The relation of self-hatred and suicidality in people with schizophrenia-spectrum symptoms

It is well known that depressive symptoms represent a risk for suicidality in general. It is less clear, however, that general depressive symptoms com prise a definite suicide risk factor for people with schizophrenia. Based o n this, as well as on the early writings of E. Bleuler (1911/1987), it was hypothesized that there may be a particular aspect of depressive symptoms t hat combines with schizophrenia to encourage suicidality. Specifically, sch izophrenia may impart to self-concept a quality of self-hatred that encoura ges suicidality in schizophrenic people. If so, then an index of self-hatre d should be more correlated with suicidality among people with schizophreni a-spectrum symptoms than among people with fewer such symptoms. Two studies evaluated this possibility. In Study 1 on 243 suicidal outpatients affilia ted with the military, self-hate and suicidality were more correlated among people with schizotypal symptoms than among other patients. In Study 2 on 113 VA psychiatric inpatients, self-hate and suicidality were more correlat ed among people with a diagnosis of schizophrenia than among patients with a diagnosis of major depression. Study limitations were noted, and it was s uggested that self-hatred be a focus of suicide risk assessment in schizoph renic people.