Suicide attempts and associated factors in older adults with schizophrenia

Abstract

Background Although there have been numerous studies of suicidality in younger populations with schizophrenia, there have been no studies focused on community-dwelling older adults with schizophrenia. This study provides data on the prevalence of suicidality and factors associated with previous suicide attempts among a mixed racial sample of older persons with schizophrenia living in New York City. Methods The schizophrenia group consisted of 198 persons aged ≥55 years who developed schizophrenia before age 45. A community comparison group (n=113) was recruited using randomly selected block-groups. Fifteen predictor variables of lifetime suicide attempts based on a risk model of suicide in schizophrenia were identified. Results Persons in the schizophrenia group had a significantly higher prevalence of current and lifetime “suicidality” (i.e., wants to be dead, suicidal thoughts, or suicide attempts) when compared to the community group (current: 10% versus 2%; lifetime: 56% versus 7%) as well as past suicidal attempts (30% versus 4%). Within the schizophrenia group, in logistic regression analysis, 2 variables were significantly associated with lifetime suicidal attempts: current syndromal depression and higher scores on the Traumatic and Victimization Scale. Conclusions The data confirmed that in later life, persons with schizophrenia continue to have a higher prevalence of suicidality than their age peers in the community. Our findings underscore the importance of monitoring for suicidality in this age group. The relative paucity of risk factors means that practitioners can more easily focus their therapeutic efforts on at-risk individuals.

Childhood trauma associates with clinical features of schizophrenia in a sample of Chinese inpatients

“…We found that EA and PA were associated with suicidal behavior, which was consistent with a study conducted in Western countries (Cohen et al, 2010). In contrast, PA, EN, PN and total abuse were significantly related to aggressive behavior in this sample, which is consistent with findings reported by another study conducted in Chinese schizophrenic samples (Chen et al, 2012).…”

“…A rapidly growing body of literature is examining the impact of childhood trauma on various clinical features and symptoms particularly post-traumatic stress disorder (PTSD) symptoms in individuals with schizophrenia and other serious mental illnesses (Calhoun et al, 2007;Gearon et al, 2003;Lysaker et al, 2001;Rosenberg et al, 2007). However, very few studies have focused on the effect of childhood trauma on suicidal and aggressive behaviors in patients with schizophrenia (Cohen et al, 2010). The dose-effect of childhood trauma on clinical features also remains understudied.…”

Adolescent suicide in New York City: plenty of room for new research

“…Cohen et al (20) found a 4 % increase in current suicidality and a 26 % -49 % increase in lifetime suicidality among older schizophrenic patients (aged 55 years and older) in NYC when compared with a community control group. While a NYC based study was not found for younger persons with schizophrenia, meta-analyses suggest that suicide rates in adolescents and young adults with schizophrenia have been found to be up to three times higher than rates in older populations (24) .…”

“…Owing to the recent increase in PTSD symptomology in Manhattan following the September 11th terrorist attacks and the wars in Iraq and Afghanistan, it is important for clinicians and general health professionals to be aware of the associations between PTSD and suicidality (14,20,22) .…”

Recovering From the Suicide of a Client With Schizophrenia: Recommendations for Case Managers

“…Sadly,theriskofsuicideforpersonsexperiencingschizophrenia ishigherthanforotherdiagnosticgroups.Thedistressassociated withthedisorderresultsin40%-50%ofthosepersonsexperiencing suicidalideationduringtheirlifetimes,with20%-50%attempt-ingtheactand5%-10%succeeding (Banwari,Vankar,&Parikh, 2013;Kasckow,Felmet,&Zisook,2011).Ratesareloweramong personswhousethenewerantipsychoticdrugs,possiblybecause oftheirreducedriskofadverseeffects(Reutforsetal.,2013).The risk of suicide attempts is greatest during the first 10 years after the onset of the disorder, with 50% occurring during the first 2 years. Even into middle age (after 45 years old), however, 24% ofpersonwithschizophreniaexperiencesuicidalideationand5% make attempts (Cohen, Abdallah, & Diwan, 2010).Those with accompanyingmooddisordersareatthreetimestheriskofothers (Reutforsetal.,2010).…”