Suicide Among Schizophrenies: A Comparison of Attempters and Completed Suicides

1986 ◽  
Vol 149 (6) ◽  
pp. 784-787 ◽  
Author(s):  
Robert E. Drake ◽  
Charlene Gates ◽  
Paul G. Cotton

Schizophrenies who completed suicide were compared with those who made suicide attempts, on the basis of blind ratings of previous hospital records and follow-up interviews with treating clinicians. Results indicated that the two groups were relatively distinct. Suicides tended to live alone and to feel depressed, hopeless, worthless, and suicidal. Attempters, on the other hand, lived with their families or others and were less likely to manifest several features of depression during a period in hospital. In evaluating suicide potential among schizophrenics, living situation and mental state changes indicating depression, suicidal intent, worthlessness, and hopeiessness are more important than a history of suicidal behaviour.

1998 ◽  
Vol 22 (7) ◽  
pp. 424-427 ◽  
Author(s):  
John Joyce ◽  
Simon Fleminger

Those who attempt suicide by jumping often have a history of major psychiatric disorder, are left with a high level of physical and psychological morbidity and have a poor outcome. Services are failing this group in that national statistics may underestimate its size, and even when patients are in contact and are symptomatic and expressing suicidal intent before the incident many go on to jump. Care in hospital and preparation for follow up is uncoordinated.


Crisis ◽  
2008 ◽  
Vol 29 (4) ◽  
pp. 209-212 ◽  
Author(s):  
Merete Nordentoft ◽  
Jacob Branner

The objective was to examine gender differences in choice of method and suicidal intent among persons referred to a suicide prevention center. A total of 351 consecutive patients who had attempted suicide were interviewed using the European Parasuicide Study Interview Schedule I (EPSIS I) while participating in a 2-week inpatient treatment program. They were invited to a 1-year follow-up interview, and followed in the National Patient Register. Compared to women, men who had attempted suicide were older, had better self-esteem, fewer depressive symptoms, and higher total suicidal intention scores, but they were not more likely to use violent methods. Neither use of violent method nor dangerousness of the attempt was associated with suicidal intention. Although men had higher suicide intent scores than women, there were no significant gender differences in the number of repeat suicide attempts during a 1-year follow-up period. Suicidal intent was not related to dangerousness of suicide method.


1977 ◽  
Vol 130 (4) ◽  
pp. 377-385 ◽  
Author(s):  
David W. Pierce

SummaryThe difficulties in measuring suicidal intent in cases of self-injury are discussed, and a scale is described to measure this intent. This scale has been used in 500 cases of self-injury. It is practical and reliable. Results show that the scores derived from it are closely related to the similar Beck Scale; they are also related to age, sex, social isolation, method of self-injury, previous history of self-injury or of psychiatric treatment, physical health at the time of self-injury and alcohol abuse. These results are discussed with particular reference to suicide prediction and the future validation of the scale by long-term follow-up.


2020 ◽  
Vol 46 (Supplement_1) ◽  
pp. S118-S119
Author(s):  
Heidi Taipale ◽  
Markku Lähteenvuo ◽  
Antti Tanskanen ◽  
Ellenor Mittendorfer-Rutz ◽  
Jari Tiihonen

Abstract Background Suicidal attempts and suicide are rather common phenomena in persons with schizophrenia whom are 6–14 times more likely to die due to suicide than the general population. Very little is known on effectiveness of antipsychotics in preventing suicide attempts and completed suicides among patients with schizophrenia. Whether all antipsychotics are effective in preventing attempted or completed suicides also remains unclear. The objective of our study was to investigate comparative effectiveness of antipsychotics for risk of attempted or completed suicide among all patients with schizophrenia in Finland and Sweden. Methods Two nationwide register-based cohort studies were conducted including all individuals with schizophrenia in Finland (N=61889) and Sweden (N=29823). The Finnish cohort included all persons treated for schizophrenia in inpatient care (1972–2014), with follow-up for drug use and outcomes during 1996–2017. The Swedish cohort included all persons with treatment contact due to schizophrenia in inpatient or specialized outpatient care, sickness absence, or disability pension (2006–2013), with follow-up for drug use and outcomes during 2006–2016. The main exposure included the ten most commonly used antipsychotic monotherapies, and also adjunctive pharmacotherapies (antidepressants, mood stabilizers, lithium, benzodiazepines and related drugs were investigated). The main outcome measure was attempted or completed suicide which was analyzed with within-individual models by comparing use and non-use periods in the same individual. Sensitivity analyses were conducted by between-individual models, with attempted suicide (hospitalization only) as an outcome, and by censoring first 30 days from each exposure. Results are reported as hazard ratios (HRs) with 95 % confidence intervals (95% CI). Results Compared with no use of antipsychotics, clozapine was the only antipsychotic therapy consistently associated with a decreased risk of suicidal outcomes. Hazard ratios (HRs) and 95% CI for attempted or completed suicide were 0.64 (95% CI 0.49–0.84) in the Finnish cohort, and 0.66 (0.43–0.99) in the Swedish cohort, and for attempted suicide 0.60 (0.46–0.79) in the Finnish cohort and 0.62 (0.40–0.95) in the Swedish cohort. No other antipsychotic was associated with a reduced risk of attempted and/or completed suicide than clozapine. Regarding adjunctive pharmacotherapies, benzodiazepines and Z-drugs were associated with an increased risk of suicide attempts or deaths (HRs for benzodiazepines 1.29–1.30 and 1.33–1.62 for Z-drugs, not reaching statistical significance in the Swedish cohort). Discussion The results from two large nationwide cohorts provide the first evidence on comparative real-world effectiveness of specific antipsychotics in the prevention of severe suicidal behavior. Clozapine was the only pharmacological treatment associated with a substantially decreased risk of attempted or completed suicide and should be considered as a first-line treatment for patients with suicidal ideation or behavior.


2015 ◽  
Vol 28 (5) ◽  
pp. 608
Author(s):  
João Gama Marques ◽  
Alice Roberto ◽  
Cátia Guerra ◽  
Mariana Pinto da Costa ◽  
Anja Podlesek ◽  
...  

<strong>Introduction:</strong> The aim of this paper was to assess the prevalence of suicide ideation and attempts in Portuguese psychiatry trainees (adult and child and adolescence), and compare the data with the general population and other European countries.<br /><strong>Material and Methods:</strong> A structured and anonymous questionnaire was sent by email to 159 portuguese trainees of adult psychiatry and child and adolescence psychiatry with questions about personal history of suicidal ideation and suicide attempts, as well as family history of suicide attempts and completed suicides. This is part of the BoSS Study (Burnout Syndrome Study) performed in 21 countries worldwide. Data was analysed in SPSS v.19.<br /><strong>Results:</strong> From the inquired population, 62 trainees (40,3%) partially responded, and 46 (29%) were complete responders - these entered the final analysis. There was a ratio of 2:1 (female:male) and a mean age of 29 years. The suicidal ideation was present in passive form in 44% and in active form in 33%; also, 4.3% of respondents had previous suicide attempts. In first degree relatives, 22% had attempted suicide and 13% completed suicide.<br /><strong>Discussion:</strong> The results are worriying and may be associated with some factors to which this population is exposed.<br /><strong>Conclusion:</strong> It is necessary further research to better understand this phenomenon, its causes and potential modifiers.


2019 ◽  
Vol 37 (15_suppl) ◽  
pp. e23173-e23173
Author(s):  
Daniela Gercovich ◽  
Ernesto Gil Deza ◽  
Flavio Tognelli ◽  
Carlos Fernando Garcia Gerardi ◽  
Claudia Lorena Acuna ◽  
...  

e23173 Background: “The suicide rate in cancer patients is twice that observed in the general population in the United States” (JNCI vol 100, 24, page 1750, 2008). This paper focuses ona population with great psychological risk: cancer patients (Pt) with previous suicide attempts (SA) or a family history of suicide (FS); both grouped under SAFS for the purpose of this study. Methods: Between 9/26/2012 and 11/28/2018 all new patients (Pt) admitted to IOHM filled out a Past Medical History Form (PMHF) (ASCO 2013 ABST. e17539) with their preexisting clinical conditions. The database was locked and anonymized. Those with a history of SAFS before cancer diagnosis were selected. Results: Out of 15,617 Pt, 184 Pt (1.2%) were SAFS(141 Pt were SA, 39 Pt were FS and 4 Pt were both). The relative risk ofSA was ten times larger for those with FS. Psychiatric Medication: Antipsychotics: 15Pt (8%), Antidepressants: 23 Pt (12%) and Benzodiazepines 45 Pt(24%), No treatment 101 Pt (55%). Population Characteristics: Sex: F:144 Pt . M: 40 Pt. Age: 56y (r = 26-88). Tumor Dx: Breast (65 Pt ) - Gastrointestinal (24 Pt) - Urological (21 Pt ) - Lung (21 Pt ) -Gynecological (19 Pt) - Hematological (11 Pt) -Head &Neck (8 Pt) - Endocrine (7 Pt) - Other (8 Pt). Stages: Early (0-I-II-III): 130 Pt, Advanced: 54 Pt. Ob-Gyn history:25 Pt (17%) nulliparous, 18 Pt (12%) with one child, 77 Pt (53%) with 2 or 3 children and 24 Pt (17%) with more than 3 children; 62 Pt (43%) had previous abortions. Average severe comorbidities (respiratory and psychiatric) was 3 per Pt (r = 0-18). Toxic habits: Smoking: 120 Pt (65%), Alcohol: 37 Pt (20%) and Illicit Drugs: 4 Pt (2%). Follow-up: 19 months (r = 0-70). No Pt had any SA, or commited suicide, during the follow-up.Living patients:177 (96%). Conclusions: 1) In our vast cohort, 184 Pt (1.2%) were identified as highly vulnerable psychiatric Pt due to SAFS. 2) Given the high psychological risk and stressful cancer diagnosis, 83 Pt (45%) were prescribed psychiatric drugs. 3) Follow-up of SAFS Pt by a multidisciplinary team is requiredfor adequate Pt and family support.


1970 ◽  
Vol 1 (4) ◽  
pp. 359-366 ◽  
Author(s):  
Charles H. Browning ◽  
Robert L. Tyson ◽  
Sheldon I. Miller

Suicide attempts or suicide ideation are often of critical importance in defining a psychiatric emergency. Follow-up studies of the psychiatric emergency population for the subsequent incidence of attempted or completed suicide are needed to identify high and low risk groups and to measure the effectiveness of the psychiatric emergency service. Suicide problems were presenting symptoms in 28.2 percent of psychiatric emergency evaluations seen in a three month period. The 10–29 decades for females and the 10–19 decade for males were represented significantly more often than older decades. Race and marital status were not related to suicide problems. There were seventeen known suicide attempts, but no known suicides in a six month follow-up period. This finding was contrasted with the results of a similar study done nine years previously at the same hospital and with a study done by the Cleveland Suicide Prevention Center, both of which found several suicides in the follow-up period. Possible reasons for the different results are discussed.


2018 ◽  
Vol 54 ◽  
pp. 19-26 ◽  
Author(s):  
Federico M. Daray ◽  
Ángeles R. Arena ◽  
Arnaldo R. Armesto ◽  
Demián E. Rodante ◽  
Soledad Puppo ◽  
...  

AbstractObjective:The serotonin-transporter-linked polymorphic region (5-HTTLPR) polymorphisms are associated with suicidal behavior; however, prospective studies are scarce. Herein we aim to determine if 5-HTTLPR polymorphisms predict risk of short-term suicide reattempt in a high-risk suicidal sample. We also explore possible mediators or moderators of this relationship.Methods:A multicenter prospective cohort study was designed to compare data obtained form 136 patients admitted to the emergency department for current suicidal ideation or a recent suicide attempt. Subjects were clinically evaluated, genotyped, and monitored for a new suicide attempt for 6 months.Results:At 6 months of follow up, 21% of the subjects had a new suicide attempt. The frequency of L-allele and L-carrier was higher in reattempters when compared with non-reattempters (55.8% vs. 35.4%, p = 0.01 and 76.9% vs. 54.2%, p = 0.04, respectively). Reattempters also differ from non-reattempters patients with respect to age, history of previous suicide attempts, and age of onset of suicidal behavior. The logistic regression model showed that L-carriers had an odds ratio of 2.8 (95% CI: 1.0–7.6) for reattempts when compared to SS genotype. The adjusted model indicates that this association is not mediated or moderated by impulsivity.Conclusion:The 5-HTTLPR polymorphisms predicted short-term risk of suicidal reattempt independently of age and sex. L-carriers have almost three times more risk of relapse when compared with SS carriers.


2005 ◽  
Vol 27 (4) ◽  
pp. 285-289 ◽  
Author(s):  
Claudemir Benedito Rapeli ◽  
Neury José Botega

OBJECTIVE: To verify the presence of different groups of medically serious suicide attempters who had more clinical or surgical seriousness and required admission to a general hospital. METHODS: 121 patients admitted consecutively were assessed. A questionnaire containing items on the patient characteristics and psychometric scales to assess the suicidal intent and lethality were used. A cluster analysis was performed using the K-means method. RESULTS: Three groups were identified: 1) 43 subjects (mostly female) characterized by self-poisoning with medication and low suicidal intent, with highly impulsive suicide attempts; 2) 53 subjects (mostly males) who ingested pesticides and presented both moderate degrees of lethality and suicidal intent; 3) 17 subjects (predominantly males) who used more violent methods and presented high levels of lethality and suicidal intent. CONCLUSIONS: Grouped data of these inpatients could be misleading for follow-up research purposes as our findings indicate that there are relatively distinct clinical profiles among suicide attempters admitted to a general hospital.


2006 ◽  
Vol 40 (5) ◽  
pp. 414-420 ◽  
Author(s):  
May M.L. Lam ◽  
Se-Fong Hung ◽  
Eric Y.H. Chen

Objectives: The identification of individuals at high risk of becoming psychotic within the near future creates opportunities for early intervention before the onset of psychosis. This study sets out to identify a group of symptomatic young people in a Chinese population with the high likelihood of transition to psychosis within a follow-up period of 6 months, and to determine the rate of transition to psychosis in this group. Method: Symptomatic individuals with a family history of psychotic disorder, subthreshold psychotic symptoms or brief transient psychotic symptoms were identified using the operationalized criteria of an ‘At Risk Mental State’. The individuals were prospectively assessed monthly on a measure of psychopathology for 6 months. Results: Eighteen out of 62 individuals (29%) made the transition to frank psychosis within a 6 month follow-up period, with the majority occurring within 3 months. In addition, significant differences were found in the intake Positive and Negative Syndrome Scale, Comprehensive Assessment of ‘At Risk Mental State’ and Global Assessment of Functioning scores between the group that ultimately became psychotic and the group that did not. Conclusion: The period of the highest risk of transition to psychosis was within the 3 months after the study began. Thus, distressed youths in our outpatient clinic, who meet the high-risk criteria should be monitored most closely in the initial 3 months, particularly those individuals with high levels of psychopathology and functional decline.


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