Suicide risk in schizophrenia: Learning from the past to change the future

Maurizio Pompili*, Xavier F. Amador, Paolo Girardi, Jill Harkavy-Friedman, Martin Harrow, Kalman Kaplan, Michael Krausz, David Lester, Herbert Y. Meltzer, Jiri Modestin, Lori P. Montross, Preben Bo Mortensen, Povl Munk-Jørgensen, Jimmi Nielsen, Merete Nordentoft, Pirjo Irmeli Saarinen, Sidney Zisook, Scott T. Wilson, Roberto Tatarelli

*Corresponding author for this work

Research output: Contribution to journalReview article

196 Citations (Scopus)

Abstract

Suicide is a major cause of death among patients with schizophrenia. 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. 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. 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. Suicidal schizophrenics usually fear further mental deterioration, and they experience either excessive treatment dependence or loss of faith in treatment. 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. Protective factors play also an important role in assessing suicide risk and should also be carefully evaluated. 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. 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. Better knowledge may help clinicians and caretakers to implement preventive measures. This review paper is the results of a joint effort between researchers in the field of suicide in schizophrenia. Each expert provided a brief essay on one specific aspect of the problem. 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.

Original languageEnglish (US)
Article number10
JournalAnnals of General Psychiatry
Volume6
DOIs
StatePublished - Mar 16 2007

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Suicide
Schizophrenia
Learning
Consensus
Research Personnel
Self-Injurious Behavior
Social Isolation
Fear
Substance-Related Disorders
Cause of Death
Hospitalization
Guidelines
Depression
Health
Therapeutics
Research

ASJC Scopus subject areas

  • Psychiatry and Mental health

Cite this

Pompili, M., Amador, X. F., Girardi, P., Harkavy-Friedman, J., Harrow, M., Kaplan, K., ... Tatarelli, R. (2007). Suicide risk in schizophrenia: Learning from the past to change the future. Annals of General Psychiatry, 6, [10]. https://doi.org/10.1186/1744-859X-6-10
Pompili, Maurizio ; Amador, Xavier F. ; Girardi, Paolo ; Harkavy-Friedman, Jill ; Harrow, Martin ; Kaplan, Kalman ; Krausz, Michael ; Lester, David ; Meltzer, Herbert Y. ; Modestin, Jiri ; Montross, Lori P. ; Bo Mortensen, Preben ; Munk-Jørgensen, Povl ; Nielsen, Jimmi ; Nordentoft, Merete ; Saarinen, Pirjo Irmeli ; Zisook, Sidney ; Wilson, Scott T. ; Tatarelli, Roberto. / Suicide risk in schizophrenia : Learning from the past to change the future. In: Annals of General Psychiatry. 2007 ; Vol. 6.
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abstract = "Suicide is a major cause of death among patients with schizophrenia. 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. 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. 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. Suicidal schizophrenics usually fear further mental deterioration, and they experience either excessive treatment dependence or loss of faith in treatment. 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. Protective factors play also an important role in assessing suicide risk and should also be carefully evaluated. 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. 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. Better knowledge may help clinicians and caretakers to implement preventive measures. This review paper is the results of a joint effort between researchers in the field of suicide in schizophrenia. Each expert provided a brief essay on one specific aspect of the problem. 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.",
author = "Maurizio Pompili and Amador, {Xavier F.} and Paolo Girardi and Jill Harkavy-Friedman and Martin Harrow and Kalman Kaplan and Michael Krausz and David Lester and Meltzer, {Herbert Y.} and Jiri Modestin and Montross, {Lori P.} and {Bo Mortensen}, Preben and Povl Munk-J{\o}rgensen and Jimmi Nielsen and Merete Nordentoft and Saarinen, {Pirjo Irmeli} and Sidney Zisook and Wilson, {Scott T.} and Roberto Tatarelli",
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Pompili, M, Amador, XF, Girardi, P, Harkavy-Friedman, J, Harrow, M, Kaplan, K, Krausz, M, Lester, D, Meltzer, HY, Modestin, J, Montross, LP, Bo Mortensen, P, Munk-Jørgensen, P, Nielsen, J, Nordentoft, M, Saarinen, PI, Zisook, S, Wilson, ST & Tatarelli, R 2007, 'Suicide risk in schizophrenia: Learning from the past to change the future', Annals of General Psychiatry, vol. 6, 10. https://doi.org/10.1186/1744-859X-6-10

Suicide risk in schizophrenia : Learning from the past to change the future. / Pompili, Maurizio; Amador, Xavier F.; Girardi, Paolo; Harkavy-Friedman, Jill; Harrow, Martin; Kaplan, Kalman; Krausz, Michael; Lester, David; Meltzer, Herbert Y.; Modestin, Jiri; Montross, Lori P.; Bo Mortensen, Preben; Munk-Jørgensen, Povl; Nielsen, Jimmi; Nordentoft, Merete; Saarinen, Pirjo Irmeli; Zisook, Sidney; Wilson, Scott T.; Tatarelli, Roberto.

In: Annals of General Psychiatry, Vol. 6, 10, 16.03.2007.

Research output: Contribution to journalReview article

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T1 - Suicide risk in schizophrenia

T2 - Learning from the past to change the future

AU - Pompili, Maurizio

AU - Amador, Xavier F.

AU - Girardi, Paolo

AU - Harkavy-Friedman, Jill

AU - Harrow, Martin

AU - Kaplan, Kalman

AU - Krausz, Michael

AU - Lester, David

AU - Meltzer, Herbert Y.

AU - Modestin, Jiri

AU - Montross, Lori P.

AU - Bo Mortensen, Preben

AU - Munk-Jørgensen, Povl

AU - Nielsen, Jimmi

AU - Nordentoft, Merete

AU - Saarinen, Pirjo Irmeli

AU - Zisook, Sidney

AU - Wilson, Scott T.

AU - Tatarelli, Roberto

PY - 2007/3/16

Y1 - 2007/3/16

N2 - Suicide is a major cause of death among patients with schizophrenia. 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. 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. 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. Suicidal schizophrenics usually fear further mental deterioration, and they experience either excessive treatment dependence or loss of faith in treatment. 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. Protective factors play also an important role in assessing suicide risk and should also be carefully evaluated. 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. 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. Better knowledge may help clinicians and caretakers to implement preventive measures. This review paper is the results of a joint effort between researchers in the field of suicide in schizophrenia. Each expert provided a brief essay on one specific aspect of the problem. 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.

AB - Suicide is a major cause of death among patients with schizophrenia. 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. 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. 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. Suicidal schizophrenics usually fear further mental deterioration, and they experience either excessive treatment dependence or loss of faith in treatment. 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. Protective factors play also an important role in assessing suicide risk and should also be carefully evaluated. 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. 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. Better knowledge may help clinicians and caretakers to implement preventive measures. This review paper is the results of a joint effort between researchers in the field of suicide in schizophrenia. Each expert provided a brief essay on one specific aspect of the problem. 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.

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Pompili M, Amador XF, Girardi P, Harkavy-Friedman J, Harrow M, Kaplan K et al. Suicide risk in schizophrenia: Learning from the past to change the future. Annals of General Psychiatry. 2007 Mar 16;6. 10. https://doi.org/10.1186/1744-859X-6-10