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Are Suicidal Thoughts Associated with Psychotic Experiences?


In a recent study published in JAMA Psychiatry, researchers determine if there is a relationship between psychotic experiences (PEs) and increased risks of suicidal thoughts and behaviors (STBs).

There have been several studies published about the association of psychotic experiences and risk for suicidal thoughts and behavior.  A psychotic experience or episode is when the perceived or interpreted thought processes are out of touch with reality and include experiences such as hallucinations and delusions. Suicidal thoughts, also called suicidal ideation, are when persons think about killing themselves, which can be a plan of action to take one’s life or just constant feelings and thoughts of wanting to die.

As published in JAMA Psychiatry, the objective of the study was to determine the association between PEs and succeeding STBs across the lifespan. Additionally, the study examined whether other mental disorders contributed to this association. The data analyzed originated from 19 World Health Organization (WHO) World Mental Health (WMH) surveys. A total of 33,370 adult respondents from 19 countries participated in answering questions that assessed psychotic experiences, suicidal thoughts and behaviors (for example suicidal ideation, plans, and attempts), and the 21 DSM-IV mental disorders. The researcher applied a discrete-time survival analysis to investigate the associations of psychotic experiences with a successive onset of suicidal thoughts and behaviors.

This analysis revealed that respondents with one or more psychotic experiences had a two-fold increased chance of successive suicidal thoughts and behaviors, even after adjusting for previous or intervening mental disorders related to suicidal ideation. Additionally, the study revealed that there were significant dose-response relationships observed between psychotic experience types followed by suicidal thoughts and behaviors that remained after accounting for the presence of mental disorders. Across the lifespan, psychotic experiences were able to predict the subsequent suicidal thought or behavior. These associations, however, were strongest among children ages 12 and younger.

After adjusting for the precursor mental disorders, they concluded that lifetime suicidal ideation, plans, and attempts are significantly associated with temporally prior psychotic episodes. The researchers further concluded that screening for psychotic episodes is an important way to predict suicidal thoughts and behaviors.

Written by Dr. MòNique J. Grant Coke, DNP, MPH, BSN, Medical Writer


Bromet EJ, Nock MK, Saha S, et al. Association Between Psychotic Experiences and Subsequent Suicidal Thoughts and Behaviors A Cross-National Analysis From the World Health Organization World Mental Health Surveys. JAMA Psychiatry 2017; ePub(ePub): ePub. 


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