Prevalence And Risk Factors Associated with Suicidal Ideation Among Schizophrenic Patients- A Conceptual Perspective
Abstract
Schizophrenia is a chronic illness caused by interrelated biological, developmental and environmental factors. Among the numerous challenges faced by individuals with schizophrenia, presence of suicidal ideation is a matter of significant concern due to high prevalence. This paper aims to explore the theoretical aspects underlying the suicidal ideation in individuals diagnosed with schizophrenia. The paper first provides an overview of the complex interplay between schizophrenia and suicidal ideation. Furthermore, it delves into the impact of various socio-demographic, clinical and psycho-social risk factors, such as age, gender, marital status, types of symptoms, and level of insight on suicidal ideation in schizophrenia. In addition, the paper discusses prominent theoretical framework and mechanisms underlying suicidal ideation in schizophrenia. The findings contribute to the existing body of knowledge as well as inform the development of targeted interventions and prevention measures for individuals with schizophrenia having suicidal ideation which is crucial for enhancing clinical interventions and ultimately reducing the devastating impact of suicide in schizophrenia.
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Abraham, C., & Jayakrishnaveni, C. (2020). Prevalence of Depression and Suicidality in Schizophrenia-A Cross Sectional Study. International Journal of Scientific Study, 7(10), 81-85.
Anderson, K.K., Norman, R., MacDougall, A., Edwards, J., Palaniyappan, L., Lau, C., Kurdyak, P., (2018). Effectiveness of early psychosis intervention: comparison of service users and nonusers in population-based health administrative data. Am. J. Psychiatry 175, 443–452.
Ashok, A. H., Baugh, J., & Yeragani, V. K. (2012). Paul Eugen Bleuler and the origin of the term schizophrenia (SCHIZOPRENIEGRUPPE). Indian journal of psychiatry, 54(1), 95.
Austad, G., Joa, I., Johannessen, J. O., & Larsen, T. K. (2015). Gender differences in suicidal behaviour in patients with first‐episode psychosis. Early intervention in psychiatry, 9(4), 300-307.
Ayalew, M., Defar, S., & Reta, Y. (2021). Suicide behavior and its predictors in patients with schizophrenia in Ethiopia. Schizophrenia research and treatment, 2021.
Barrett EA, Mork E, Faerden A, et al. (2015) The development of insight and its relationship with suicidality over one year follow-up in patients with first episode psychosis. Schizophr Res 162: 97–102.
Besteher B, Wagner G, Koch K, et al. (2016) Pronounced prefronto-temporal cortical thinning in schizophrenia: Neuroanatomical correlate of suicidal behavior? Schizophr Res 176: 151–157.
Borders, A. (2020). Chapter 4—Rumination and dysregulated behaviours. Rumination and related constructs, 101-134.
Bornheimer, L. A. (2016). Moderating effects of positive symptoms of psychosis in suicidal ideation among adults diagnosed with schizophrenia. Schizophrenia research, 176(2-3), 364-370.
Bornheimer, L. A., & Nguyen, D. (2016). Suicide among individuals with schizophrenia: a risk factor model. Social Work in Mental Health, 14(2), 112-132.
Brown, G. K., Ten Have, T., Henriques, G. R., Xie, S. X., Hollander, J. E., & Beck, A. T. (2005). Cognitive therapy for the prevention of suicide attempts: a randomized controlled trial. Jama, 294(5), 563-570.
Cassidy, R.M., Yang, F., Kapczinski, F., Passos, I.C., 2018. Risk factors for suicidality in patients with schizophrenia: a systematic review, meta-analysis, and meta-regression of 96 studies. Schizophr. Bull. 44, 787–797.
Castelein, S., Liemburg, E. J., de Lange, J. S., van Es, F. D., Visser, E., Aleman, A., &Knegtering, H. (2015). Suicide in recent onset psychosis revisited: significant reduction of suicide rate over the last two decades—a replication study of a dutch incidence cohort. PloS one, 10(6), e0129263.
Chong, B. T. W., Wahab, S., Muthukrishnan, A., Tan, K. L., Ch’ng, M. L., & Yoong, M. T. (2020). Prevalence and factors associated with suicidal ideation in institutionalized patients with schizophrenia. Psychology research and behavior management, 949-962.
Coope, C., Donovan, J., Wilson, C., Barnes, M., Metcalfe, C., Hollingworth, W., … Gunnell, D. (2015). Characteristics of people dying by suicide after job loss, financial difficulties and other economic stressors during a period of recession (2010–2011): A review of coroners’ records. Journal of Affective Disorders, 183, 98–105.
De Sousa, A., Shah, B., & Shrivastava, A. (2020). Suicide and schizophrenia: an interplay of factors. Current psychiatry reports, 22, 1-5.
Dong, M., Wang, S. B., Wang, F., Zhang, L., Ungvari, G. S., Ng, C. H., ... & Xiang, Y. T. (2019). Suicide-related behaviours in schizophrenia in China: a comprehensive meta-analysis. Epidemiology and psychiatric sciences, 28(3), 290-299.
Fang, X., Chen, Y., Wang, Y., & Zhang, C. (2019). Identification of risk factors for suicidal ideation in patients with schizophrenia. Psychiatry Research, 271, 195-199.
Fleischhacker, W. W., Kane, J. M., Geier, J., Karayal, O., Kolluri, S., Eng, S. M., ... & Strom, B. L. (2014). Completed and attempted suicides among 18,154 subjects with schizophrenia included in a large simple trial. The Journal of clinical psychiatry, 75(3), 3543.
Ganguly, P., Soliman, A., & Moustafa, A. A. (2018). Holistic management of schizophrenia symptoms using pharmacological and non-pharmacological treatment. Frontiers in public health, 6, 166.
Girgis, R. R. (2020). The neurobiology of suicide in psychosis: A systematic review. Journal of Psychopharmacology, 34(8), 811-819.
Haining, K., Karagiorgou, O., Gajwani, R., Gross, J., Gumley, A. I., Lawrie, S. M., ... & Uhlhaas, P. J. (2021). Prevalence and predictors of suicidality and non‐suicidal self‐harm among individuals at clinical high‐risk for psychosis: Results from a community‐recruited sample. Early intervention in psychiatry, 15(5), 1256-1265.
Harmer, B., Lee, S., TvH, D., &Saadabadi, A. (2020). Suicidal ideation.
Hennen, J., & Baldessarini, R. J. (2005). Suicidal risk during treatment with clozapine: a meta-analysis. Schizophrenia research, 73(2-3), 139-145.
Hswen, Y., Naslund, J.A., Brownstein, J.S., Hawkins, J.B., 2018. Monitoring online discussions about suicide among twitter users with schizophrenia: Exploratory study. JMIR Ment Health 5 (4), e11483.
Husain, M. O., Chaudhry, I. B., Khan, Z., Khoso, A. B., Kiran, T., Bassett, P., ... & Husain, N. (2021). Depression and suicidal ideation in schizophrenia spectrum disorder: a cross-sectional study from a lower middle-income country. International journal of psychiatry in clinical practice, 25(3), 245-251.
Joiner, T. E. (2005). Why people die by suicide. Cambridge, MA: Harvard University Press.
Keilp, J., Gorlyn, M., Russell, M., et al., 2013. Neuropsychological function and suicidal behavior: attention control, memory and executive dysfunction in suicide attempt. Psychol. Med. 43 (3), 539–551.
Kjelby E, Sinkeviciute I, Gjestad R, Kroken RA, Løberg EM, Jørgensen HA, et al. (2015) Suicidality in schizophrenia spectrum disorders: the relationship to hallucinations and persecutory delusions. Eur Psychiatry.30:830–6.
Kurtz, M. M., Gopal, S., John, S., & Thara, R. (2018). Cognition, social cognition and functional disability in early-stage schizophrenia: a study from southern India. Psychiatry Research, 265, 231-237.
Lawlor, C., Vitoratou, S., Duffy, J., Cooper, B., De Souza, T., Le Boutillier, C., ... & Jolley, S. (2022). Managing emotions in psychosis: Evaluation of a brief DBT‐informed skills group for individuals with psychosis in routine community services. British Journal of Clinical Psychology, 61(3), 735-756
Liu, R. T., Bettis, A. H., & Burke, T. A. (2020). Characterizing the phenomenology of passive suicidal ideation: a systematic review and meta-analysis of its prevalence, psychiatric comorbidity, correlates, and comparisons with active suicidal ideation. Psychological medicine, 50(3), 367-383.
Meltzer, H. Y., Alphs, L., Green, A. I., Altamura, A. C., Anand, R., Bertoldi, A., ... & InterSePT Study Group. (2003). Clozapine treatment for suicidality in schizophrenia: international suicide prevention trial (InterSePT). Archives of general psychiatry, 60(1), 82-91.
Millan, M. J., Andrieux, A., Bartzokis, G., Cadenhead, K., Dazzan, P., Fusar-Poli, P., ... & Weinberger, D. (2016). Altering the course of schizophrenia: progress and perspectives. Nature Reviews Drug Discovery, 15(7), 485-515.
Mitter, N., Subramaniam, M., Abdin, E., Poon, L. Y., & Verma, S. (2013). Predictors of suicide in Asian patients with first episode psychosis. Schizophrenia research, 151(1-3), 274-278.
Notaras M, Hill R, Van den Buuse M. A role for the BDNF gene Val66Met polymorphism in schizophrenia? A comprehensive review. Neurosci Biobehav Rev. 2015; 51:15–30.
Penttilä M, Jääskeläinen E, Hirvonen N, Isohanni M, Miettunen J. Duration of untreated psychosis as predictor of long-term outcome in schizophrenia: systematic review and meta-analysis. Br J Psychiatry. 2014; 205:88–94.
Popovic D, Benabarre A, Crespo JM, Goikolea JM, Gonzalez-Pinto A, Gutierrez-Rojas L, Montes JM, Vieta E (2014). Risk factors for suicide in schizophrenia: systematic review and clinical recommendations. Acta Psychiatrica Scandinavica 130, 418–426.
Pu, S., Setoyama, S., & Noda, T. (2017). Association between cognitive deficits and suicidal ideation in patients with major depressive disorder. Scientific reports, 7(1), 1-6.
Richard-Devantoy, S., Berlim, M., Jollant, F., 2014. Suicidal behaviour and memory: a systematic reviewand meta-analysis. World J Biol Psychiat. 16 (8), 544–566.
Richard-Devantoy, S., Olié, E., Guillaume, S., et al., 2013. Distinct alterations in value-based decision-making and cognitive control in suicide attempters: toward a dual neurocognitive model. J Affect Disorders. 151 (3), 1120–1124.
Tarrier, N., Gooding, P., Pratt, D., Kelly, J., Awenat, Y., & Maxwell, J. (2013). Cognitive behavioural prevention of suicide in psychosis: A treatment model. New York, NY: Routledge.
Taylor, P. J., Hutton, P., & Wood, L. (2015). Are people at risk of psychosis also at risk of suicide and self-harm? A systematic review and metaanalysis. Psychological Medicine, 45(5), 911–926
Too, L. S., Spittal, M. J., Bugeja, L., Reifels, L., Butterworth, P., & Pirkis, J. (2019). The association between mental disorders and suicide: A systematic review and meta-analysis of record linkage studies. Journal of Affective Disorders, 259, 302–313.
Shrivastava A, Jadhav V, Karia S, Shah N, De Sousa A. (2016). Serum thyroid stimulating hormone levels and suicidal tendency in patients with first-episode schizophrenia: an exploratory study. Thyroid Res Pract.13:63–6.
Shrivastava A, Avinash De Sousa G. Brain-derived neurotrophic factor and suicide in schizophrenia: critical role of neuroprotective mechanisms as an emerging hypothesis. (2016) Indian j Psychol Med.38(6):499–504.
Verma, D., Srivastava, M. K., Singh, S. K., Bhatia, T., & Deshpande, S. N. (2016). Lifetime suicide intent, executive function and insight in schizophrenia and schizoaffective disorders. Schizophrenia research, 178(1-3), 12-16.
Wats, A. (2015). Intellectual Functioning in Schizophrenia, Depression and Normal Control.
WHO (2022). Sschizophrenia/fact sheets/newsroom. Retrieved from https://www.who.int/
Yin, Y., Tong, J., Huang, J., Tian, B., Chen, S., Tan, S., ... & Hong, L. E. (2023). Auditory hallucinations, depressive symptoms, and current suicidal ideation or behavior among patients with acute-episode schizophrenia. Archives of Suicide Research, 27(2), 323-338.
Zaheer, J., Olfson, M., Mallia, E., Lam, J. S., de Oliveira, C., Rudoler, D., ... & Kurdyak, P. (2020). Predictors of suicide at time of diagnosis in schizophrenia spectrum disorder: a 20-year total population study in Ontario, Canada. Schizophrenia Research, 222, 382-388.
Zhornitsky, S., Rizkallah, E., Pampoulova, T., Chiasson, J.P., Lipp, O., Stip, E., et al., 2012. Sensation-seeking, social anhedonia, and impulsivity in substance use disorder patients with and without schizophrenia and in non-abusing schizophrenia patients. Psychiatry Res 200 (2-3), 237–241.