(BRC) An examination of the interplay between sleep disturbance, dissociation and suicide-related outcomes (including self-harm) in people with schizophrenia and how they impact on patient safety within mental health services

   Faculty of Biology, Medicine and Health

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  Dr Lee Mulligan, Dr G Haddock, Prof Dawn Edge  No more applications being accepted  Competition Funded PhD Project (Students Worldwide)

About the Project

Suicide is the leading cause of unnatural death among people with schizophrenia. In this group: i. rates of suicide deaths are 10 times higher than in the general population; ii. approximately 50% will attempt suicide in their lifetime; and iii. suicidal thoughts and self-harm, which are often precursors to suicide attempts and deaths, are highly prevalent. Consequently, the reduction and prevention of suicide and self-harm in schizophrenia remains an international public health and patient safety priority. Sleep disturbance is a common feature of schizophrenia and is strongly associated with both suicide and self-harm. Studies have shown that prolonged sleep issues can also contribute to dissociative-like symptoms, such as feeling detached from one’s own thoughts, feelings and identity. Not only are these symptoms distressing, but recent research has found they also correlate with suicide and self-harm. However, no studies have explicitly tested dissociation as a putative mechanism that leads to, or magnifies, suicidal experiences and self-harm in people with psychosis who experience sleep disturbance. Examining this relationship holds promise in driving the development of new interventions that will maximise patient safety for people with schizophrenia within mental health services and improve the prevention of suicide and self-harm in a clinical group characterised by significantly heightened risks.

This PhD proposal seeks to examine the interplay between sleep disturbance, dissociation, and suicide-related experiences (including self-harm) in people with a diagnosis of schizophrenia and how they impact on patient safety within mental health services. It will examine the subjective experience of sleep disturbance, dissociation, suicide and self-harm in people with schizophrenia via qualitative methods and directly test concurrent and temporal relationships between these variables, both in-the-moment and over time, using Experience Sampling (ES). The project’s findings will be informative for clinicians and researchers alike. It will inform the development of a new psychological intervention to address sleep disturbance, dissociation and prevent suicide and self-harm in people with schizophrenia and contribute to a training package and skills tool kit for NHS staff to improve the safety of care delivered by front-line staff within mental health services.

Gillian Haddock: https://research.manchester.ac.uk/en/persons/gillian.haddock

Dawn Edge: https://research.manchester.ac.uk/en/persons/dawn.edge

Lee Mulligan: https://research.manchester.ac.uk/en/persons/lee.mulligan


Applicants must have obtained or be about to obtain a First or Upper Second class UK honours degree, or the equivalent qualifications gained outside the UK, in a relevant discipline.

Before you Apply 

Applicants must make direct contact with the primary supervisor before applying to discuss their interest in the project. It is your responsibility to make arrangements to meet with potential supervisors, prior to submitting a formal online application.  

How to Apply 

To be considered for this project you MUST submit a formal online application form - full details on how to apply can be found on the BRC website https://www.bmh.manchester.ac.uk/study/research/funded-programmes/manchester-brc-phd-studentships/ 

Your application form must be accompanied by a number of supporting documents by the advertised deadlines. Without all the required documents submitted at the time of application, your application will not be processed and we cannot accept responsibility for late or missed deadlines. Incomplete applications will not be considered. If you have any queries regarding making an application please contact our admissions team.

Equality, Diversity and Inclusion  

Equality, diversity and inclusion is fundamental to the success of The University of Manchester, and is at the heart of all of our activities. The full Equality, diversity and inclusion statement can be found on the website https://www.bmh.manchester.ac.uk/study/research/apply/equality-diversity-inclusion/  

Psychology (31)

Funding Notes

This studentship covers tuition fees and stipend and is open to both the UK and international applicants. We are able to offer a limited number of studentships to applicants outside the UK. Therefore, full studentships will only be awarded to exceptional quality candidates, due to the competitive nature of this scheme.


Bai, W., Liu, Z. H., Jiang, Y. Y., Zhang, Q. E., Rao, W. W., Cheung, T., ... & Xiang, Y. T. (2021). Worldwide prevalence of suicidal ideation and suicide plan among people with schizophrenia: a meta-analysis and systematic review of epidemiological surveys. Translational Psychiatry, 11(1), 552.
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Davies, G., Haddock, G., Yung, A. R., Mulligan, L. D., & Kyle, S. D. (2017). A systematic review of the nature and correlates of sleep disturbance in early psychosis. Sleep Medicine Reviews, 31, 25-38.
Chapman, C. L., Mullin, K., Ryan, C. J., Kuffel, A., Nielssen, O., & Large, M. M. (2015). Meta‐analysis of the association between suicidal ideation and later suicide among patients with either a schizophrenia spectrum psychosis or a mood disorder. Acta Psychiatrica Scandinavica, 131(3), 162-173.
Černis, E., Molodynski, A., Ehlers, A., & Freeman, D. (2022). Dissociation in patients with non-affective psychosis: Prevalence, symptom associations, and maintenance factors. Schizophrenia Research, 239, 11-18.
Chiu, V. W., Ree, M., Janca, A., & Waters, F. (2016). Sleep in schizophrenia: exploring subjective experiences of sleep problems, and implications for treatment. Psychiatric Quarterly, 87(4), 633-648.
Correll, C. U., Solmi, M., Croatto, G., Schneider, L. K., Rohani‐Montez, S. C., Fairley, L., ... & Tiihonen, J. (2022). Mortality in people with schizophrenia: a systematic review and meta‐analysis of relative risk and aggravating or attenuating factors. World Psychiatry, 21(2), 248-271.
Gooding, P. A., Pratt, D., Awenat, Y., Drake, R., Elliott, R., Emsley, R., ... & Haddock, G. (2020). A psychological intervention for suicide applied to non-affective psychosis: the CARMS (Cognitive AppRoaches to coMbatting Suicidality) randomised controlled trial protocol. BMC Psychiatry, 20(1), 1-14.
Lorentzen, E. A., Mors, O., & Kjær, J. N. (2022). The prevalence of self-injurious behavior in patients with schizophrenia spectrum disorders: a systematic review and meta-analysis. Schizophrenia Bulletin Open, 3(1), sgac069.
Lu, Li, Min Dong, Ling Zhang, Xiao-Min Zhu, Gabor S. Ungvari, Chee H. Ng, Gang Wang, and Yu-Tao Xiang. "Prevalence of suicide attempts in individuals with schizophrenia: a meta-analysis of observational studies." Epidemiology and psychiatric sciences 29 (2020): e39.
Moreno-Küstner, B., Guzman-Parra, J., Pardo, Y., Sanchidrián, Y., Díaz-Ruiz, S., & Mayoral-Cleries, F. (2021). Excess mortality in patients with schizophrenia spectrum disorders in Malaga (Spain): A cohort study. Epidemiology and Psychiatric Sciences, 30, e11.
Mulligan, L. D., Haddock, G., Emsley, R., Neil, S. T., & Kyle, S. D. (2016). High resolution examination of the role of sleep disturbance in predicting functioning and psychotic symptoms in schizophrenia: A novel experience sampling study. Journal of Abnormal Psychology, 125(6), 788.
O’Connor, R. C., & Portzky, G. (2018). Looking to the future: a synthesis of new developments and challenges in suicide research and prevention. Frontiers in Psychology, 9, 2139.
Waite, F., Sheaves, B., Isham, L., Reeve, S., & Freeman, D. (2020). Sleep and schizophrenia: From epiphenomenon to treatable causal target. Schizophrenia Research, 221, 44-56.