Rates and Risk Factors for Suicide Ideas among Schizophrenia Patients in Indonesia

Suicide Probability Among Patients With Schizophrenia and Bipolar Disorder

PURPOSE

To evaluate the possibility of suicide and related factors among individuals with schizophrenia and bipolar disorder (BD).

METHOD

Data were collected for 270 individuals registered in a community mental health center using the Suicide Probability Scale (SPS). Subsequently, t test and multiple linear regression analyses were conducted on independent samples.

RESULTS

There was no statistically significant difference found between mean SPS scores of participants with schizophrenia and BD. However, hostility subscale mean scores of participants with schizophrenia were higher than those of participants with BD, and the difference was statistically significant. Sex, family history of mental illness, need for help with medication, suicidal ideation in the past 10 days, and number of suicide attempts were important predictors of suicide probability.

CONCLUSION

Individuals with schizophrenia and BD and in remission should be evaluated periodically for the possibility of suicide. [Journal of Psychosocial Nursing and Mental Health Services, xx(xx), xx-xx.].

A Deeper Dive Into the Relation Between Psychotic-like Experiences and Suicidal Ideation and Behaviors in Children Across the United States

BACKGROUND AND HYPOTHESIS

Children who endorse psychotic-like experiences (PLEs) appear to be at a greater risk for suicidal ideation and behavior (SI/SB) compared to their peers who do not endorse PLEs. Despite evidence of differential relations among subtypes of PLEs and SI/SB, the research on which PLE subtypes produce the strongest associations remains mixed. Further, though there is evidence that general psychological distress may help explain the relation between PLEs and SI/SB, no research has investigated the role of distress specific to PLEs in this association.

STUDY DESIGN

The present study sought to assess the associations among individual Prodromal Questionnaire-Brief Child Version (PQ-BC) items and SI/SB, as well as to explore the role of distress associated with PLEs as a mediator and/or moderator in a demographically diverse sample of children across the United States (N = 11 875).

STUDY RESULTS

Results revealed that individual items of the PQ-BC may be differentially predictive of lifetime SI (ßs = 0.000-0.098) and SB (ßs=0.002-0.059), even when controlling for sociodemographic variables, internalizing symptoms, and traumatic experiences, with particularly strong associations observed among items indexing thought control, auditory hallucinations, suspiciousness, and nihilistic thinking/dissociative experiences. Item 13, nihilistic thinking/dissociative experiences, displayed the strongest effect sizes. Findings from moderation and mediation models provided evidence consistent with distress as both a partial mediator and moderator of the relation between total PLEs and individual PQ-BC items with SI and SB.

CONCLUSIONS

Distress specific to PLEs may be an important modifiable risk factor to target in suicide assessment, prevention, and intervention efforts.

[Impact of alcohol abuse on suicide risk in schizophrenic patients]

Suicide is one of the main causes of death among patients with mental illnesses. At the same time, alcohol consumption is associated with high risk of autoaggressive and suicidal behavior in population. On the other hand there is an opinion that alcohol may have an illusory-compensatory effect. In that case, alcohol consumption may be an attempt to decrease different symptoms such as depression, anxiety or hallucinations. An analysis of co-occurring schizophrenia and alcohol abuse is presented. Suicide statistics among patients with schizophrenia is studied. Different mechanisms contributing to suicide are highlighted. The correlations of other risk factors with suicide attempts with the assessment of the patient's social resources and environment were studied. The role of alcohol in the presence of other obvious risk factors has been assessed. Possible mechanisms of the protective role of alcohol in relation to suicides among patients with schizophrenia are presented. The authors outline topics of perspective research to clarify the risk of self-destructive behavior in patients with schizophrenia with comorbid alcohol dependence, to search for its predictors and to develop well-grounded complex preventive measures.

Clinical features and psychiatric comorbidities in military veterans with schizophrenia with or without suicidality

Suicide is currently among the leading causes of death among individuals with schizophrenia. Reducing mortality from suicide remains a major clinical challenge in the care of veterans with schizophrenia. There is a need to increase our understanding of what elevates suicide risk in veterans with schizophrenia as a first step towards the future development of suicide prevention interventions. This study compared demographic and clinical features of military veterans with schizophrenia with vs. without suicidality to determine specific risk factors for suicidality. The sample consisted of two groups of veterans with schizophrenia: suicide ideators and/or attempters (SIA) and individuals without a history of suicidal ideation or attempts (no-SIA). Participants were interviewed using the Structured Clinical Interview for DSM-5 Axis I disorders (SCID-I), Positive and Negative Syndrome Scale for Schizophrenia (PANSS), Hamilton Depression Rating Scale (HDRS), and Schizotypal Personality Questionnaire (SPQ). In bivariate analyses, the PANSS-Positive Symptom scores, PANSS-General Psychopathology scores, HDRS total score, HDRS-Paranoid symptoms item score, and SPQ total scores were higher among SIA compared with no-SIA patients. In this unique clinical sample of veterans with schizophrenia, SIA patients were more likely to have mood disorders, post-traumatic stress disorder (PTSD), and/or alcohol use disorder in comparison to the no-SIA group. Logistic regression analysis indicated that the HDRS total score and presence/absence of comorbid mood disorder drive the difference between the groups. These results indicate that suicide risk assessment in veterans with schizophrenia should include identifying individuals with comorbid mood disorders/symptoms, PTSD, alcohol use disorder, marked positive symptoms, and schizotypal features.