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Suicide and schizophrenia: A systematic review of rates and risk factors.

Hor K, Taylor Kahyee; ORCID: http://orcid.org/0000-0003-3995-0655 M, K. H ...see all

Journal of Psychopharmacology, vol. 24, issue 11, Suppl 4 (2010) pp. 81-90 Published by Sage Publications

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Abstract

Risk assessment is a core skill in psychiatry. Risk prediction for suicide in schizophrenia is known to be complex. We undertook a systematic review of all original studies concerning suicide in schizophrenia published since 2004. We found 51 data-containing studies (from 1281 studies screened) that met our inclusion criteria, and ranked these by standardized quality criteria. Estimates of rates of suicide and risk factors associated with later suicide were identified, and the risk factors were grouped according to type and strength of association with suicide. Consensus on the lifetime risk of suicide was a rate of approximately 5%. Risk factors with a strong association with later suicide included being young, male, and with a high level of education. Illness-related risk factors were important predictors, with number of prior suicide attempts, depressive symptoms, active hallucinations and delusions, and the presence of insight all having a strong evidential basis. A family history of suicide, and comorbid substance misuse were also positively associated with later suicide. The only consistent protective factor for suicide was delivery of and adherence to effective treatment. Prevention of suicide in schizophrenia will rely on identifying those individuals at risk, and treating comorbid depression and substance misuse, as well as providing best available treatment for psychotic symptoms. (PsycINFO Database Record (c) 2016 APA, all rights reserved)

Author-supplied keywords

  • *Risk Assessment
  • *Risk Factors
  • *Schizophrenia
  • *Suicide
  • *psychology
  • *schizophrenia/ep [Epidemiology]
  • *suicide
  • addiction
  • clinical trial (topic)
  • comorbidity
  • depression/ep [Epidemiology]
  • female
  • human
  • male
  • mortality
  • review
  • risk factor
  • statistics
  • suicide attempt
  • time

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Authors

  • Kahyee Hor

  • Mark A I - ORCID: http://orcid.org/Hor Taylor Kahyee; ORCID: http://orcid.org/0000-0003-3995-0655

  • Hor K.

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