Suicide and schizophrenia: a systematic review of rates and risk factors
Kahyee Hor,Matthew Taylor +1 more
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TLDR
A systematic review of all original studies concerning suicide in schizophrenia published since 2004 found that number of prior suicide attempts, depressive symptoms, active hallucinations and delusions, and the presence of insight all had a strong evidential basis.Abstract:
Risk assessment is a core skill in psychiatry. Risk prediction for suicide in schizophrenia is known to be complex. We undertook a systematic review of all original studies concerning suicide in schizophrenia published since 2004. We found 51 data-containing studies (from 1281 studies screened) that met our inclusion criteria, and ranked these by standardized quality criteria. Estimates of rates of suicide and risk factors associated with later suicide were identified, and the risk factors were grouped according to type and strength of association with suicide. Consensus on the lifetime risk of suicide was a rate of approximately 5%. Risk factors with a strong association with later suicide included being young, male, and with a high level of education. Illness-related risk factors were important predictors, with number of prior suicide attempts, depressive symptoms, active hallucinations and delusions, and the presence of insight all having a strong evidential basis. A family history of suicide, and comorbid substance misuse were also positively associated with later suicide. The only consistent protective factor for suicide was delivery of and adherence to effective treatment. Prevention of suicide in schizophrenia will rely on identifying those individuals at risk, and treating comorbid depression and substance misuse, as well as providing best available treatment for psychotic symptoms.read more
Citations
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Suicide and suicidal behaviour
Gustavo Turecki,David A. Brent +1 more
TL;DR: Improved recognition and understanding of clinical, psychological, sociological, and biological factors might help the detection of high-risk individuals and assist in treatment selection.
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Years of potential life lost and life expectancy in schizophrenia: a systematic review and meta-analysis.
Carsten Hjorthøj,Carsten Hjorthøj,Anne Emilie Stürup,John J. McGrath,John J. McGrath,John J. McGrath,Merete Nordentoft,Merete Nordentoft +7 more
TL;DR: The effects of schizophrenia on years potential life lost and life expectancy seem to be substantial and not to have lessened over time, and development and implementation of interventions and initiatives to reduce this mortality gap are urgently needed.
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Royal Australian and New Zealand College of Psychiatrists clinical practice guidelines for the management of schizophrenia and related disorders
Cherrie Galletly,David J. Castle,Frances Dark,Verity Humberstone,Assen Jablensky,Eoin Killackey,Jayashri Kulkarni,Patrick D. McGorry,Olav Nielssen,Nga Tran +9 more
TL;DR: This guideline takes a holistic approach, addressing all aspects of the care of people with schizophrenia and related disorders, not only correct diagnosis and symptom relief but also optimal recovery of social function, and uses a clinical staging model as a framework for recommendations regarding assessment, treatment and ongoing care.
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Pharmacological treatment of schizophrenia: a critical review of the pharmacology and clinical effects of current and future therapeutic agents
TL;DR: An update and critical review of the pharmacology and clinical profiles of current antipsychotic drugs and drugs acting on novel targets with potential to be therapeutic agents in the future is provided.
References
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Schizophrenia and suicide: systematic review of risk factors
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Cross-national analysis of the associations among mental disorders and suicidal behavior: findings from the WHO World Mental Health Surveys
Matthew K. Nock,Irving Hwang,Nancy A. Sampson,Ronald C. Kessler,Matthias C. Angermeyer,Annette L. Beautrais,Guilherme Borges,Evelyn J. Bromet,Ronny Bruffaerts,Giovanni de Girolamo,Ron de Graaf,Silvia Florescu,Oye Gureje,Josep Maria Haro,Chiyi Hu,Yueqin Huang,Elie G. Karam,Norito Kawakami,Viviane Kovess,Daphna Levinson,Jose Posada-Villa,Rajesh Sagar,Toma Tomov,Maria Carmen Viana,David R. Williams +24 more
TL;DR: Using data from over 100,000 individuals in 21 countries participating in the WHO World Mental Health Surveys, Matthew Nock and colleagues investigate which mental health disorders increase the odds of experiencing suicidal thoughts and actual suicide attempts.
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Conditions predisposing to suicide: a review
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