Suicide risk in schizophrenia: An analysis of 17 consecutive suicides

The aim of this study was to investigate interactional factors related to t he recognition of suicide risk in patients with schizophrenia, The study fo cused on 17 schizophrenia patients who had committed suicide during the Nat ional Suicide Prevention Project in Finland between April 1, 1987, and Marc h 31, 1988, in the province of Kuopio, Consensus case reports were assemble d by using the psychological autopsy method, Study methods included structu red and in-depth interviews of next of kin and interviews of health care or social services workers who had treated the suicide victims. Male and fema le patients with schizophrenia committed suicide in equal proportions. Most had suffered from schizophrenia for more than 15 years; all but one had be en receiving psychiatric treatment at the time of suicide. Retrospective as sessment indicated that 59 percent of the patients were clinically depresse d at the time of suicide. In 76 percent of the cases, the mental health pro fessionals involved in treatment had not believed that there was a risk of suicide during their last contact with the patient. In 29 percent of the ca ses, the patient's paranoid ideas concerning treatment personnel had increa sed. Patients' withdrawal from human relationships because of depression wa s related to loss of the treatment professional concern for the patients. T he findings in this descriptive study suggest that withdrawal by a patient with schizophrenia and an increase in the patient's paranoid behavior shoul d be regarded as signals of risk of suicide.