Regardless, it is still an unacceptably high incidence. This percentage surprised many researchers as it was lower than previously thought. However, a recent meta-analysis estimated that 4.9% of schizophrenics commit suicide during their lifetime. Follow-up studies have estimated that 10–13% of individuals with schizophrenia die by suicide, which is the main cause of death among these patients. In 1977, Miles reviewed 34 studies of suicide among schizophrenics and estimated that 10% of schizophrenic patients kill themselves. It presents a review of the many aspects of suicidal behavior in schizophrenia and attempts to develop and share guidelines for the prevention of suicide in schizophrenics. A comprehensive analysis recently appeared, and a number of opinion leaders have been involved in the develpment of books, papers and conferences to understand and prevent suicidal behavior in patients suffering from schizophrenia. This is the first attempt to present a consensus report as well as the development of a set of guidelines for reducing suicide risk among schizophenia patients.ĭespite great efforts, suicide rates among schizophrenic patients remain alarmingly high. Each expert provided a brief essay on one specific aspect of the problem. This review paper is the results of a joint effort between researchers in the field of suicide in schizophrenia. Better knowledge may help clinicians and caretakers to implement preventive measures. Although, there is general consensus on the risk factors, accurate knowledge as well as early recognition of patients at risk is still lacking in everyday clinical practice. The neurobiological perspective offers a new approach for understanding self-destructive behavior among patients with schizophrenia and may improve the accuracy of screening schizophrenics for suicide. Protective factors play also an important role in assessing suicide risk and should also be carefully evaluated. Awareness of illness has been reported as a major issue among suicidal schizophrenic patients, yet some researchers argue that insight into the illness does not increase suicide risk. Suicidal schizophrenics usually fear further mental deterioration, and they experience either excessive treatment dependence or loss of faith in treatment. Hopelessness, social isolation, hospitalization, deteriorating health after a high level of premorbid functioning, recent loss or rejection, limited external support, and family stress or instability are risk factors for suicide in patients with schizophrenia. There is almost total agreement that the schizophrenic patient who is more likely to commit suicide is young, male, white and never married, with good premorbid function, post-psychotic depression and a history of substance abuse and suicide attempts. Research indicates that at least 5–13% of schizophrenic patients die by suicide, and it is likely that the higher end of range is the most accurate estimate. Suicide is a major cause of death among patients with schizophrenia.
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