Published online Feb 26, 2020. doi: 10.12998/wjcc.v8.i4.757
Peer-review started: October 18, 2019
First decision: November 11, 2019
Revised: November 15, 2019
Accepted: January 15, 2020
Article in press: January 15, 2020
Published online: February 26, 2020
Processing time: 131 Days and 11.9 Hours
Previous studies found several factors associated with suicide in schizophrenic patients, such as age, sex, education level, history of suicide attempts, psychotic symptoms, social factors, and substance abuse. However, there might be some additional factors that were not considered in previous studies but may be correlated with a greater likelihood of suicide attempts, such as medication and treatment.
To investigate the prevalence of suicide attempts and identify the risk of suicidality in hospitalized schizophrenia patients.
This is a cross-sectional study of schizophrenic patients admitted to a psychiatric hospital who were 18 years of age or more. The outcomes and possible suicide risk factors in these patients were collated. The current suicide risk was evaluated using the mini-international neuropsychiatric interview module for suicidality and categorized as none (0 points), mild (1-8 points), moderate (9-16 points), or severe (17 or more points). This study used ordinal logistic regression to assess the association of potential risk factors with the current suicide risk in schizophrenic patients.
Of 228 hospitalized schizophrenia patients, 214 (93.9%) were included in this study. The majority (79.0%) of patients were males. Females appeared to have a slightly higher suicidality risk than males, with borderline significance. With regard to the current suicide risk assessed with the mini-international neuropsychiatric interview, 172 (80.4%) schizophrenic patients scored zero, 20 (9.4%) had a mild risk, 8 (3.7%) had a moderate risk, and 14 (6.5%) had a severe risk. The total prevalence of current suicide risk in these schizophrenic patients was 19.6%. Based on multivariable ordinal logistic regression analysis with backward elimination, it was found that younger age, a current major depressive episode, receiving fluoxetine or lithium carbonate in the previous month, or a relatively higher Charlson comorbidity index score were all significantly and independently associated with a higher level of suicide risk.
The prevalence rate of suicide attempts in schizophrenia is high. Considering risk factors in routine clinical assessments, environmental manipulations and adequate treatment might prevent or decrease suicide in these patients.
Core tip: The results of the present study suggest that the prevalence of suicidality in schizophrenic patients is high (19.6%). Females appear to have a slightly higher suicide risk than males, with borderline significance. Additionally, the factors related to higher levels of suicide risk were younger age, a current major depressive episode, receiving fluoxetine or lithium carbonate in the previous month, and a relatively higher score on the Charlson comorbidity index. Based on such findings, routine identification of suicidality, including suicidal ideation, suicide plans, suicide attempts, and monitoring and reducing the related factors should be beneficial in the management of inpatient schizophrenic patients.