Risk factors for completed suicide in schizophrenia

Chian Jue Kuo, Shang Ying Tsai, Chun Hsuan Lo, Ying Ping Wang, Chiao Chicy Chen

Research output: Contribution to journalArticle

61 Citations (Scopus)

Abstract

Objective: Schizophrenic patients in Taiwan have lower comorbidity of substance use disorders than do those in Western countries, and most of them live with their families. This study investigated the risk factors for completed suicide in this population with inherently lower rates of the confounding variables of substance abuse and social isolation. Method: 4237 acute inpatients with DSM-III, DSM-III-R, or DSM-IV schizophrenia admitted from January 1, 1985, to December 31, 2000, were followed through 2001 by record linkage to the Death Certification System. Seventy-eight subjects who died from suicide during this period were matched with living controls randomly for age (± 5 years), sex, and the same year of index admission. Demographic and clinical variables were collected from medical records and formally confirmed at every admission and outpatient follow-up. Results: Among 78 case-control pairs, the lifetime prevalence of substance use disorders was 7.1%, and 93.6% of the subjects lived with their families. Approximately half of the completed suicides occurred within 4 years after the first admission. Conditional logistic regression analysis revealed a strong association with the following 3 variables: depressive syndrome in residual phase (adjusted odds ratio [OR] = 23.07, p <.005), higher suicide intensity (adjusted OR = 2.78, p <.05), and later age at onset (increase per year, adjusted OR = 1.07, p <.05). Fasting cholesterol level and clozapine use had no association with completed suicide. Conclusions: The peak period for completed suicide was early years after the first admission. The target population for additional measures to prevent suicide should include patients with depressive syndrome in residual phase, higher suicide intensity, and later onset of illness.

Original languageEnglish
Pages (from-to)579-585
Number of pages7
JournalJournal of Clinical Psychiatry
Volume66
Issue number5
Publication statusPublished - May 2005

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Suicide
Schizophrenia
Diagnostic and Statistical Manual of Mental Disorders
Substance-Related Disorders
Odds Ratio
Depressive Disorder
Social Isolation
Confounding Factors (Epidemiology)
Clozapine
Health Services Needs and Demand
Certification
Taiwan
Age of Onset
Medical Records
Comorbidity
Inpatients
Fasting
Outpatients
Logistic Models
Cholesterol

ASJC Scopus subject areas

  • Psychiatry and Mental health
  • Clinical Psychology

Cite this

Kuo, C. J., Tsai, S. Y., Lo, C. H., Wang, Y. P., & Chen, C. C. (2005). Risk factors for completed suicide in schizophrenia. Journal of Clinical Psychiatry, 66(5), 579-585.

Risk factors for completed suicide in schizophrenia. / Kuo, Chian Jue; Tsai, Shang Ying; Lo, Chun Hsuan; Wang, Ying Ping; Chen, Chiao Chicy.

In: Journal of Clinical Psychiatry, Vol. 66, No. 5, 05.2005, p. 579-585.

Research output: Contribution to journalArticle

Kuo, CJ, Tsai, SY, Lo, CH, Wang, YP & Chen, CC 2005, 'Risk factors for completed suicide in schizophrenia', Journal of Clinical Psychiatry, vol. 66, no. 5, pp. 579-585.
Kuo CJ, Tsai SY, Lo CH, Wang YP, Chen CC. Risk factors for completed suicide in schizophrenia. Journal of Clinical Psychiatry. 2005 May;66(5):579-585.
Kuo, Chian Jue ; Tsai, Shang Ying ; Lo, Chun Hsuan ; Wang, Ying Ping ; Chen, Chiao Chicy. / Risk factors for completed suicide in schizophrenia. In: Journal of Clinical Psychiatry. 2005 ; Vol. 66, No. 5. pp. 579-585.
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