Abstract
Suicide has consistently been the most common cause of premature death in schizophrenia. A large 5-year World Health Organization study consisting of the follow-up of 1056 patients exhibiting psychotic symptoms found the most common cause of death in those with schizophrenia was suicide (Sartoriuset al, 1986). In their review of the subject Caldwell and Gottesman (1990) found that 9–13% of patients with schizophrenia eventually commit suicide. At least 20–40% make suicide attempts (Meltzer & Fatemi, 1995) and 1–2% go on to complete in their attempt within the next 12 months (Meltzer & Okayli 1995). Therefore, suicide in schizophrenia has long been a major area of concern and research efforts.
Highlights
Suicide has consistently been the most common cause of premature death in schizophrenia
Results from the recent UK National Confidential Inquiry into Suicide and Homicide by People with Mental Illness (Appleby et al, 1999a) revealed that 20% of suicide victims during the period 1996ö1998 had a diagnosis of schizophrenia
What is unclear is what risk factors specific to this diagnostic group have been reliably reported in well-controlled studies, how best to incorporate these into current assessment procedures, and whether when applied to empirical clinical practice, such procedures can reduce suicide rates
Summary
Suicide in schizophrenia ö how can research influence training and clinical practice?{. In Denmark, Mortensen and Juel (1993) used the national case register to retrospectively examine mortality in a sample of 9156 patients following their first admission with schizophrenia, and reported 50% of males and 35% of females went on to commit suicide during the 17-year study period, with the relative risk of suicide increasing by 56% over this time. This suggests that the current level of risk is not stable, and is certainly not improving. This paper reviews the research findings to date, and discusses possible areas for future investigation
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