Current Research on Suicide and Parasuicide: Selected Proceedings of the Second European Symposium on Suicidal Behaviour, Edinburgh, June 1988

By Stephen David Platt; Norman Kreitman | Go to book overview

Schizophrenia and suicide in psychiatric
in-patients

M. WOLFERSDORF, P. BARTH, B. STEINER, F. KELLER, R. VOGEL, G. HOLE and R. SCHTITTLER


Introduction

In reports on suicide in the general population, schizophrenia is rarely mentioned; Robinset al. ( 1959) give a figure of 2 per cent, Dorpat and Riply ( 1960) of 11 per cent, Barraclough et al. ( 1974) of 3 per cent and Beskow ( 1979) of 6 per cent (males only) of suicides with the diagnosis of schizophrenia. In reports on attempted suicides it is even rarer: e.g. Feudell ( 1965) 4 per cent, Wedler 1984) 1.4 per cent, and Metzger and Schneider ( 1984) 2 per cent.

Suicide mortality among schizophrenics reaches 10 per cent in long-term follow-ups ( Miles, 1977), and, according to Roy ( 1986), most of the schizophrenics (72 per cent) who commit suicide do so when not in in-patient psychiatric care.

According to our own studies, we find among schizophrenics in psychiatric hospitals approximately 12 per cent acutely and chronically suicidal patients (affective psychosis, ICD-9-296: 26 per cent). Hospital suicides are mainly schizophrenics: Wolfers dorf and Vogel ( 1987) found in a survey of nineteen hospital suicide studies 42 per cent with the diagnosis schizophrenia and 28 per cent with the diagnosis primary depression (endogenous and psychoreactive forms).

Thus it seems that outside the psychiatric hospital the group of schizophrenic patients is of little importance as far as suicide mortality is concerned ( Kreitman, 1986), yet within the psychiatric hospital it is this group which accounts for most suicides.

It is, therefore, all the more striking that there have been few controlled studies of this group of patients which go beyond descriptions of warning signals. For instance, there are reports concerning the imminent suicide risk among patients with

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