Beliefs about illness and their relationship with hopelessness, depression, insight and suicide attempts in schizophrenia.

BACKGROUND Although the negative appraisals of the illness may be related to suicidal thinking and behaviours in schizophrenia, this has been insufficiently studied. The aim of this study was to analyze the relationship between schizophrenic patients' cognitions about their illness and past suicidal behaviours. The relationship between patients' beliefs about their illness with potential mediators of suicidal behaviours such as depressive symptoms, hopelessness and insight was also investigated. SUBJECTS AND METHODS A group of 60 patients diagnosed with schizophrenia according to ICD-10 criteria belonging to a follow-up study were assessed one year after their last psychiatric admission. Psychopathological variables were assessed by the Calgary Depression Scale, Beck Hopelessness Scale and the first three items of the Scale to Assess Unawareness of Mental Disorder. The appraisals of the illness were assessed by the Personal Beliefs about Illness Questionnaire. RESULTS Negative appraisals were associated with hopelessness and depressive symptoms. Negative expectations and stigma showed the strongest associations. Contrary to our expectations, this scale was not able to differentiate between patients with and without past suicidal behaviour. CONCLUSIONS Negative appraisals of the illness in patients with schizophrenia seem to have psychopathological consequences such as greater hopelessness and depression. Since these psychopathological features are linked to suicidal risk, the psychotherapeutic approach counteracting negative beliefs about the illness may reduce the risk of suicide.