Cookies on this website
We use cookies to ensure that we give you the best experience on our website. If you click 'Continue' we'll assume that you are happy to receive all cookies and you won't see this message again. Click 'Find out more' for information on how to change your cookie settings.

New research shows that by lessening the severity and impact of persecutory symptoms of psychosis, it may be possible to reduce the likelihood of someone with psychosis having thoughts of suicide or harming themselves.

Close-up of a devastated young man holding his head in his hands and friends supporting him during group therapy

Researchers from Oxford, Birmingham, London, and Naples have published a new study examining the results from several UK surveys to investigate how self-harm and different symptoms of psychosis may be related in adult populations. 

Using data from the three most recent rounds of UK APMS (Adult Psychiatric Morbidity Survey), the study’s authors compared how suicidal thoughts and attempts by individuals in the general population may be related to someone hearing voices and abnormal thoughts – both at a single point in time and then over a period of time, to investigate whether one might predict the other. For any relationships found, additional factors were taken into account, such as depression, having a very variable mood, or being impulsive.

Research shows that in virtually every case in each of the three datasets, current symptoms of psychosis were linked to previous and / or current suicidal attempts and thoughts. However, persecutory thoughts (false beliefs that people wish to harm you) were more likely to be related to self-harm than auditory hallucinations (hearing voices).

Further analysis examining the same group over time showed a clear relationship between earlier persecutory thoughts and later suicidal thoughts. When looking at possible factors that might mediate these relationships, features of depression and variable mood were more likely to be involved than being an impulsive person.

The first author of the study, Dr Angharad de Cates, Wellcome Trust Clinical Doctoral Fellow at the Department of Psychiatry, University of Oxford, said:


'As clinicians, we are understandably worried about the increased risk of self-harm and suicide in those with schizophrenia and other psychotic illnesses. Our study suggests that compared to hearing voices, current persecutory thoughts may be a bigger predictor of individuals at the greatest risk, presumably due to the distress and possible depressive symptoms that may result. It is possible that we can make a difference and reduce risk by actively screening for, and treating, persecutory and depressive thoughts.' 

The senior author of the study, Professor Matthew Broome said:


‘Those with psychosis are at greatly elevated risk of self-harm and suicide, both when they are becoming unwell, and also after recovery. This important study helps us scientifically to understand the processes which may connect certain symptoms of psychosis with self-harm and suicide, but also is clinically important in demonstrating that through addressing persecutory thoughts, depression, or mood instability, we may be able to impact on suicidal thinking and actions.’

To read the full paper, Self-harm, suicidal ideation, and the positive symptoms of psychosis: Cross-sectional and prospective data from a national household survey.


Please follow the link below to read the news on the NIHR BRC website.

Similar stories

Mitigating Impacts of COVID-19 Pandemic on Parents and Carers During School Closures

The International Public Policy Observatory's (IPPO) Rapid Evidence Review has now been released. Co-authored by Professor Cathy Creswell, the Review was commissioned by the UK Department for Education following a recommendation from the Scientific Advisory Group for Emergencies (SAGE).

Improved Risk Estimation of Bipolar Spectrum Disorders in Adolescent Offspring of Bipolar Parents

This new study using Canadian and Swiss data showed that the risk calculator used to predict the likelihood of developing a major mood disorder was correct approximately 70% of the time. The study results suggest this may be a useful clinical tool in routine practice for improved individualised risk estimation of bipolar spectrum disorders among the adolescent offspring of a parent with a bipolar disorder.

Impact of COVID-19 Partial School Closures and Mental Health

New research found that secondary school students with access to on-site school provision were more likely to report symptoms of depression and anxiety, as well as perceiving their mental wellbeing to have deteriorated during the first national lockdown, compared to students receiving remote school provision. Importantly, the poorer mental health for the group accessing school was explained by their different backgrounds and certain risk factors, such as past mental health needs and upcoming examinations.

Effect of the COVID-19 Pandemic on Eating Disorders

Using the electronic health records of over 5 million people aged under 30, researchers in the Oxford University Department of Psychiatry found that eating disorders were diagnosed significantly more commonly in 2020 than in previous years, with the rate increasing steadily throughout the year.

The Mental Health Impacts of Being an Olympian

The athletes competing in the Olympics mount a tremendous responsibility on their shoulders. Representing the pinnacle of human performance, Olympians are not merely idolized for their athletic abilities, but also often praised for their moral character, sportsmanship, and/or mental resilience.

Ground-breaking Treatment Offers New Hope for Patients with Persecutory Delusions

Feeling Safe is a new treatment programme for persecutory delusions, which promises a step change in the treatment of severe mental health problems.