Lifetime psychiatric symptoms in persons with schizophrenia who died by suicide compared to other means of death.
ABSTRACT The focus of this report is to compare the psychiatric symptomatology of individuals with schizophrenia who have died by suicide to those who have died by other means of death. This study includes individuals with a diagnosis of schizophrenia whose families donated their brain tissue to the Maryland Brain Collection between September 1989 and August 1998. The psychological autopsy method was used to assess the deceased individual's demographic and clinical characteristics, psychiatric symptoms and history of suicidal thoughts and attempts. Ninety-seven individuals with schizophrenia were identified for this study. Fifteen had committed suicide, while the remaining 82 died from other causes. Thoughts of suicide and previous suicide attempts were more frequent among the group that died from suicide (93% compared to 26%) (p < 0.0001). Suicide victims had a higher rate of depressive symptoms and were twice as likely to have a depressed mood. The incidence of thoughts of dying was 60% compared to 20% in those who did not commit suicide (p = 0.002). Loss of interest was reported to occur in 20% in the suicide group compared to 4% in the group of individuals that died from other causes (p = 0.05). Victims of suicide also had higher rates of positive symptoms throughout their lifetime including thought control, flight of ideas, and loose associations. Suicide is one of the leading cause of premature death in individuals with schizophrenia and identification of risk factors is of great importance. Individuals who die by suicide experience higher rates of depressive symptoms, suicidal thoughts and positive symptoms during their life.
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ABSTRACT: Because psychiatric disorders are risk factors for suicide, psychiatric consultation should be an essential element of suicide prevention among individuals with a high risk of suicide. The aim of the present study was to compare the characteristics of individuals who had or had not received psychiatric consultation before they attempted suicide in Japan.BMC Psychiatry 05/2014; 14(1):146. · 2.24 Impact Factor
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ABSTRACT: Objective: Schizophrenia is associated with an increase in the risk of both homicide and suicide. The objectives of this study were to systematically review all published articles that examined the relation between neurocognitive deficits and suicidal or homicidal behaviours in schizophrenia, and to identify vulnerabilities in suicidal and homicidal behaviour that may share a common pathway in schizophrenia. Methods: A systematic review of the literature was performed using MEDLINE to include all studies published up to August 31, 2012. Results: Among the 1760 studies, 7 neuropsychological and 12 brain imaging studies met the selection criteria and were included in the final analysis. The neuropsychological and functional neuroimaging studies were inconclusive. The structural imaging studies reported various alterations in patients with schizophrenia and a history of homicidal behaviour, including: reduced inferior frontal and temporal cortices, increased mediodorsal white matter, and increased amygdala volumes. Patients with a history of suicidal acts showed volumetric reductions in left orbitofrontal and superior temporal cortices, while right amygdala volume was increased, though, these findings have rarely been replicated. Finally, no study has directly compared neurocognitive markers of suicidal and homicidal risk. Conclusion: These results suggest that brain alterations, in addition to those associated with schizophrenia, may predispose some patients to a higher risk of homicide or suicide in particular circumstances. Moreover, some of these alterations may be shared between homicidal and suicidal patients. However, owing to several limitations, including the small number of available studies, no firm conclusions can be drawn and further investigations are necessary.Canadian journal of psychiatry. Revue canadienne de psychiatrie 01/2014; 59(1):18-25. · 2.41 Impact Factor
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ABSTRACT: Depressive symptoms are associated with poor outcomes, increased risk of relapse, and high suicide rates in patients with schizophrenia and schizoaffective disorder. This randomized, open-label, parallel-group, flexible-dose study (NCT00640562) assessed the efficacy of quetiapine extended release (XR) versus risperidone on depressive symptoms in this patient population. Noninferiority of quetiapine XR versus risperidone from baseline to week 12 was assessed by least squares mean (LSM) reduction in the Calgary Depression Scale for Schizophrenia (CDSS). Noninferiority was indicated if the difference in CDSS reductions between quetiapine XR and risperidone had a 95% confidence interval (CI) lower limit of more than -2.7. Overall, 216 patients received quetiapine XR (n=109; 400-800 mg/day) or risperidone (n=107; 4-6 mg/day). In the per-protocol population, LSM CDSS reductions for quetiapine XR and risperidone were 8.4 and 6.2 points, respectively (95% CI 0.8-3.7). As the lower limit of the 95% CI was more than -2.7 and the LSM reduction for quetiapine XR was 2.2 points higher than that for risperidone, noninferiority of quetiapine XR versus risperidone was demonstrated. Adverse events for quetiapine XR and risperidone were comparable. In this study, quetiapine XR was noninferior to risperidone at reducing depressive symptoms in patients with schizophrenia or schizoaffective disorder.International clinical psychopharmacology 05/2014; 29(3):166-176. · 3.35 Impact Factor