Benster Lindsay L, Stapper Noah, Rodriguez Katie, Daniels Hadley, Villodas Miguel, Weissman Cory R, Daskalakis Zafiris J, Appelbaum Lawrence G
Department of Psychiatry, UC San Diego, La Jolla, CA 92093, USA.
Department of Clinical Psychology, San Diego State University, San Diego, CA 92182, USA.
Brain Sci. 2024 Sep 30;14(10):995. doi: 10.3390/brainsci14100995.
: Schizophrenia (SZ) is a severe psychiatric disorder characterized by a complex interplay of genetic, developmental, and environmental factors that significantly increase the risk of suicidal ideation (SI) and suicide attempts (SAs). This systematic review synthesizes current research on the developmental predictors of SI in individuals with SZ, aiming to delineate the multifactorial etiology of suicide within this population. : A comprehensive search across Medline, PsycINFO, and EMBASE databases identified 23 eligible studies, emphasizing the varied methodological approaches and the global distribution of research efforts. : These studies demonstrate a robust association between early life adversities, particularly childhood trauma such as physical neglect, emotional abuse, and sexual abuse, and the increased prevalence of SI and SAs in SZ. This review also highlights the significant genetic factors associated with the development of suicidality in SZ, raising the possibility that polymorphisms in inflammation-related genes and neurodevelopmental abnormalities may influence susceptibility to SI. Notably, family history of psychiatric conditions may exacerbate the risk of SI through both hereditary and environmental mechanisms. Environmental factors, including socioeconomic status and social support, are also implicated, underscoring the role of broader socio-environmental conditions influencing outcomes. : This review supports the integration of biopsychosocial models in understanding SI in SZ, advocating for interventions addressing the complex interplay of risk factors and the need for longitudinal studies to elucidate the dynamic interactions between risk factors over time. This comprehensive understanding is crucial for developing targeted preventive strategies and enhancing the clinical management of SZ, aiming to reduce suicidality in this vulnerable population.
精神分裂症（SZ）是一种严重的精神疾病，其特征是遗传、发育和环境因素复杂相互作用，显著增加了自杀意念（SI）和自杀未遂（SA）的风险。本系统综述综合了目前关于SZ患者SI发育预测因素的研究，旨在阐明该人群自杀的多因素病因。：对Medline、PsycINFO和EMBASE数据库进行全面检索，确定了23项符合条件的研究，强调了多样的方法学途径和研究工作的全球分布。：这些研究表明，早期生活逆境，特别是童年创伤，如身体忽视、情感虐待和性虐待，与SZ中SI和SA患病率增加之间存在密切关联。本综述还强调了与SZ自杀倾向发展相关的重要遗传因素，提出炎症相关基因多态性和神经发育异常可能影响对SI易感性的可能性。值得注意的是，精神疾病家族史可能通过遗传和环境机制加剧SI风险。环境因素，包括社会经济地位和社会支持，也有牵连，强调了更广泛的社会环境条件对结果的影响作用。：本综述支持将生物心理社会模型整合到理解SZ中的SI，倡导针对风险因素复杂相互作用的干预措施，以及进行纵向研究以阐明风险因素随时间的动态相互作用的必要性。这种全面理解对于制定有针对性的预防策略和加强SZ的临床管理至关重要，旨在降低这一脆弱人群的自杀倾向。
