mickaël Ehrminger
1,2,*,
Mathieu Urbach
1,3,
Christine Passerieux
1,2,3,
Bruno Aouizerate
1,4,5,
Fabrice Berna
1,6,7,
Anne-Lise Bohec
1,8,9,
Delphine Capdevielle
1,10,11,
Isabelle Chereau
1,12,13,
Julie Clauss
1,6,7,
Caroline Dubertret
1,14,15,16,
Aurélie Esselin
1,2,
Catherine Faget
1,17,18,
Guillaume Fond
1,18,19,
Roxana Mihaela Honciuc
1,12,13,
Marine Jarroir
1,2,
Jasmina Mallet
1,14,15,16,
David Misdrahi
1,20,21,
Baptiste Pignon
1,22,23,
Romain Rey
1,8,9,
Franck Schürhoff
1,22,23,
Hanan Yazbek
1,10,11,
Eric Brunet-Gouet
1,2,3 and
Paul Roux
1,2,3add Show full author list remove Hide full author list
1
Fondation Fondamental, 94000 Créteil, France
2
HandiRESP Laboratory (EA4047) Health Sciences Department Simone Veil, University of Versailles Saint-Quentin-En-Yvelines, 78180 Montigny-le-Bretonneux, France
3
Department of Adult Psychiatry, Versailles Hospital, 78157 Le Chesnay, France
4
Department of Adult Psychiatry, Charles Perrens Hospital, 33076 Bordeaux, France
5
Laboratory of Nutrition and Integrative Neurobiology (UMR INRA 1286), University of Bordeaux, 33000 Bordeaux, France
6
Department of Psychiatry, University Hospitals of Strasbourg, 67000 Strasbourg, France
7
Cognitive Neuropsychology and Physiopathology of Schizophrenia (INSERM U1114), University of Strasbourg, 67000 Strasbourg, France
8
Schizophrenia Expert Centre, Le Vinatier Hospital, 69500 Bron, France
9
PSYR2 Team, Lyon Neuroscience Research Center (INSERM U1028/CNRS UMR5292), University of Lyon 1, 69000 Lyon, France
10
Academic Department of Adult Psychiatry, Hospital La Colombière, CHU Montpellier, 34000 Montpellier, France
11
Neuropsychiatry: Epidemiological and Clinical Research (INSERM UMR S1061), University of Montpellier, 34000 Montpellier, France
12
Department of Psychiatry B, Clermont-Ferrand Hospital, 63000 Clermont-Ferrand, France
13
School of medicine, University of Clermont Auvergne, 63000 Clermont-Ferrand, France
14
Department of Psychiatry, Louis Mourier Hospital, AP-HP, 92700 Colombes, France
15
Institute of Psychiatry and Neuroscience of Paris (INSERM UMR1266), University Paris Descartes, 75013 Paris, France
16
School of medicine, University of Paris Diderot, Sorbonne Paris Cité, 75018 Paris, France
17
Ste Marguerite Hospital, AP-HM, 13009 Marseille, France
18
CEReSS - Health Service Research and Quality of Life Center (EA 3279), School of medicine - La Timone Medical Campus, Aix-Marseille University, 13005 Marseille, France
19
La Conception Hospital, AP-HM, 13005 Marseille, France
20
Department of Adult Psychiatry, Charles Perrens Hospital, 33076 Bordeaux, France
21
Institute for Cognitive and Integrative Neuroscience (CNRS UMR 5287-INCIA), University of Bordeaux, 34000 Bordeaux, France
22
Translational Psychiatry Team (INSERM U955), Mondor University Hospital, AP-HP, 94000 Créteil, France
23
Schizophrenia Expert Center, DHU Pe-PSY, Mondor University Hospital, AP-HP, 94000 Créteil, France
 
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*
Author to whom correspondence should be addressed.
J. Clin. Med. 2019, 8(8), 1196; https://doi.org/10.3390/jcm8081196
Received: 23 July 2019 / Revised: 6 August 2019 / Accepted: 7 August 2019 / Published: 10 August 2019
(This article belongs to the Section Psychiatry)
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Abstract

Background: Up to half of the patients with schizophrenia attempt suicide during their lifetime. Better insight is associated with better functioning but also with increased suicidality. The direction of the relationship between insight and suicidality is not clear, hence we aimed to provide new elements using structural equation modeling. Methods: Insight, quality of life (QoL), depression, and suicidality were measured at baseline and at 12 months in individuals with schizophrenia spectrum disorders. The relationships between these variables were investigated by latent difference score models, controlling for chlorpromazine doses, positive and negative symptoms, and general psychopathology. Results: 738 patients were included, and 370 completed the study. Baseline levels of insight predicted changes in suicidality, whereas baseline levels of suicidality did not predict changes in insight, suggesting that better insight underlies suicidality and predicts its worsening. Our results suggest this temporal sequence: better insight → worse QoL → increased depression → increased suicidality, while insight also affects the three variables in parallel. Conclusion: Better insight predicts a worsening of QoL, depression and suicidality. These findings contribute to our global understanding of the longitudinal influence of insight on suicidality. We advocate that insight-targeted interventions should not be proposed without the monitoring of depression and suicide prevention. View Full-Text
Keywords: Schizophrenia; suicide; insight; quality of life; depression; structural equation modeling Schizophrenia; suicide; insight; quality of life; depression; structural equation modeling
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MDPI and ACS Style

Ehrminger, M.; Urbach, M.; Passerieux, C.; Aouizerate, B.; Berna, F.; Bohec, A.-L.; Capdevielle, D.; Chereau, I.; Clauss, J.; Dubertret, C.; Esselin, A.; Faget, C.; Fond, G.; Honciuc, R.M.; Jarroir, M.; Mallet, J.; Misdrahi, D.; Pignon, B.; Rey, R.; Schürhoff, F.; Yazbek, H.; Brunet-Gouet, E.; Roux, P. Modeling the Longitudinal Effects of Insight on Depression, Quality of Life and Suicidality in Schizophrenia Spectrum Disorders: Results from the FACE-SZ Cohort. J. Clin. Med. 2019, 8, 1196. https://doi.org/10.3390/jcm8081196

AMA Style

Ehrminger M, Urbach M, Passerieux C, Aouizerate B, Berna F, Bohec A-L, Capdevielle D, Chereau I, Clauss J, Dubertret C, Esselin A, Faget C, Fond G, Honciuc RM, Jarroir M, Mallet J, Misdrahi D, Pignon B, Rey R, Schürhoff F, Yazbek H, Brunet-Gouet E, Roux P. Modeling the Longitudinal Effects of Insight on Depression, Quality of Life and Suicidality in Schizophrenia Spectrum Disorders: Results from the FACE-SZ Cohort. Journal of Clinical Medicine. 2019; 8(8):1196. https://doi.org/10.3390/jcm8081196

Chicago/Turabian Style

Ehrminger, Mickaël, Mathieu Urbach, Christine Passerieux, Bruno Aouizerate, Fabrice Berna, Anne-Lise Bohec, Delphine Capdevielle, Isabelle Chereau, Julie Clauss, Caroline Dubertret, Aurélie Esselin, Catherine Faget, Guillaume Fond, Roxana M. Honciuc, Marine Jarroir, Jasmina Mallet, David Misdrahi, Baptiste Pignon, Romain Rey, Franck Schürhoff, Hanan Yazbek, Eric Brunet-Gouet, and Paul Roux. 2019. "Modeling the Longitudinal Effects of Insight on Depression, Quality of Life and Suicidality in Schizophrenia Spectrum Disorders: Results from the FACE-SZ Cohort" Journal of Clinical Medicine 8, no. 8: 1196. https://doi.org/10.3390/jcm8081196

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