Suicide attempts in schizophrenic patients : Clinical variables

Introduction: Schizophrenia is associated with a significant risk of suicide: 40-50% of schizophrenic patients report suicidal ideation at some point in their lives, and 4-13% eventually commit suicide. In order to be able to predict and prevent suicide in schizophrenic patients, it is necessary to investigate and characterise suicide victims who meet the criteria for psychotic disorders and risk factors. Methods: The aim of this retrospective study was to verify the associations between suicide attempts (SAs) and the demographic and clinical variables of 106 patients who met the DSM-IV-TR criteria for schizophrenia.The patients were divided into two groups on the basis of the presence/absence of lifetime suicide attempts, and their main demographic and clinical characteristics were analysed and compared. Results: The patients with a history of SAs frequently had a duration of untreated psychosis (DUP) of ≥1 year (chi-squared test= 9.984, df= 1, p= 0.0016). They also showed significant associations with the presence of a depressive dimension (chi-squared test= 4.439, df= 1, p= 0.0351), hospitalisations before SAs (chi-squared test= 25.515, df= 1, p <0.001), and a family history of psychiatric disorders (chi-squared test= 12.668, df= 2, p= 0.0018) or suicidal behaviours (chi-squared test= 18.241, df= 2, p= 0.0001). Finally, they were more frequently prescribed typical antipsychotic agents. Conclusions: The severity of psychiatric symptoms indicates a high risk of suicide in schizophrenic patients. Further prospective studies of larger samples should investigate the role of early interventions and atypical antipsychotic treatment in reducing the risk.