Suicide Attempts, Neurocognitive Dysfunctions and Clinical Correlates in Middle-Aged and Elderly Chinese Schizophrenia Patients

Abstract

Background: Suicide is a common and complex symptom of schizophrenia that may be related to clinical variables and neurocognitive function. This study aimed to investigate the associated correlates of suicide attempts in Chinese middle-aged and elderly inpatients with schizophrenia, including demographic and clinical characteristics and cognitive level, which has not yet been reported.Methods: A total of 426 schizophrenia inpatients were recruited for this study. Clinical symptoms were evaluated using the Positive and Negative Syndrome Scale (PANSS). Neurocognitive function was measured by the Repeatable Battery for the Assessment of Neuropsychological Status (RBANS).Results: The prevalence of suicide attempts in middle-aged and elderly Chinese schizophrenia patients was 13.3%. Female patients had a higher suicide rate than male patients. Patients with suicide attempts had significantly higher PANSS-positive subscores, depressive subscores, and RBANS-story recall than non-attempter patients (all p < 0.05). Multiple logistic regression showed that gender, positive subscore, depressive subscore and RBANS-story recall (OR = 1.10–2.19, p < 0.05) were independently associated with suicide attempts in middle-aged and elderly schizophrenia patients.Conclusions: Our study showed that the rate of suicide attempts in Chinese middle-aged and elderly schizophrenia patients is high. Compared to non-attempters, there are less cognitive impairments, more clinical symptoms, and more female patients in the suicide attempters.

Suicidal ideation in Chinese adults with schizophrenia: associations with neurocognitive function and empathy

“…This is similar to the results of previous studies [ 20 , 21 ], and suggests that suicidal ideation among patients with SZ might not be related to neurocognitive function. However, the results of previous studies are inconsistent, and some studies [ 14 – 16 ] have reported that impaired neurocognition in patients with SZ is a risk factor for suicide while others suggest that the risk of suicide in patients with SZ increases with improved cognitive function [ 17 – 19 ]. Thus, given that the reported relationship between suicidal ideation and neurocognitive in patients with SZ is inconsistent, further prospective studies with larger samples are needed.…”

“…However, findings on the association between suicide risk and cognitive impairment in SZ have been inconsistent. Some studies [ 14 – 16 ] have reported that impaired neurocognition in patients with SZ is a risk factor for suicide, while others have reported a positive relationship between suicidal risk and improved cognitive function [ 17 – 19 ], or no association between the two variables [ 20 , 21 ]. Neurocognitive decline is often associated with aging [ 22 ], so the current study focused on young adults aged 18–44 years.…”

Visuospatial ability and attention as risk factors for suicidal ideation in middle-aged and elderly schizophrenia patients: a cross-sectional study

“…The relationship between neurocognition and suicidal ideation is heterogeneous in previous studies. Some studies insisted that preserved neurocognition is associated with the suicidality [ 15 , 21 , 22 ], while the other studies insisted that there is no correlation between neurocognition and suicidality [ 23 , 24 , 59 ]. There are various reasons for these heterogeneous results, such as patient selection bias, different definitions of suicidal categories and different measurement tools for neurocognition.…”

“…Neurocognition impairment is an essential feature of SZ [ 20 ]. Previous studies have reported that preserved neurocognitive function are related to suicidality in SZ patients [ 15 , 21 , 22 ]. However, other studies reported that suicidality is not correlated with neurocognitive function in SZ patients [ 23 – 25 ].…”

“…However, other studies reported that suicidality is not correlated with neurocognitive function in SZ patients [ 23 – 25 ]. The association between distinct neurocognitive domains and suicidality in SZ patients are largely inconclusive [ 15 , 21 , 22 ]. A study carried on outpatients with SZ has showed that attention, memory and verbal fluency are associated with suicidal ideation [ 26 ].…”