The Prevalence of Suicide Attempts and Independent Demographic and Clinical Correlates among Chronic Schizophrenia Patients in Agricultural Areas of China

The coronavirus disease 2019 (COVID-19) pandemic has a disproportionate impact on vulnerable subpopulations, including those with severe mental illness (SMI). This study examined the one-year prevalence of suicidal ideation (SI), suicide plans (SP), and suicide attempts (SA) in bipolar disorder (BD) and schizophrenia (SCZ) patients during the pandemic. Prevalence rates were compared between the two disorders and associated factors were examined. A survey was conducted in six tertiary psychiatric hospitals and psychiatric units. People with a diagnosis of BD or SCZ were invited to participate. SI, SP, and SA (suicidality for short) were assessed and associated factors were examined using binary logistical regression. The 1-year prevalence of SI, SP and SA in BD patients were 58.3%, (95% CI: 54.1–62.6%), 38.4% (95% CI: 34.3–42.6%) and 38.6% (95% CI: 34.5–42.8%), respectively, which were higher than the corresponding figures in SCZ patients (SI: 33.2%, 95% CI: 28.6–37.8%; SP: 16.8%, 95% CI: 13.2–20.5%; SA: 19.4%, 95% CI: 15.5–23.3%). Patients with younger age, experience of cyberbullying, a history of SA among family or friends, a higher fatigue and physical pain score, inpatient status, and severe depressive symptoms were more likely to have suicidality. The COVID-19 pandemic was associated with increased risk of suicidality, particularly in BD patients. It is of importance to regularly screen suicidality in BD and SCZ patients during the pandemic even if they are clinically stable.

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“…(3) SA: "Over the past year, have you made an attempt for suicide?" These questions on suicidality have been widely used in other studies [39,40]…”

Section: Measurementsmentioning

confidence: 99%

Suicidality in clinically stable bipolar disorder and schizophrenia patients during the COVID-19 pandemic

Bai

Cai

et al. 2022

Transl Psychiatry

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“…There were 4,559 articles identified. After reviewing titles, abstracts and full text, 40 studies ( 32 – 71 ) were finally selected for analyses. A PRISMA flowchart demonstrating the detailed selection process is shown in Figure 1 .…”

Section: Resultsmentioning

confidence: 99%

“…Our study complements this finding by revealing that self-directed violence prevalence among patients diagnosed with schizophrenia in China varies largely across provinces. What’s more, economic disparity may contribute to the large variation, and previous studies report that patients diagnosed with schizophrenia in relatively underdeveloped economic areas have a higher risk for self-directed violence, while those in wealthier areas have a lower risk ( 71 , 86 ). However, our study shows no difference in prevalence of suicide ideation and lifetime self-harm between patients residing within and outside economic circles, which may be due to the small sample size.…”

Section: Discussionmentioning

confidence: 99%

Prevalence of suicide ideation, self-harm, and suicide among Chinese patients with schizophrenia: a systematic review and meta-analysis

Liang

Zou

et al. 2023

Front. Public Health

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AimsSuicide ideation, self-harm, and suicide are common in patients with schizophrenia, but the reported prevalence vary largely across studies. Improved prevalence estimates and identification of moderators of the above self-directed violence are needed to enhance recognition and care, and to guide future management and research. This systematic review aims to estimate the pooled prevalence and identify moderators of suicide ideation, self-harm, and suicide among patients diagnosed with schizophrenia in China.MethodsRelevant articles published until September 23, 2021, were searched using PubMed, EBSCO, Web of Science, Embase, Science Direct, CNKI, CBM, VIP, and Wanfang databases. Eligible studies published in English or Chinese which reported the prevalence of suicide ideation, self-harm, or suicide among Chinese patients with schizophrenia were collected. All studies passed a quality evaluation. This systematic review was registered with PROSPERO (registration number CRD42020222338). PRISMA guidelines were used in extracting and reporting data. Random-effects meta-analyses were generated using the meta package in R.ResultsA total of 40 studies were identified, 20 of which were evaluated as high-quality studies. Based on these studies, the prevalence of lifetime suicide ideation was 19.22% (95% CI: 7.57–34.50%), prevalence of suicide ideation at the time of investigation was 18.06% (95% CI: 6.49–33.67%), prevalence of lifetime self-harm was 15.77% (95% CI: 12.51–19.33%), and prevalence of suicide was 1.49% (95% CI: 0.00–7.95%). Multivariate meta-regression analysis revealed that age (β = − 0.1517, p = 0.0006) and dependency ratio (β = 0.0113, p < 0.0001) were associated with the lifetime prevalence of self-harm. Study assessment score (β = 0.2668, p < 0.0001) and dependency ratio (β = 0.0050, p = 0.0145) were associated with the lifetime prevalence of suicide ideation. Results of the spatial analysis showed that the prevalence of self-directed violence varied greatly across different provinces.ConclusionThis systematic review provides estimates of the prevalence of self-directed violence among Chinese patients with schizophrenia and explores its moderators and spatial patterns. Findings also have important implications for allocating prevention and intervention resources to targeted high-risk populations in high prevalence areas.

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“…Furthermore, animal model of Zhong et al 12 demonstrated that the activity and functioning of critical neural areas in the prefrontal cortex is more severely affected in schizophrenia with depression mouse models than in mouse models of schizophrenia or depression alone. More importantly, it was found that combined treatment using antipsychotics and antidepressants cannot fully undo either the behavioral or the neural activity damages.…”

Section: Screening For Depression Among Schizophrenia Patients Discussionmentioning

confidence: 99%

Screening for Depression among Schizophrenia Patients: A Cross-sectional Study

Al-Ruwais¹,

AlHarbi²,

Abalkhail³

et al. 2021

Eastern Journal of Psychiatry

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The Prevalence of Suicide Attempts and Independent Demographic and Clinical Correlates among Chronic Schizophrenia Patients in Agricultural Areas of China

Cited by 7 publications

References 51 publications

Suicidality in clinically stable bipolar disorder and schizophrenia patients during the COVID-19 pandemic

Suicidality in clinically stable bipolar disorder and schizophrenia patients during the COVID-19 pandemic

Prevalence of suicide ideation, self-harm, and suicide among Chinese patients with schizophrenia: a systematic review and meta-analysis

Screening for Depression among Schizophrenia Patients: A Cross-sectional Study

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