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Suicide among patients with schizophrenia: a consideration of risk and protective factors
Lori P Montross1, Sidney Zisook, John Kasckow
1University of California San Diego, Department of Psychiatry, Division of Geriatric Psychiatry, San Diego, CA 92161, USA. pmontro@ucsd.edu
Background:
The elevated rate of suicide among patients with schizophrenia is well documented and thus frequently researched. The majority of research has focused solely on the identification of risk factors that predispose patients to attempt or commit suicide. This review serves to expand on the literature pertaining to suicide risk factors by additionally outlining how protective factors may shield against suicide within this unique patient population.
Methods:
A literature review of English-language publications pertaining to suicide among people with schizophrenia was completed using PsychINFO and MEDLINE databases between the years of 1960-2004 and 1950-2004 respectively. Special emphasis was given to studies of risk factors and protective factors for suicide.
Results:
Commonly supported risk factors for suicide were identified: previous attempts, severity of illness, comorbidity, social isolation, temporal relationships, and demographic characteristics. Risk factors such as a history of violence, the presence of command hallucinations, and recent tragic loss were found to warrant future study. Social support, positive coping skills, life satisfaction, and resiliency emerged as protective factors that may mitigate suicide.
Conclusions:
Understanding why some patients wish to end their lives but also why some desire to live allows for more comprehensive suicide prevention.
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