Department of Psychiatry, Yokohama City University School of Medicine, Yokohama, Japan.
Psychiatry Res. 2011 Jun 30;188(1):78-82. doi: 10.1016/j.psychres.2010.09.008. Epub 2010 Oct 16.
Suicidality in patients with schizophrenia is high. To clarify the characteristics of suicidal behavior in patients with schizophrenia, we investigated suicide attempters with schizophrenia spectrum disorders in comparison with patients with mood disorders. One hundred patients with schizophrenia spectrum disorders and 155 patients with mood disorders admitted to an emergency department after a suicide attempt were interviewed in detail on items concerning 1) demographic characteristics, 2) previous suicidal behavior, and 3) index suicidal behavior. Differences between the two groups were subsequently analyzed. Patients with schizophrenia spectrum disorders showed a lower incidence of previous deliberate self-harm, and a higher incidence of a subsequent suicide attempt more than 1 year after the previous suicide attempt as well as a higher lethality of index suicide attempt compared to patients with mood disorders. Furthermore, the most common motive for making a suicide attempt in patients with schizophrenia spectrum disorders was having a mental problem. This study revealed the factors associated with suicide attempts among Japanese patients with schizophrenia spectrum disorders, and the nature of these factors makes it difficult to predict future attempts. This makes clear the importance of continuous long-term follow-up with careful attention to the mental symptoms and psychological burden for such patients.
精神分裂症患者的自杀率较高。为了明确精神分裂症患者自杀行为的特征，我们将患有精神分裂症谱系障碍的自杀未遂者与患有心境障碍的患者进行了比较。我们详细访谈了 100 名患有精神分裂症谱系障碍的患者和 155 名因自杀未遂而入住急诊科的心境障碍患者，访谈内容涉及 1）人口统计学特征，2）既往自杀行为，以及 3）本次自杀行为。随后分析了两组之间的差异。与心境障碍患者相比，精神分裂症谱系障碍患者既往故意自残的发生率较低，而既往自杀未遂 1 年后再次自杀未遂的发生率较高，本次自杀未遂的致死率也较高。此外，精神分裂症谱系障碍患者自杀未遂的最常见动机是存在心理问题。本研究揭示了与日本精神分裂症谱系障碍患者自杀未遂相关的因素，这些因素的性质使得难以预测未来的尝试。这清楚地表明，对于此类患者，需要持续进行长期随访，并密切关注其精神症状和心理负担。
