Association between auditory P300 event-related potential and suicidal thoughts and behaviors in first-episode antipsychotic-naïve patients with schizophrenia

Shaobing Li; Chenghao Lu; Nannan Liu; Yanzhe Li; Xinxu Wang; Shen Li; Jie Li; Xiang Yang Zhang

doi:10.1016/j.schres.2024.10.015

Association between auditory P300 event-related potential and suicidal thoughts and behaviors in first-episode antipsychotic-naïve patients with schizophrenia

Schizophr Res. 2024 Oct 26:274:352-359. doi: 10.1016/j.schres.2024.10.015. Online ahead of print.

Authors

Shaobing Li¹, Chenghao Lu², Nannan Liu¹, Yanzhe Li¹, Xinxu Wang¹, Shen Li³, Jie Li⁴, Xiang Yang Zhang⁵

Affiliations

¹ Institute of Mental Health, Tianjin Anding Hospital, Mental Health Center of Tianjin Medical University, Tianjin 300222, China; Brain Assessment & Intervention Laboratory, Tianjin Anding Hospital, Mental Health Center of Tianjin Medical University, Tianjin 300222, China.
² Institute of Mental Health, Tianjin Anding Hospital, Mental Health Center of Tianjin Medical University, Tianjin 300222, China.
³ Institute of Mental Health, Tianjin Anding Hospital, Mental Health Center of Tianjin Medical University, Tianjin 300222, China; Brain Assessment & Intervention Laboratory, Tianjin Anding Hospital, Mental Health Center of Tianjin Medical University, Tianjin 300222, China. Electronic address: [email protected].
⁴ Institute of Mental Health, Tianjin Anding Hospital, Mental Health Center of Tianjin Medical University, Tianjin 300222, China. Electronic address: [email protected].
⁵ CAS Key Laboratory of Mental Health, Institute of Psychology, Chinese Academy of Sciences, Beijing, China; Department of Psychology, University of Chinese Academy of Sciences, Beijing, China. Electronic address: [email protected].

PMID: 39490216
DOI: 10.1016/j.schres.2024.10.015

Abstract

Objective: Suicidal thoughts and behaviors (STBs) are critical concern in schizophrenia (SZ). Concurrent changes in event-related potential (ERP), particularly the P300 (P3) components, have been observed in SZ patients, but the association between these changes and STBs remains unclear. This study aims to explore the relationships between P3 components and STBs in first-episode antipsychotic-naïve SZ (FEAN-SZ) patients.

Methods: The study included 321 FEAN-SZ patients and 146 healthy controls (HC). Sociodemographic data, clinical assessments, and ERP P3 components (N1, P3a, and P3b) were collected. Psychotic symptoms were assessed using the Positive and Negative Syndrome Scale (PANSS), while depressive symptoms were evaluated with the Hamilton Depression Scale (HAMD).

Results: Compared to HC, FEAN-SZ patients exhibited lower N1 and P3 amplitudes and longer latencies (all p_s < 0.001). Patients with STBs exhibited higher scores on negative, general psychopathology, PANSS total and HAMD, decreased N1 and P3a amplitudes, as well as prolonged P3a and P3b latencies compared to those without STBs (all p_s < 0.001). The P3a latency predicted the general psychopathology scores (β = 0.103, p < 0.001), and the N1 amplitude predicted the HAMD scores (β = -1.057, p = 0.001), both exclusively within the STBs group. Logistic regression analysis identified that N1 amplitude (Beta = -0.132, p = 0.018, OR = 1.02, 95%CI = 1.01-1.04) and HAMD scores (Beta = 0.068, p = 0.001, OR = 1.07, 95%CI = 1.03-1.11) as independent predictors of STBs in FEAN-SZ patients. Combining these variables yielded an area under the receiver operating characteristic (AUCROC) curve of 0.840 for distinguishing between patients with and without STBs.

Conclusions: FEAN-SZ patients with STBs have lower P3 amplitude and longer latency. The N1 amplitude and depressive levels are associated with STBs in FEAN-SZ patients. The N1 amplitude may serve as an early biological marker for STBs in SZ patients.

Keywords: Depression; Event-related potential; First-episode antipsychotic-naïve; P300; Schizophrenia; Suicide.