Depression, Hopelessness and Suicide in Chronic Schizophrenia

Abstract

Hospital records for 104 schizophrenic patients, 15 of whom subsequently committed suicide, were rated blindly for individual depressive symptoms comprising DSM III major depressive episode, and for hopelessness. Our results indicate that a large proportion of schizophrenic patients experienced major depressive episodes, and that these can be reliably identified. Presuicidal schizophrenics also experienced depressed mood, but only a minority developed the full syndrome; they typically exhibited the psychological, but not somatic symptoms. The relationship between depression and suicide disappears when hopelessness is taken into account.

Suicide and schizophrenia: a nationwide psychological autopsy study on age- and sex-specific clinical characteristics of 92 suicide victims with schizophrenia

“…This result may be due to the comprehensive data collection in our study, which included information on mental state close to the time of suicide. The rate of current depression in the present study (64%) accords with previous findings documenting an average of 60% of suicide victims suffering from affective symptoms (17,19,22,(46)(47)(48)(49).…”

Symptoms, subtype, and suicidality in patients with schizophrenia spectrum disorders

“…Organizing available data concerning suicide risk factors into a coherent clinical profile, Drake et al (33,41,42) noted that schizophrenic patients who kill themselves tend to be younger and to have good premorbid functioning and high self-expectations for performance. Suffering from a recurrent illness with numerous relapses, they find themselves neither able to achieve these expectations nor able to relinquish them and accept the limitations and disabilities imposed by mental illness.…”

Psychodynamic treatment of schizophrenia: is there a future?

“…In the follow-up study reported by Stone (1986), 20 % of the patients who received psychodynamic therapy committed suicide, approximately double the suicide rate commonly reported for schizophrenics (Winokur & Tsuang, 1975;Drake & Cotton, 1986;Roy, 1986;Roy et al 1986). This high suicide rate may be further evidence for the potentially negative effects of psychodynamic treatment for this population.…”