Study on the correlation between serum total cholesterol levels and suicidal ideation in patients with first-episode drug-naïve schizophrenia: a cross-sectional study.

Background: The pathological physiology of schizophrenia (SZ) is associated with defects in biological energy metabolism. Abnormal blood lipid levels may influence the emergence of suicidal ideation (SI) in SZ. This study aims to evaluate the relationship between blood lipid levels, psychiatric symptoms, and SI in first-episode drug-naïve (FEDN) SZ patients. Method: This study included 183 patients with FEDN SZ and 101 healthy controls (HC). The Beck Scale for Suicide Ideation Chinese Version and the Positive and Negative Syndrome Scale five-factor model were utilized to assess the intensity of SI and the clinical symptoms of the participants. All subjects underwent testing for levels of total cholesterol (TC), triglycerides (TG), high-density lipoprotein (HDL), and low-density lipoprotein (LDL). Relevant variables were identified through differential comparisons and logistic regression analysis. The risk was evaluated using the area under the Receiver Operating Characteristic (ROC) curve (AUC). Result: Compared with the HC group, the levels of serum TC, TG and LDL in FEDN SZ patients were higher, while the HDL level decreased (P<0.05). The levels of serum TC, HDL, LDL, positive and depressive symptom factor scores of FEDN SZ patients with SI were higher (P<0.05). Stepwise regression scores showed that serum TC levels, positive and depressive symptom factor scores were positively correlated with the generation of SI in FEDN SZ patients (P<0.05); The AUCROC shows that the combined discriminant efficacy of the three indicators is AUC = 0.824. Conclusion: The higher the serum TC levels, positive symptom factor scores, and depressive symptom factor scores in FEDN SZ patients, the greater the risk of SI. Therefore, timely measurement of serum TC levels during the initial diagnosis of FEND SZ patients can help promptly initiate therapeutic interventions, reduce the incidence of SI, and improve the prognosis of FEND SZ patients.