Psychiatric Quarterly

, Volume 68, Issue 4, pp 361-375

First online:

Assessment and Intervention for the Suicidal Patient with Schizophrenia

  • Jill M. Harkavy-FriedmanAffiliated withColumbia University and New York State Psychiatric Institute
  • , Elizabeth A. NelsonAffiliated withNew York State Psychiatric Institute

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The risk for suicidal behavior in schizophrenia is high with 10–15% committing suicide and 20–40% making suicide attempts. Due to the chronicity and complexity of schizophrenia and the multi-determined nature of suicidal behavior, the clinician must utilize a biopsychosocial approach to assessment and intervention. Clinical factors such as psychosis, depression and substance abuse increase the risk for suicidal behavior in schizophrenia. Social factors such as social adjustment and social supports also play a critical role. Ongoing assessment and intervention of suicidal behavior, clinical symptomatology, social environment and treatment issues are essential. Prediction and prevention of suicidal behavior are not always possible however. Treatment focused on the reduction of symptomatology and maintenance of an effective social environment may attenuate the risk for suicidal behavior in schizophrenia.