Revisiting the Association of Aggression and Suicidal Behavior in Schizophrenic Inpatients

Department of Psychiatry and Psychotherapy, University of Regensburg, Regensburg, Germany.
Suicide and Life-Threatening Behavior (Impact Factor: 1.4). 02/2011; 41(2):171-9. DOI: 10.1111/j.1943-278X.2011.00018.x
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Our study investigated the association of aggression and suicidal behavior in schizophrenic inpatients. Eight thousand nine hundred one admissions for schizophrenia (1998-2007) to a psychiatric university hospital were included. Schizophrenic suicides (n = 7)/suicide attempters (n = 40) were compared to suicides (n = 30)/suicide attempters (n = 186) with other diagnoses and to schizophrenic non-attempters regarding aggression. Logistic regression analysis was performed to explore risk factors for attempted suicide. Schizophrenic suicides/suicide attempters did not differ from other suicides/suicide attempters or from schizophrenic non-attempters with regard to aggression. Risk of inpatient suicide attempt was increased for patients with attempted suicide at admission, high school graduation, and disorganized subtype. Aggression could not be found to be a predictor of attempted suicide. Aggression seems to have a minor role for suicidal behavior in schizophrenia.

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    • "Interestingly, a cross-sectional survey did not find aggression to be a predictor of attempted suicide. Aggression seems to have only a minor role in suicidal behavior in schizophrenia [18]. Aggression is complex, and it is unclear whether increased aggression correlates with suicide. "
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    BMC Public Health 06/2014; 14(1):551. DOI:10.1186/1471-2458-14-551 · 2.26 Impact Factor
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    ABSTRACT: Objective: The study aimed to examine suicidal behaviour during in-patient care in a psychiatric university hospital. Method: Based upon a psychiatric basic documentation system prevalence and risk factors of in-patient suicides and suicide attempts were investigated (1995 - 2010). Results: A total of 42 in-patient suicides and 166 attempts were found among 16 251 patients. According to the multivariate logistic regression analysis the risk of suicide during hospitalization increases significantly for male patients, with more previous psychiatric hospitalizations and suicidality according to clinical impression at admission or suicide attempt before admission. Patients with affective or schizophrenic disorders were at highest risk. The following risk factors are associated with suicide attempt during stay: female gender, borderline personality disorder (F60.3), more previous psychiatric hospitalizations, shorter duration of disorder, earlier age of onset, suicidality according to clinical impression at admission or suicide attempt before admission. Conclusion: As depressive and schizophrenic patients represent the high-risk group of in-patient suicide, suicide prevention should be a major goal in their treatment. More frequent suicide risk assessment is recommended particularly before granting a leave or an outing.
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