Suicide risk in schizophrenia - A follow-up study after 20 years. Part 1: Outcome and associated social factors

Objective. This study re-evaluated, after a period of 20 years, a cohort of patients with schizophrenia who had been considered to be at high risk for suicide. The outcome and social factors associated with their suicide risk were investigated over the two decades. Method. Subjects were contacted and interviewed face to face using a questionnaire devised for this purpose. The Beck Hopelessness Scale (BHS) was administered and ratings were compared with those from the original study. The Calgary Depression Scale for Schizophrenia (CDSS) was administered. Cross-tabulations were performed to identify factors associated with increased suicide risk. A psychological autopsy was performed for those subjects who had committed suicide since the original study. Results. Fourteen of the original 33 high-suicide-risk schizophrenia patients were traced. Three subjects had committed suicide during the 20-year period. Among the living subjects, risks for suicide were found to be lower than those 20 years earlier. Male gender, poor social support, early age of illness onset, current admission to or recent discharge from hospital, and a higher level of education were all factors associated with increased suicide risk. Conclusion. Demographic factors and those related to illness course found to be associated with suicide risk in patients with schizophrenia in this study are in accord with those reported in the literature.