Are there subtypes of suicidal schizophrenia? A prospective study.
BACKGROUND
Tragically, suicide is not uncommon in schizophrenia. The principal objective of this study was to examine possible subtypes of suicidal schizophrenic patients and identify their clinical and psychopathological profiles at long-term follow-up.


METHODS
The study involved 62 patients diagnosed with schizophrenia according to ICD-10 criteria, who were consecutively admitted following a suicide attempt. Of these subjects, 47 (75.8%) could be re-evaluated after 1 year. Sociodemographic, general clinical, and psychopathological variables were evaluated.


RESULTS
Two predominant subgroups were identified according to suicidal motivation: psychotic motivation and depressive motivation. At re-evaluation after 1 year, the depressive motivation subgroup showed higher depression and hopelessness scores. This subgroup also had greater educational level, age, and duration of illness, and more frequent existence of previous suicide attempts compared to the psychotic motivation subgroup. Of note in the psychotic motivation subgroup was the presence of hopelessness. The variables of educational level, duration of illness, and previous suicide attempts were the ones that best distinguished these subgroups.


CONCLUSIONS
These findings reinforce the notion that meaningful subgroups occur among suicidal schizophrenic patients. The different psychopathological profiles of the two prominent subgroups suggest the need for a different management approach in each case. The identification of these profiles in both subtypes at long-term follow-up may facilitate their detection by clinicians and, therefore, foster the adoption of appropriate preventive measures against subsequent suicidal behavior.
Acosta
Francisco J
FJ
Department of Psychiatry, University Insular Hospital of Gran Canaria, Gran Canaria, Spain. fjacostaartiles@hotmail.com
Aguilar
Eduardo J
EJ
Cejas
María R
MR
Gracia
Ramón
R
Caballero-Hidalgo
Araceli
A
Siris
Samuel G
SG
D000328:Adult; D003710:Demography; D003863:Depression / Q000209:etiology; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D009042:Motivation; D015999:Multivariate Analysis; D011446:Prospective Studies; D011569:Psychiatric Status Rating Scales; D012189:Retrospective Studies; D012559:Schizophrenia / Q000150:complications*; D012565:Schizophrenic Psychology; D013405:Suicide / Q000145:classification* / Q000523:psychology*