Suicide attempts of schizophrenia patients: A case-controlled study in tertiary care

Background: Schizophrenia is one of the disorders in which suicide attempts and death by suicide are pronounced. However, there is paucity of data regarding suicide attempts by schizophrenia patients. The aim of the present study was to characterize a large sample of schizophrenia patients in tertiary care who had attempted suicide. Method: Over a 15-year period all computerized records of admissions of adult schizophrenia patients were examined. Patients who had attempted suicide were defined as the index group and the comparison group was comprised of the next admission of a patient suffering from schizophrenia who did not attempt suicide prior to hospitalization. Results: There were 10,006 admissions of patients suffering from schizophrenia during the study period. Of these, 1094 (10.9%) records comprise the index group (patients who had attempted suicide), 380 women and 714 men, mean age for the group 39.6 +/- 12.9 years. The comparison group of patients matched for diagnosis (N = 1094), consisted of 302 women and 792 men, mean age for this group was 42.9 +/- 13.7 years. Four variables significantly differentiated between groups. Patients who had attempted suicide were younger (39.6 vs. 42.9 years; p = 0.00), higher percentage of females (34.7% vs. 27.6%; p = 0.00), with increased rates of co-morbid physical illness (27.5% vs. 20.4%; p = 0.00) notably cardiovascular and diabetes and with a higher rate of alcohol and drug abuse (32.1% vs. 12.4%; P = 0.00). Conclusions: The present study emphasizes several significant factors associated with attempted suicide amongst schizophrenia patients notably physical co-morbidity and abuse of alcohol and drugs. These need be integrated into existing risk assessment schemes thus aiding in decreasing adverse outcomes in this vulnerable group of patients. (C) 2007 Published by Elsevier Ltd.