Risk factors for completed suicide in schizophrenia and other chronic psychotic disorders: a case-control study.
OBJECTIVE
Despite an increased risk for suicide among individuals diagnosed with psychotic disorders, risk factors for completed suicide remain largely unexamined in this population. Using a case-control design, this study aimed to investigate clinical and behavioural risk factors for suicide completion in schizophrenia and other chronic psychotic disorders.


METHODS
A total of 81 psychotic subjects were examined; of these, 45 died by suicide. Proxy-based interviews with, on average, 2 informants were conducted using the SCID I and II interviews and a series of personality trait assessments.


RESULTS
Psychotic individuals at risk for suicide are most readily identified by the presence of depressive disorders NOS, moderate to severe psychotic symptoms and a family history of suicidal behaviour. They also exhibited fewer negative symptoms, had more comorbid diagnoses and, contrary to findings in other populations, we found that cluster A and C personality trait symptoms seem to have protective effects against suicide in schizophrenics and other chronic psychotic suicides.


CONCLUSIONS
Our study suggests that behavioural mediators of suicide risk, such as impulsive-aggressive behaviours, do not play a role in schizophrenic and chronic psychotic suicide. This is contrary to findings in other diagnostic groups, thus implying heterogeneity in predisposing mechanisms involved in suicide.
McGirr
A
A
McGill Group for Suicide Studies, Douglas Hospital Research Centre, 6875 LaSalle blvd, Montreal QC, Canada H4H 1R3.
Tousignant
M
M
Routhier
D
D
Pouliot
L
L
Chawky
N
N
Margolese
H C
HC
Turecki
G
G
D000328:Adult; D000374:Aggression; D014150:Antipsychotic Agents; D001344:Autopsy; D016022:Case-Control Studies; D002908:Chronic Disease; D005260:Female; D006801:Humans; D007175:Impulsive Behavior; D008297:Male; D011618:Psychotic Disorders / Q000188:drug therapy / Q000453:epidemiology* / Q000523:psychology; D012307:Risk Factors; D012559:Schizophrenia / Q000188:drug therapy / Q000453:epidemiology*; D012565:Schizophrenic Psychology; D013405:Suicide / Q000706:statistics & numerical data*
D014150:Antipsychotic Agents