[Suicide by schizophrenic patients in psychiatric hospitals].

A detailed investigation was carried out on the schizophrenics who committed suicide at the Tokyo Metropolitan Hospital Matsuzawa during the last 30 years. Of these 58 schizophrenics, 52 cases (male 25, female 27) were studied in this report. The mean age of suicide patients was 38.6 years (male: 34.3 years, female: 42.6 years); in males the suicide occurred between 20 and 39 years (80%), while females showed a wider distribution with two peaks in the 25 to 34 years group (26%) and the 40 to 54 years group (41%). 88% (22/25) of males were unmarried, whereas only 33% (9/27) of the women were unmarried. Suicide methods were comprised of hanging (51.9%-27 cases), being run over by a streetcar (28.8%-15 cases), drowning (6 cases), jumping off a high building (3 cases) and intoxication by creosol liquid soap (1 case). In case of male patients hanging was most frequent (72%), followed by jumping into a streetcar to get run over (24%). Likewise, hanging and jumping into a streetcar were most frequent in females (33.3%, respectively), followed by drowning (22.2%), a method selected by females only. From 1951 to 1960 (right before and after the introduction of psychopharmacotherapy) hanging ranked first, but the suicide methods were shifted to the jumping into a streetcar and drowning after installation of the Open-Door-System (around the years 1961-1970). During the last 10 years (from 1971 to 1980) suicide by jumping from a high building increased. Suicide committed in the open ward occurred 9 times only (17.3%); it was, therefore, a much rarer occurrence than had been expected. This fact may show that such an open ward system would be associated with a relatively low risk of suicide. After introduction of psychiatric pharmacotherapy and as social rehabilitation continued, the incidence was relatively stable and no increase was found in our data. Only 4 patients (7.7%) left suicide notes, which made it difficult to draw a clear conclusion on the motivations. Twenty-six cases (50%) died by the first attempted suicide, but in 13 cases (25%) suicide was finally accomplished after the second trial or more. Women performed several repeated suicide attempts (37%), whereas the male patients died at the first or second attempt (88%). Hospitalization lasted on an average for 5 years and 8 months (male: 3 years and 8 months, female: 7 years and 6 months); the shortest stay was 2 days and the longest was 25 years and 11 months.(ABSTRACT TRUNCATED AT 400 WORDS)