Abstract
BackgroundIn cases of untreated schizophrenia, the patients’ entourage often does not recognize the psychotic symptoms of the patient and the possibility that the patient may attempt suicide. The aim of this study was to investigate the discrepancies between the subjective experiences and observed behaviors in near-fatal suicide attempters with untreated schizophrenia.MethodsA semi-structured interview was carried out with seven near-fatal suicide attempters with untreated schizophrenia to examine the subjective experiences at the time of the suicide attempt. The families of the patients were also interviewed to determine their recognition of the patients’ psychotic symptoms and the suicidal ideation. The interview data were analyzed qualitatively.ResultsSix subjects were undergoing exacerbation of the psychotic symptoms at the time of exhibiting the suicide-related ideation. One subject had been in a prolonged depressive state before attempting suicide. Although all the patients experienced severe distress due to psychotic symptoms and depressive mood, they all exhibited only low level or no help-seeking behavior, and six of seven families had not recognized the change in the patient’s mental condition.ConclusionsAppropriate information about schizophrenia should be provided to the general public so that any help-seeking by the patients with this disease is not overlooked. In addition, accessible early intervention services for psychosis should be established.
Highlights
In cases of untreated schizophrenia, the patients’ entourage often does not recognize the psychotic symptoms of the patient and the possibility that the patient may attempt suicide
Psychological autopsy is a wellestablished method, its efficiency is limited in cases of untreated schizophrenia, because the patient’s entourage had often not recognized the psychotic symptoms of the patient [16,17], and as a result, they may not be able to report on the mental status associated with the suiciderelated behavior
Instead of psychological autopsy, we conducted semi-structured interviews of persons diagnosed with schizophrenia for the first time in their lives only after they exhibited near-fatal suicide attempts [18] in order to examine the subjective experiences which are potentially relevant to suicide in people with untreated schizophrenia
Summary
In cases of untreated schizophrenia, the patients’ entourage often does not recognize the psychotic symptoms of the patient and the possibility that the patient may attempt suicide. The aim of this study was to investigate the discrepancies between the subjective experiences and observed behaviors in near-fatal suicide attempters with untreated schizophrenia. Psychological autopsy is a wellestablished method, its efficiency is limited in cases of untreated schizophrenia, because the patient’s entourage had often not recognized the psychotic symptoms of the patient [16,17], and as a result, they may not be able to report on the mental status associated with the suiciderelated behavior. Instead of psychological autopsy, we conducted semi-structured interviews of persons diagnosed with schizophrenia for the first time in their lives only after they exhibited near-fatal suicide attempts [18] in order to examine the subjective experiences which are potentially relevant to suicide in people with untreated schizophrenia. A better understanding of the subjective experiences related to suicide and of the discrepancies between the subjective experiences and observed behaviors may be helpful to devise more effective measures for preventing suicide among persons with schizophrenia
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