Schizophrenia and suicide: systematic review of risk factors
Schizophrenia and suicide: systematic review of risk factors
BACKGROUND: Suicide risk is greatly increased in schizophrenia. Detection of those at risk is clinically important.
AIMS: To identify risk factors for suicide in schizophrenia.
METHOD: The international literature on case-control and cohort studies of patients with schizophrenia or related conditions in which suicide was reported as an outcome was systematically reviewed. Studies were identified through searching electronic databases and reference lists, and by consulting experts.
RESULTS: Twenty-nine eligible studies were identified. Factors with robust evidence of increased risk of suicide were previous depressive disorders (OR=3.03, 95% CI 2.06-4.46), previous suicide attempts (OR=4.09, 95% CI 2.79-6.01), drug misuse (OR=3.21, 95% CI 1.99-5.17), agitation or motor restlessness (OR=2.61, 95% CI 1.54-4.41), fear of mental disintegration (OR=12.1, 95% CI 1.89-81.3), poor adherence to treatment (OR=3.75, 95% CI 2.20-6.37) and recent loss (OR=4.03, 95% CI 1.37-11.8). Reduced risk was associated with hallucinations (OR=0.50, 95% CI 0.35-0.71).
CONCLUSIONS: Prevention of suicide in schizophrenia is likely to result from treatment of affective symptoms, improving adherence to treatment, and maintaining special vigilance in patients with risk factors, especially after losses.
humans, review, prevention & control, therapy, patients, depressive disorder, research design, suicide, fear, schizophrenia, research, socioeconomic factors, psychology, psychiatry, schizophrenic psychology, risk factors, treatment
9-20
Hawton, Keith
9f57477d-ec55-44f3-b172-20872ed9d02a
Sutton, Lesley
87bfb557-5fce-4101-a790-c8b40aed17b0
Haw, Camilla
7aaad16c-ad16-4786-8de5-11fc6d0a4520
Sinclair, Julia
be3e54d5-c6da-4950-b0ba-3cb8cdcab13c
Deeks, Jonathan J.
5770c02a-1faf-4df6-b6ad-f0e8ef4c0c2a
July 2005
Hawton, Keith
9f57477d-ec55-44f3-b172-20872ed9d02a
Sutton, Lesley
87bfb557-5fce-4101-a790-c8b40aed17b0
Haw, Camilla
7aaad16c-ad16-4786-8de5-11fc6d0a4520
Sinclair, Julia
be3e54d5-c6da-4950-b0ba-3cb8cdcab13c
Deeks, Jonathan J.
5770c02a-1faf-4df6-b6ad-f0e8ef4c0c2a
Hawton, Keith, Sutton, Lesley, Haw, Camilla, Sinclair, Julia and Deeks, Jonathan J.
(2005)
Schizophrenia and suicide: systematic review of risk factors.
British Journal of Psychiatry, 187 (1), .
Abstract
BACKGROUND: Suicide risk is greatly increased in schizophrenia. Detection of those at risk is clinically important.
AIMS: To identify risk factors for suicide in schizophrenia.
METHOD: The international literature on case-control and cohort studies of patients with schizophrenia or related conditions in which suicide was reported as an outcome was systematically reviewed. Studies were identified through searching electronic databases and reference lists, and by consulting experts.
RESULTS: Twenty-nine eligible studies were identified. Factors with robust evidence of increased risk of suicide were previous depressive disorders (OR=3.03, 95% CI 2.06-4.46), previous suicide attempts (OR=4.09, 95% CI 2.79-6.01), drug misuse (OR=3.21, 95% CI 1.99-5.17), agitation or motor restlessness (OR=2.61, 95% CI 1.54-4.41), fear of mental disintegration (OR=12.1, 95% CI 1.89-81.3), poor adherence to treatment (OR=3.75, 95% CI 2.20-6.37) and recent loss (OR=4.03, 95% CI 1.37-11.8). Reduced risk was associated with hallucinations (OR=0.50, 95% CI 0.35-0.71).
CONCLUSIONS: Prevention of suicide in schizophrenia is likely to result from treatment of affective symptoms, improving adherence to treatment, and maintaining special vigilance in patients with risk factors, especially after losses.
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More information
Published date: July 2005
Keywords:
humans, review, prevention & control, therapy, patients, depressive disorder, research design, suicide, fear, schizophrenia, research, socioeconomic factors, psychology, psychiatry, schizophrenic psychology, risk factors, treatment
Identifiers
Local EPrints ID: 62403
URI: http://eprints.soton.ac.uk/id/eprint/62403
ISSN: 0007-1250
PURE UUID: efd45fdf-0a59-49fe-b359-c90c92b64872
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Date deposited: 03 Sep 2008
Last modified: 23 Jul 2022 01:41
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Contributors
Author:
Keith Hawton
Author:
Lesley Sutton
Author:
Camilla Haw
Author:
Jonathan J. Deeks
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