Skip to main content
Top
Published in: International Journal of Mental Health Systems 1/2007

Open Access 01-12-2007 | Research

Communication of suicide intent by schizophrenic subjects: data from the Queensland Suicide Register

Authors: Diego De Leo, Helen Klieve

Published in: International Journal of Mental Health Systems | Issue 1/2007

Login to get access

Abstract

Background

Suicide in mentally ill subjects, like schizophrenics, remains unbearably frequent in Australia and elsewhere. Since these patients are known to constitute a high-risk group, suicide in them should be amongst the most preventable ones. The objective of this study is to investigate the frequency of suicide communication in subjects with reported history of schizophrenia who completed suicide.

Method

The Queensland Suicide Register (QSR) was utilised to identify suicide cases. Frequency of suicide communication was examined in subjects with schizophrenia, and compared with persons with other psychiatric conditions and with subjects with no reported diagnosis. Socio-demographic variables, history of suicidal behaviour, pharmacological treatment and mental health service utilisation were also compared among the three groups.

Results and discussion

Subjects with a reported diagnosis of schizophrenia comprised 7.2% (n = 135) of the 1,863 suicides included in this study. Subjects with schizophrenia and those with other psychiatric disorders communicated their suicide intent more frequently than those with no psychiatric diagnosis, and persons with schizophrenia communicated their intent more than those with other psychiatric diagnoses. Seventy one per cent of schizophrenia subjects had contact with a mental health professional within the three months prior to suicide.

Conclusion

The fact that subjects with schizophrenia had the highest prevalence of suicide intent communication could offer concrete opportunities for suicide prevention.
Literature
1.
go back to reference Tsuang MT, Lyons MJ, Farone SV: Premature deaths in schizophrenia and affective disorders: an analysis of survival curves and variables affecting the shortened survival. Archives of General Psychiatry. 1990, 156: 17-26. Tsuang MT, Lyons MJ, Farone SV: Premature deaths in schizophrenia and affective disorders: an analysis of survival curves and variables affecting the shortened survival. Archives of General Psychiatry. 1990, 156: 17-26.
2.
go back to reference Hunt IM, Kapur N, Windfuhr K, Robinson J, Bicley H, Flynn S, Parson R, Burns J, Shaw J, Appleby L: Suicide in schizophrenia: findings from a national clinical survey. Journal of Psychiatric Practice. 2006, 12: 139-147. 10.1097/00131746-200605000-00002.CrossRefPubMed Hunt IM, Kapur N, Windfuhr K, Robinson J, Bicley H, Flynn S, Parson R, Burns J, Shaw J, Appleby L: Suicide in schizophrenia: findings from a national clinical survey. Journal of Psychiatric Practice. 2006, 12: 139-147. 10.1097/00131746-200605000-00002.CrossRefPubMed
3.
go back to reference Healy D, Harris M, Tranter R, Gutting P, Austin R, Jones-Edwards G, Roberts AP: Lifetime suicide rates in treated schizophrenia: 1875-1924 and 1994-1998 cohorts compared. British Journal of Psychiatry. 2006, 188: 223-228. 10.1192/bjp.188.3.223.CrossRefPubMed Healy D, Harris M, Tranter R, Gutting P, Austin R, Jones-Edwards G, Roberts AP: Lifetime suicide rates in treated schizophrenia: 1875-1924 and 1994-1998 cohorts compared. British Journal of Psychiatry. 2006, 188: 223-228. 10.1192/bjp.188.3.223.CrossRefPubMed
4.
go back to reference Roy A: Suicide in schizophrenia. Suicide. Edited by: Roy A. 1986, Baltimore , Williams & Wilkins, 97-112. Roy A: Suicide in schizophrenia. Suicide. Edited by: Roy A. 1986, Baltimore , Williams & Wilkins, 97-112.
5.
go back to reference Isometsä ET: Psychological autopsy studies: a review. European Psychiatry. 2001, 16: 379-385. 10.1016/S0924-9338(01)00594-6.CrossRefPubMed Isometsä ET: Psychological autopsy studies: a review. European Psychiatry. 2001, 16: 379-385. 10.1016/S0924-9338(01)00594-6.CrossRefPubMed
6.
go back to reference Roy A, Draper R: Suicide among psychiatric hospital in-patients. Psychological Medicine. 1995, 25: 199-202.CrossRefPubMed Roy A, Draper R: Suicide among psychiatric hospital in-patients. Psychological Medicine. 1995, 25: 199-202.CrossRefPubMed
7.
go back to reference Australian Institute of Health and Welfare: Mental Health Services in Australia 1999-00. AIHW Catalogue No. HSE-19. 2002, Canberra , AIHW Australian Institute of Health and Welfare: Mental Health Services in Australia 1999-00. AIHW Catalogue No. HSE-19. 2002, Canberra , AIHW
8.
go back to reference De Leo D, Spathonis K: Do pharmacological and psychosocial interventions reduce suicide in schizophrenia and schizophrenia spectrum disorders?. Archives of Suicide Research. 2003, 7: 353-374. 10.1080/713848945.CrossRef De Leo D, Spathonis K: Do pharmacological and psychosocial interventions reduce suicide in schizophrenia and schizophrenia spectrum disorders?. Archives of Suicide Research. 2003, 7: 353-374. 10.1080/713848945.CrossRef
9.
go back to reference Kelly DL, Shim JC, Feldman SM, Yu Y, Conley RR: Lifetime psychiatric symptoms in persons with schizophrenia who died by suicide compared to other means of death. Journal of Psychiatric Research. 2004, 38: 531-536. 10.1016/j.jpsychires.2004.02.001.CrossRefPubMed Kelly DL, Shim JC, Feldman SM, Yu Y, Conley RR: Lifetime psychiatric symptoms in persons with schizophrenia who died by suicide compared to other means of death. Journal of Psychiatric Research. 2004, 38: 531-536. 10.1016/j.jpsychires.2004.02.001.CrossRefPubMed
10.
go back to reference Montross LP, Zisook S, Kasckow J: Suicide among patients with schizophrenia: a consideration of risk and protective factors. Annals of Clinical Psychiatry. 2005, 17: 173-182. 10.1080/10401230591002156.CrossRefPubMed Montross LP, Zisook S, Kasckow J: Suicide among patients with schizophrenia: a consideration of risk and protective factors. Annals of Clinical Psychiatry. 2005, 17: 173-182. 10.1080/10401230591002156.CrossRefPubMed
11.
go back to reference Isometsä ET, Heikkinen ME, Marttunen MJ, Henriksson MM, Aro HM, Lönnqvist JK: The last appointment before suicide: is suicide intent communicated?. American Journal of Psychiatry. 1995, 152: 919-922.CrossRefPubMed Isometsä ET, Heikkinen ME, Marttunen MJ, Henriksson MM, Aro HM, Lönnqvist JK: The last appointment before suicide: is suicide intent communicated?. American Journal of Psychiatry. 1995, 152: 919-922.CrossRefPubMed
12.
go back to reference Reid WH, Mason M, Hogan T: Suicide prevention effects associated with clozapine therapy in schizophrenia and schizoaffective disorder. Psychiatric Services. 1998, 49: 1029-1033.CrossRefPubMed Reid WH, Mason M, Hogan T: Suicide prevention effects associated with clozapine therapy in schizophrenia and schizoaffective disorder. Psychiatric Services. 1998, 49: 1029-1033.CrossRefPubMed
13.
go back to reference Heilä H, Isometsä ET, Henriksson MM, Heikkinen ME, Marttunen MJ, Lönnqvist JK: Antecedents of suicide in people with schizophrenia. British Journal of Psychiatry. 1998, 173: 330-333.CrossRefPubMed Heilä H, Isometsä ET, Henriksson MM, Heikkinen ME, Marttunen MJ, Lönnqvist JK: Antecedents of suicide in people with schizophrenia. British Journal of Psychiatry. 1998, 173: 330-333.CrossRefPubMed
14.
go back to reference Bertolote JM, Fleischmann A, De Leo D, Wasserman D: Suicide and mental disorders: do we know enough? (Editorial). British Journal of Psychiatry. 2003, 183: 382-383. 10.1192/bjp.183.5.382.CrossRefPubMed Bertolote JM, Fleischmann A, De Leo D, Wasserman D: Suicide and mental disorders: do we know enough? (Editorial). British Journal of Psychiatry. 2003, 183: 382-383. 10.1192/bjp.183.5.382.CrossRefPubMed
15.
go back to reference Henriksson MM, Aro HM, Marttunen MJ, Heikkinen ME, Isometsä ET, Kuoppasalmi KI: Mental disorders and comorbidity in suicide. American Journal of Psychiatry. 1993, 150: 935-940.CrossRefPubMed Henriksson MM, Aro HM, Marttunen MJ, Heikkinen ME, Isometsä ET, Kuoppasalmi KI: Mental disorders and comorbidity in suicide. American Journal of Psychiatry. 1993, 150: 935-940.CrossRefPubMed
16.
go back to reference Suominen KH, Isometsä ET, Lönnqvist JK: Co-morbid substance use reduces the health care contacts of suicide attempters with schizophrenia spectrum disorders. Schizophrenia Bulletin. 2002, 28: 637-647.CrossRefPubMed Suominen KH, Isometsä ET, Lönnqvist JK: Co-morbid substance use reduces the health care contacts of suicide attempters with schizophrenia spectrum disorders. Schizophrenia Bulletin. 2002, 28: 637-647.CrossRefPubMed
17.
go back to reference Heilä H, Isometsä ET, Henriksson MM, Heikkinen ME, Marttunen M, Lönnqvist JK: Suicide and schizophrenia: a nation wide psychological autopsy study on age and sex-specific clinical characteristics of 92 suicide victims with schizophrenia. American Journal of Psychiatry. 1997, 154: 1235-1242.CrossRefPubMed Heilä H, Isometsä ET, Henriksson MM, Heikkinen ME, Marttunen M, Lönnqvist JK: Suicide and schizophrenia: a nation wide psychological autopsy study on age and sex-specific clinical characteristics of 92 suicide victims with schizophrenia. American Journal of Psychiatry. 1997, 154: 1235-1242.CrossRefPubMed
18.
go back to reference Australian Bureau of Statistics: Suicides, 1994 to 2004, Catalogue No. 3309.0. 2006, Canberra , ABS Australian Bureau of Statistics: Suicides, 1994 to 2004, Catalogue No. 3309.0. 2006, Canberra , ABS
19.
go back to reference Hawton K, Appleby L, Platt S, Foster T, Cooper J, Malmberg A: The psychological autopsy approach to studying suicide: a review of methodological issues. Journal of Affective Disorders. 1998, 50: 269-276. 10.1016/S0165-0327(98)00033-0.CrossRefPubMed Hawton K, Appleby L, Platt S, Foster T, Cooper J, Malmberg A: The psychological autopsy approach to studying suicide: a review of methodological issues. Journal of Affective Disorders. 1998, 50: 269-276. 10.1016/S0165-0327(98)00033-0.CrossRefPubMed
20.
go back to reference Pouliot L, De Leo D: Psychological autopsy studies: Methodological issues. Suicide and Life-Threatening Behavior. 2006, 36: 419-510. 10.1521/suli.2006.36.5.491.CrossRef Pouliot L, De Leo D: Psychological autopsy studies: Methodological issues. Suicide and Life-Threatening Behavior. 2006, 36: 419-510. 10.1521/suli.2006.36.5.491.CrossRef
21.
go back to reference Melle I, Johannesen JO, Friis S, Haahr U, Joa I, Larsen TK, Opjordsmoen S, Rund BR, Simonsen E, Vaflum P, McGlashan T: Early detection of the first episode of schizophrenia and suicidal behavior. American Journal of Psychiatry. 2006, 163: 800-804. 10.1176/appi.ajp.163.5.800.CrossRefPubMed Melle I, Johannesen JO, Friis S, Haahr U, Joa I, Larsen TK, Opjordsmoen S, Rund BR, Simonsen E, Vaflum P, McGlashan T: Early detection of the first episode of schizophrenia and suicidal behavior. American Journal of Psychiatry. 2006, 163: 800-804. 10.1176/appi.ajp.163.5.800.CrossRefPubMed
22.
go back to reference Spitzer R, Williams J, Gibbons M: Instruction manual for the Structured Clinical Interview for DSM-III-R (SCID, 4/1/87 Revision). 1987, Biometrics Research Department, New York State Psychiatric Institute, New York Spitzer R, Williams J, Gibbons M: Instruction manual for the Structured Clinical Interview for DSM-III-R (SCID, 4/1/87 Revision). 1987, Biometrics Research Department, New York State Psychiatric Institute, New York
Metadata
Title
Communication of suicide intent by schizophrenic subjects: data from the Queensland Suicide Register
Authors
Diego De Leo
Helen Klieve
Publication date
01-12-2007
Publisher
BioMed Central
Published in
International Journal of Mental Health Systems / Issue 1/2007
Electronic ISSN: 1752-4458
DOI
https://doi.org/10.1186/1752-4458-1-6

Other articles of this Issue 1/2007

International Journal of Mental Health Systems 1/2007 Go to the issue