From psychotic symptoms to suicide probability and depressive symptoms: the mediating role of hopelessness in schizophrenia spectrum disorders — evidence from covariate-adjusted structural equation modelling
- 1Department of Psychiatry, İzmir City Hospital
- 2Department of Psychology, Division of Clinical Psychology, İzmir Demokrasi University
- 3Department of Child and Adolescent Psychiatry, İzmir City Hospital
Abstract
Objective: Suicide is a leading cause of premature mortality among individuals with schizophrenia spectrum disorders. Although depression and hopelessness are associated with suicidality, the underlying mechanisms remain unclear. This study examined whether hopelessness mediates the associations between psychotic symptoms and both suicide risk and depressive symptoms.
Methods: This cross-sectional study included 200 individuals with schizophrenia spectrum disorders (123 with schizophrenia and 77 with schizophreniform disorder). Psychotic symptoms and depressive symptoms were assessed using clinician-administered measures, whereas hopelessness and suicide risk were assessed using self-report measures. Structural equation modeling examined the mediating role of hopelessness while controlling for age, sex, years of education, age at illness onset, and history of suicide attempts.
Results: Hopelessness partially mediated the associations between psychotic symptoms and both suicide risk and depressive symptoms. The indirect effects remained significant after adjustment for demographic and clinical covariates. A history of suicide attempts was associated with higher hopelessness, depressive symptoms, and suicide risk, whereas higher educational attainment was associated with lower suicide risk.
Conclusions: Hopelessness appears to be an important cognitive-affective process associated with psychotic symptoms, suicide probability, and depressive symptoms beyond established demographic and clinical risk factors. Routine assessment of hopelessness may improve suicide risk identification and inform targeted interventions. Longitudinal studies are needed to confirm these findings.
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BibTeX
@article{aral2026from,
title = {{From psychotic symptoms to suicide probability and depressive symptoms: the mediating role of hopelessness in schizophrenia spectrum disorders — evidence from covariate-adjusted structural equation modelling}},
author = {Ayse Erguner Aral and Gizem Gerdan and Burcu Kiliç Göçhasanoğlu and Armagan Aral},
journal = {Frontiers in Psychiatry},
year = {2026},
month = nov,
doi = {10.3389/fpsyt.2026.2014306},
url = {https://www.frontiersin.org/articles/10.3389/fpsyt.2026.2014306/full},
note = {CC BY 4.0},
}
RIS
TY - JOUR
TI - From psychotic symptoms to suicide probability and depressive symptoms: the mediating role of hopelessness in schizophrenia spectrum disorders — evidence from covariate-adjusted structural equation modelling
AU - Ayse Erguner Aral
AU - Gizem Gerdan
AU - Burcu Kiliç Göçhasanoğlu
AU - Armagan Aral
PY - 2026
DA - 2026/11/09
JO - Frontiers in Psychiatry
DO - 10.3389/fpsyt.2026.2014306
UR - https://www.frontiersin.org/articles/10.3389/fpsyt.2026.2014306/full
AB - Objective: Suicide is a leading cause of premature mortality among individuals with schizophrenia spectrum disorders. Although depression and hopelessness are associated with suicidality, the underlying mechanisms remain unclear. This study examined whether hopelessness mediates the associations between psychotic symptoms and both suicide risk and depressive symptoms. Methods: This cross-sectional study included 200 individuals with schizophrenia spectrum disorders (123 with schizophrenia and 77 with schizophreniform disorder). Psychotic symptoms and depressive symptoms were assessed using clinician-administered measures, whereas hopelessness and suicide risk were assessed using self-report measures. Structural equation modeling examined the mediating role of hopelessness while controlling for age, sex, years of education, age at illness onset, and history of suicide attempts. Results: Hopelessness partially mediated the associations between psychotic symptoms and both suicide risk and depressive symptoms. The indirect effects remained significant after adjustment for demographic and clinical covariates. A history of suicide attempts was associated with higher hopelessness, depressive symptoms, and suicide risk, whereas higher educational attainment was associated with lower suicide risk. Conclusions: Hopelessness appears to be an important cognitive-affective process associated with psychotic symptoms, suicide probability, and depressive symptoms beyond established demographic and clinical risk factors. Routine assessment of hopelessness may improve suicide risk identification and inform targeted interventions. Longitudinal studies are needed to confirm these findings.
SN - 1664-0640
ER -