Abstract

STUDY OF SUICIDALITY AND SUICIDE BEHAVIOR AMONG INDIVIDUALS WITH LONG-STANDING DURATION OF SCHIZOPHRENIA IN INDIA:AN EXPLORATIVE STUDY

Author(s): Amresh K Shrivastava, Avinash A De Sousa, Sagar B Karia, Nilesh B Shah

Objective: Suicide is a common occurrence in schizophrenia and is seen in all phases of the illness. Early identification of patients who are more likely to attempt suicide may help in suicide prevention among patients with schizophrenia. The present study was aimed at determining the clinical differences and differences in demographic and risk factors in patients with schizophrenia that attempt suicide and those that do not. Methods: A total of 200 consecutive follow-up patients having schizophrenia were assessed clinically for variables related to suicide and suicidal behaviour in the outpatient department of a tertiary psychiatry centre. All patients were administered the Positive and Negative Symptom Scale (PANSS) for schizophrenia to assess clinical symptoms and severity while the Clinical Global Impression – Severity (CGI-S) scale was also used. Results: Out of the 200 patients studied, 38% (n = 76) patients had made one severe suicide attempt by excluding parasuicide or deliberate self-harm at least once, and 9.5% (n = 19) had attempted suicide more than three times. More patients with a suicide attempt showed good clinical outcome (CGI ≥ 3) (42.1% versus 33.0%, χ2 = 1.040, p = 0.301). The patients who attempted suicide were predominantly male, with a mean age of 34.2 years. Lesser number of them was single (32.89% vs. 43.5%, χ2 = 1.814, p = 0.178). Their duration of illness was shorter (9.6 years versus 11.4 years, t = 2.8841, p = 0.0043) and more patients with attempted suicide had higher scores on negative symptoms scales of PANSS (t=2.1122, p = 0.035) at the time of assessment. Conclusions: The findings in our research warrant the need studying suicide in schizophrenia in larger samples and to replicate our findings and also determine methods to reduce the incidence of suicide in schizophrenia via interventional programmes.

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