Awareness of disorder and suicide risk in the treatment of schizophrenia: Results of the international suicide prevention trial

Marc Bourgeois, Joel Swendsen*, Frederick Young, Xavier Amador, Stefano Pini, Giovanni B. Cassano, Jean Pierre Lindenmayer, Chuanchieh Hsu, Larry Alphs, Herbert Y. Meltzer

*Corresponding author for this work

Research output: Contribution to journalArticlepeer-review

103 Scopus citations

Abstract

Objective: Schizophrenia is characterized by high suicide risk and low awareness of disorder. Although awareness has benefits for medication compliance and clinical outcome, it is unclear how it may relate to suicide risk in this population. Method: This multicenter investigation assessed awareness and suicide-related behavior in 980 patients with schizophrenia or schizoaffective disorder. Patients were followed over 2 years and assessed by blinded raters for suicide-related events. Results: Awareness of psychiatric condition at baseline was associated with increased risk of suicide events over the follow-up. This effect was mediated by depression and hopelessness levels. By contrast, changes in awareness associated with treatment decreased the risk of suicide. Conclusions: Although some patients may become depressed after acknowledging the clinical handicaps of their disorder, treatment-related changes in awareness are generally associated with a positive outcome relative to suicide risk. The complex interactions and mediation effects of these clinical variables require careful monitoring.

Original languageEnglish (US)
Pages (from-to)1494-1496
Number of pages3
JournalAmerican Journal of Psychiatry
Volume161
Issue number8
DOIs
StatePublished - Aug 1 2004

ASJC Scopus subject areas

  • Psychiatry and Mental health

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