Abstract
Suicide is one of the main premature causes of death in patients with schizophrenia. However, little is known about the relationship between neurocognitive functioning and suicidality in violent offenders with schizophrenia who have been sentenced to psychiatric treatment after committing violent crimes. We examined the neurocognitive functioning of a sample of 61 violent offenders, most of them murderers with schizophrenia who were classified as suicide attempters (n = 26) and non-attempters (n = 35). We compared the neurocognitive functioning of both groups using a neuropsychological battery. Suicide attempters showed similar performance to non-attempters in a neuropsychological test across all domains of cognitive functioning, memory, attention, verbal fluency, and executive functioning. However, after controlling for demographic and clinical variables, suicide attempters performed better than non-attempters in two planning-related tasks: the Tower of London (p < 0.01) and the Zoo Map (p < 0.01). Suicide attempters were also characterized as having more family histories of suicidality and as displaying more depressive symptoms and negative symptoms of psychopathology on the Positive and Negative Syndrome Scale (PANSS) scale. These results suggest that suicide attempters have a greater ability to formulate plans and initiate goals directed at making a suicide attempt.
Highlights
Suicide is a major cause of death among people with schizophrenia and related disorders
The risk for suicide among people with schizophrenia and related disorders is much more elevated among patients sentenced to compulsory psychiatric treatment and among those exposed to the criminal justice system due to violent crimes [3]
We examined a sample of 61 extreme violent offenders with schizophrenia and related disorders sentenced to compulsory psychiatric treatment in a maximum security forensic psychiatric hospital in Spain
Summary
Suicide is a major cause of death among people with schizophrenia and related disorders. Some specific risk factors, such as stresses of imprisonment, mental illness, social deprivation, a history of suicide attempts, and childhood physical abuse, have been demonstrated to play an important role in suicide and self-harm among people in custody, among psychiatric forensic patients with schizophrenia [9,10]. Most of these relevant environmental correlates of suicide and violence are present in a large number of patients with schizophrenia who will not commit suicide [11]
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