Suicide risk, psychopathology and cognitive impairments in schizophrenia with insomnia: a large-scale cross-sectional study.

BACKGROUND: The relationship between suicide risk, cognitive impairments, and psychiatric symptoms in schizophrenia patients with insomnia remains controversial. This study aims to investigate the prevalence of suicide risk, clinical characteristics, and cognitive impairments in a large sample of chronic schizophrenia patients with insomnia. METHODS: We recruited 1,436 chronic schizophrenia patients. Sociodemographic data were collected from all participants. The Positive and Negative Syndrome Scale (PANSS), Insomnia Severity Index (ISI), and Beck Scale for Suicide Ideation (BSI) were used to assess patients' psychiatric symptoms, insomnia, and severity of suicidal ideation, respectively. The Repeatable Battery for the Assessment of Neuropsychological Status (RBANS) was utilized to evaluate cognitive function in the patients. RESULTS: Insomnia prevalence was 9.5%. Patients with insomnia had a significantly higher suicide risk compared to those without (38% vs. 19.8%). In the insomnia group, the severity of suicidal ideation was negatively correlated with language function scores (r = -0.344, p = 0.004). Moreover, language function and general psychopathology scores were significant predictors of the severity of suicidal ideation (B = -0.59, p = 0.008; B = 0.97, p = 0.010). Language function and general psychopathology scores were also associated with suicide risk (B = -0.05, p = 0.019; B = 0.11, p = 0.012). The combined AUCROC value for these two predictors reached 0.758. CONCLUSION: Chronic schizophrenia patients with insomnia have a higher risk of suicide. Additionally, language function and general psychopathology serve as risk factors and predictors of suicide risk in chronic schizophrenia patients with insomnia.