Clinical variables associated with suicide attempts in schizophrenia before and after the first episode

Psychiatry Res. 2015 Sep 30;229(1-2):252-6. doi: 10.1016/j.psychres.2015.07.025. Epub 2015 Jul 15.

Abstract

The aim of this study was to investigate variables associated with suicide attempts in schizophrenia before and after the first episode. We evaluated history of past sucide attempts, clinical symptoms, level of functioning and cognitive performances of 172 patients with first-episode schizophrenia at first admission. Information was collected regarding clinical symptom severity, treatment compliance, and suicide attempts during the follow-up. We found that 16.5% of the patients attempted suicide before admission, and 6.2% of them attempted suicide during the follow-up. The patients who had attempted suicide before admission were mostly women, and more likely to be hospitalized in first year of follow up. BPRS-depression subscale score at admission and alcohol/substance use appeared as independent variables that found associated with suicide attempts prior to admission in logistic regression analysis. The patients who attempted suicide during the follow-up had significantly higher BPRS-depression subcale scores at sixth months of follow-up. Treatment compliance during the first 6 months and duration of remission was lower in this group. Our findings suggest that longer duration of first hospital treatment, the presence of depressive symptoms, and nonadherence to treatment in early phases of follow up after FES are predictors of suicide attempts. On the other hand, keeping remission during the follow-up protects against suicide attempts.

Keywords: First episode; Prevention; Risk factors of suicide; Schizophrenia; Suicide attempt.

MeSH terms

  • Adolescent
  • Adult
  • Alcoholism / diagnosis
  • Alcoholism / epidemiology
  • Alcoholism / psychology
  • Assessment of Medication Adherence
  • Chronic Disease
  • Comorbidity
  • Depressive Disorder / diagnosis
  • Depressive Disorder / drug therapy
  • Depressive Disorder / epidemiology
  • Depressive Disorder / psychology
  • Female
  • Follow-Up Studies
  • Hospitalization / statistics & numerical data
  • Humans
  • Male
  • Medication Adherence / psychology
  • Prospective Studies
  • Psychiatric Status Rating Scales
  • Risk Factors
  • Schizophrenia / diagnosis*
  • Schizophrenia / drug therapy
  • Schizophrenia / epidemiology
  • Schizophrenic Psychology*
  • Statistics as Topic
  • Substance-Related Disorders / diagnosis
  • Substance-Related Disorders / epidemiology
  • Substance-Related Disorders / psychology
  • Suicide / psychology
  • Suicide, Attempted / psychology*
  • Suicide, Attempted / statistics & numerical data
  • Young Adult