Suicide among women with schizophrenia spectrum disorders.
This paper presents five cases of suicide in women attending a schizophrenia clinic and demonstrates that, in the presence of psychosis, women can act impulsively and aggressively and can use lethal means to end their lives. If generalizations can be made from the stories of these five women, then multiple prior admissions, comorbid psychiatric and substance abuse diagnoses, lack of negative symptoms, full awareness of illness, and current crisis appear to constitute important risk variables. Female-specific factors associated with suicide in this sample were childhood sexual abuse, intimate partner abuse, and child loss. The author, who knew these five women very well over a long period of time, concludes that the deaths might have been prevented by critical interventions such as timely hospital admission, suicide screening prior to hospital discharge, safety check of the immediate environment, in-depth explanation of therapeutic decisions, and complete assessment of the personal meaning attached to recent events.
Seeman
Mary V
MV
Department of Psychiatry, University of Toronto, ON, Canada. mary.seeman@utoronto.ca
D000328:Adult; D014150:Antipsychotic Agents / Q000506:poisoning; D001364:Awareness; D001601:Bereavement; D002423:Cause of Death; D002650:Child Abuse, Sexual / Q000523:psychology / Q000706:statistics & numerical data; D002675:Child, Preschool; D003024:Clozapine / Q000506:poisoning; D015897:Comorbidity; D005260:Female; D006801:Humans; D007175:Impulsive Behavior / Q000401:mortality / Q000523:psychology; D008016:Life Change Events; D008403:Mass Screening; D008875:Middle Aged; D010351:Patient Discharge; D010359:Patient Readmission / Q000706:statistics & numerical data; D011613:Psychotherapy; D011618:Psychotic Disorders / Q000401:mortality* / Q000523:psychology; D012307:Risk Factors; D012559:Schizophrenia / Q000401:mortality*; D012565:Schizophrenic Psychology; D013179:Spouse Abuse / Q000523:psychology / Q000706:statistics & numerical data; D013405:Suicide / Q000706:statistics & numerical data*; D013406:Suicide, Attempted / Q000523:psychology / Q000706:statistics & numerical data; D000092864:Suicide Prevention
D014150:Antipsychotic Agents; D003024:Clozapine