Suicide Risk in Schizophrenia - a follow-up study after 20 years. Part 2: Symptomatology and pharmacotherapy

G Lippi, D J Smit, J C Jordaan, J L Roos


Objective:  This study prospectively 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 2 decades. Method Subjects were contacted and interviewed face-to-face by following a questionnaire devised for this purpose. The Beck Hopelessness Scale (BHS) was administered and ratings were compared to 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 found. Three subjects committed suicide during the 20 year period. Among the living subjects, risks for suicide were found to be lower than 20 years ago. 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 in this study to be associated with suicide risk in patients with schizophrenia, are congruous with those mentioned in the literature.


Prospective study, schizophrenia, suicide risk, hopelessness, depressive symptoms

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Submitted: 23 March 2009
Published: 01 December 2009

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South African Journal of Psychiatry    |    ISSN: 1608-9685 (PRINT)    |    ISSN: 2078-6786 (ONLINE)