Leo Sher, M.D.

Our review, “Suicide in schizophrenia: An educational overview” was published 5 years ago in the July 2019 issue of Medicina (1). The purpose of our paper was to provide an educational overview of suicidal behavior in individuals with schizophrenia.

Suicide is the largest contributor to the decreased life expectancy in individuals with schizophrenia. Demographic and psychosocial factors that increase a risk of suicide in individuals with schizophrenia include younger age, being male, being unmarried, living alone, being unemployed, being intelligent, being well-educated, good premorbid adjustment or functioning, having high personal expectations and hopes, having an understanding that life’s expectations and hopes are not likely to be met, having had recent (i.e., within past 3 months) life events, having poor work functioning, and having access to lethal means, such as firearms.

Having awareness of symptoms, especially, awareness of delusions, anhedonia, asociality, and blunted affect, having a negative feeling about, or non-adherence with, treatment are associated with greater suicide risk in patients with schizophrenia. Comorbid depression and a history of suicidal behavior are important contributors to suicide risk in patients with schizophrenia.

Prevention of suicidal behavior in schizophrenia should include recognizing patients at risk, delivering the best possible therapy for psychotic symptoms, and managing comorbid depression and substance misuse. Family interventions may reduce the risk of suicidal behavior, and therefore, should be a necessary component of a treatment plan of each patient with schizophrenia

Reference

1. Sher L, Kahn RS. Suicide in schizophrenia: An educational overview. Medicina (Kaunas). 2019 Jul 10;55(7):361. doi: 10.3390/medicina55070361.