Risk of non-fatal suicide ideation and behaviour in recent onset schizophrenia
- 256 Downloads
Suicide rates amongst schizophrenic patients are high. There are disadvantages in investigating successfully completed suicides which make suicidal ideation and previous attempts important proxy measures of suicidal risk. The aim of this study was to investigate factors associated with these risk measures.
Fifty-nine patients suffering recent onset schizophrenia were assessed for suicidal ideation and history, and a range of demographic, clinical, social (including relatives’ Expressed Emotion) and self-esteem measures. Univariate comparisons were made between those with and without suicide ideation and previous attempts. Path analysis was conducted to identify factors directly or indirectly associated with a composite scale of risk (low, medium or high).
Approximately 25% of the sample reported a current desire to kill themselves and 47% had made one or more previous attempts. There were numerous significant univariate differences between those with or without ideation or history. Path analysis indicated that greater hopelessness (OR 1.22) and longer duration of illness (OR 1.13) increased risk. Hopelessness was associated with higher negative self-evaluation and social isolation. Negative self-evaluation was associated with more relatives’ criticism which was associated with more negative symptoms. Being a male, unmarried and unemployed were all significantly associated with an increase in negative symptoms. Social isolation was associated with being unemployed, older, more positive symptoms and longer illness duration. Duration of illness was not itself predicted by any other variables.
Non-fatal suicide ideation and behaviour are significantly associated with an array of demographic, clinical, interpersonal and psychological factors. To reduce risk of suicide, these factors need to be assessed and methods developed to reduce their influence.
Key wordsschizophrenia recent-onset suicide risk suicide ideation and behaviour Expressed Emotion self-esteem
Unable to display preview. Download preview PDF.
- 2.Andrews B, Brown GW (1991) The self evaluation and social support (SESS) interview. Royal Holloway: University of LondonGoogle Scholar
- 5.Beck (1978) The Beck Hopelessness Scale. The Psychological CorporationGoogle Scholar
- 6.Beck (1991) The Beck Scale for Suicidal Ideation. The Psychological CorporationGoogle Scholar
- 10.Brown GW, Harris T (1978) The social origins of depression: a study of psychiatric disorders in women. London: TavistockGoogle Scholar
- 11.Brown GW, Andrews B, Harris T, Adler Z, Bridge L (1986a) Social support, self-esteem and depression. Psychol Med 16:813–831Google Scholar
- 16.De Hert M, Peuskens J (2000) Psychiatric aspects of suicidal behaviour: schizophrenia. In: Hawton K, van Heeringen K (eds) The international handbook of suicide and attempted suicide. Chichester: WileyGoogle Scholar
- 23.Humphreys L, Barrowclough C, Andrews B (2001) The Self Evaluation and Social Support Interview: Schizophrenia Version (SESS-sv) Academic Division of Clinical Psychology, University of Manchester, UKGoogle Scholar
- 24.Leff JP, Vaughn CE (1985) Expressed emotion in families. New York: GuilfordGoogle Scholar
- 29.Robins LN, Regier DA (1991) Psychiatric disorders in America. New York: free Press, p 50Google Scholar
- 31.Roy A (1986) Depression, attempted suicide and suicide in patients with chronic schizophrenia. Psychiatr Clin N Am 8:227–241Google Scholar
- 35.Steinwachs DM, et al. (1992) Family perspectives on meeting the needs for care of severely mentally ill relatives: a national survey. School of Public Hygiene and Public Health, John Hopkins UniversityGoogle Scholar