Schizophrenia and suicide.

OBJECTIVE

Schizophrenia is characterised by distorted thinking and perception and tends to run a chronic course. The World Health Organization reported that suicide accounts for almost 2% of the world's deaths. There is a close relationship between schizophrenia and suicide. Patients with schizophrenia experience personal distress and socio-occupational dysfunction and reduced life expectancy as a group. The current article presents a review of suicide in schizophrenia.

DATA SOURCES

The literature search included MEDLINE, CINHAL, EMBASE, and Cochrane Controlled Trials Register databases.

STUDY SELECTION

Search terms used included 'schizophrenia', 'suicide', 'positive symptoms', 'negative symptoms', 'self-harm', 'anti-psychotics', 'risk factors' in different combinations.

DATA EXTRACTION

We included epidemiological findings, socio-demographical variables, symptom profiles, biological underpinnings, risk factors, and management issues. No publication year limits were applied but the search was restricted to articles in English. The abstracts of articles retrieved in the search were manually scanned.

DATA SYNTHESIS

Male gender and being unmarried are associated with an increased risk of suicide among individuals with schizophrenia. The presence of depression and depressive features is associated with an increased risk of suicidality. An association between insight into the illness, a consequent feeling of hopelessness, and increased risk of suicide has also been a consistent finding. In contrast the role of schizophrenia subtype in suicidal risk remains controversial.

CONCLUSIONS

To date, the impact of specific pharmacotherapeutic agents and non-pharmacological interventions on the suicidal behaviour of individuals with schizophrenia is also yet to be fully explored by robust research.