Evaluation of suicidal behaviour, depression, insight and disease charasteristics in schizophrenia

Abstract

Objective: Suicide is a severe public health issue with high rates of morbidity and mortality. Schizophrenia also has a high suicide incidence, which is one of the main factors contributing to rising morbidity and mortality. For strategies to lower suicide rates, it is essential to understand the risk factors for suicide in people with schizophrenia. This study aimed to contribute to the reduction of suicide in schizophrenia and to set an example for future studies by evaluating the relationship between the risk of suicidal behavior and demographic variables and disease characteristics, depression and insight in schizophrenia patients, in the light of literature information. Material and Methods: This study included 103 schizophrenia patients who underwent follow-up for at least 4 years in a community mental health center (CMHC). The study included patients who had the mental capacity to understand and complete the questionnaires, were not experiencing an acute psychotic attack, and gave their consent to participate. The patients were given the Three Components of Insight Scale (TCIS), Scale for Evaluation of Positive Symptoms in Schizophrenia (SAPS), Scale for Evaluation of Negative Symptoms in Schizophrenia (SANS), Calgary Depression Inventory in Schizophrenia (CDIS), and Suicide Behavior Scale (SBS). Results: 47% of patients demonstrated suicidal behavior, and 69% of patients were men. 46% of the group demonstrating suicidal behavior had severe or very severe suicidal ideation. Age and disease duration were revealed to be significant risk factors for suicidal behavior (p=0.033 and p=0.004, respectively), but gender, SBS, CDIS, SANS, SAPS, and TCIS scores had no significant effect. Age and suicidal behavior risk were found to be inversely correlated, with each unit of age increase reducing the risk of suicidal behavior by 0.929 times. The risk of suicidal behavior rises along with the duration of disease. With every one unit increase in the duration of disease,the risk of suicidal behavior increases by 1.133 times. Additionally, the group with severe-very severe suicidal ideation had significantly more severe depression scores than the group with mild-moderate (p=0.01). Conclusion: Suicide and suicide attempt are important morbidity and mortality factors in schizophrenia, and it is of great importance to determine suicide risk factors and protective factors in schizophrenia patients and to create interventions for them.