The Prevalence Of Suicidal Behaviour And Independent Demographic And Clinical Correlates Among Chronic Schizophrenia Patients

Objective: Suicide is a major public health challenge around the world.The Schizophrenia is a severe getting disorder,which remains the primary cause of death among individuals with informed diseases.Numerous studies have programs that people with schizophrenia have a substantially who incidence of suicidal behaviour and the expected reduction in life expectancy is 10 to 20 years.At present,research on the prevalence and clinical symptoms of suicide-related behaviors in schizophrenic patients in China is still in the development stage,and there is insufficient understanding of suicide risk factors,and assessment and management of suicide are still lacking.The purpose of this study was to analyze the incidence and risk factors of suicide-related behaviors in chronic schizophrenia with long-term hospitalization.Methods: A total of 315 inpatients with schizophrenia who met the criteria were involved,and basic demographic variables,including age,gender,marital status,economic status and smoking behavior,and clinical variables including the age of onset,duration of illness,number of hospitalizations,type and dosage of medications were collected;Psychopathology and depressive symptoms were assessed using the Positive and Negative Syndrome Scale(PANSS)and Hamilton Depression Rating Scale(HAMD),respectively;the Chinese version of the Beck Suicide Ideation Scale(BSI-CV)was used to assess suicidal ideation and its severity;according to the conditions of suicide-related behaviors,the related risk factors were compared and analyzed.Results: A total of 190 males(60.3%)and 125 females(39.7%)were included in this study.The average age was(45.1 ± 11.7)years,the age of first onset was(26.0 ± 8.2)years,the average illness duration was(19.0 ± 10.5)years and number of admissions was(5.6 ± 4.8)times.The lifetime prevalence of suicide attempts was 22.2%(95%CI: 17.6–26.8%),patients with suicide attempts were more likely to be women,married and have more severe depressive symptoms(all P < 0.05).The lifetime and current prevalence of suicidal ideation in the whole sample was 36.8%(95%CI: 31.5–42.2%)and 6.4%(95%CI: 3.6–9.1%),respectively.Patients with suicidal ideation were more likely to have higher doses of antipsychotic drugs,higher HAMD scores,higher PANSS depression factor scores,but lower PANSS cognitive factor scores(all P < 0.05).Patients with suicidal ideation in the past week were more likely to have higher doses of antipsychotic drugs,higher HAMD scores,and higher PANSS positive factor,negative factor,depression factor scores(all P < 0.05).Multiple logistic regression analysis revealed that female gender,being married and having more severe depressive symptoms were independently and significantly associated with higher risk of suicide attempts;chlorpromazine equivalent,PANSS cognitive and depression factor scores were independently and significantly associated with higher risk of lifetime suicidal ideation;chlorpromazine equivalent and HAMD scores were independently and significantly associated with higher risk of current suicidal ideation.Conclusion: This study found a surprisingly high lifetime prevalence of suicide attempts and suicidal ideation in Chinese chronic schizophrenia patients,suggesting that it should be given sufficient attention in the clinic.Specially,female gender,being married and having more severe depressive symptoms were independently and significantly associated with higher risk of suicide attempts.For suicide prevention,regular assessments,appropriate interventions and clinical management should be integrated into a community-based psychiatric service model for this population,to strengthen early intervention and treatment of schizophrenia patients,reduce their risk of suicide,and improve their prognosis.