Suicidal Behavior in Schizophrenics

  • Alec Roy


Bleuler (1) described the suicidal drive as “the most serious of schizophrenic symptoms”. Also, recent studies suggest that depression is common during the course of schizophrenic illness (2–5). This chapter will examine whether or not there is a relationship between depression and suicide in schizophrenia. Other possible determinants of suicidal behaviour in schizophrenic patients will also be discussed.


Suicide Attempt Suicidal Behaviour Schizophrenic Patient Suicide Rate Chronic Schizophrenia 
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  1. 1.
    Bleuler E: Demential Praecox or the Group of Schizophrenias. New York, International Universities Press, 1950, page 488.Google Scholar
  2. 2.
    Roy A: Depression in chronic paranoid schizophrenia. Br J Psychiatry 137: 138–139, 1980.PubMedCrossRefGoogle Scholar
  3. 3.
    Roy A: Depression in the course of chronic undifferentiated schizophrenia. Arch Gen Psychiatry 38: 296–300, 1981.CrossRefGoogle Scholar
  4. 4.
    Roy A: Depression in chronic schizophrenia. in Psychiatry: The State of the Art. Vol. 1 Edited by Pichot P, Berner P, Wolfe R, et al, Plenum, 1983.Google Scholar
  5. 5.
    Roy A, Thompson R, Kennedy S: Depression in chronic schizophrenia. Br J Psychiatry 142: 465–470, 1983.PubMedCrossRefGoogle Scholar
  6. 6.
    Miles P: Conditions predisposing to suicide: a review. J Nery Ment Dis 164: 231–246, 1977.CrossRefGoogle Scholar
  7. 7.
    Pokorny A: Suicide rates in various psychiatric disorders. J Nery Ment Dis 139: 499–506, 1964.CrossRefGoogle Scholar
  8. 8.
    Evenson R, Wood J, Nuttall E, et al: Suicide rates among public mental health patients. Acta Psychiatr Scand 66: 254–264, 1982.CrossRefGoogle Scholar
  9. 9.
    Roy A: Risk factors for suicide in psychiatric patients. Arch Gen Psychiatry 39: 1089–1095, 1982.CrossRefGoogle Scholar
  10. 10.
    Roy A: Suicide and psychiatric patients. Psychiatr Clin North Am 8: 227–241, 1985.Google Scholar
  11. 11.
    Roy A: Suicide in schizophrenia. in Suicide Edited by Roy A, Baltimore, Williams and Wilkins, 1986.Google Scholar
  12. 12.
    Beisser A, Blanchette J: A study of suicides in a mental hospital. J Dis Nery Syst 22: 365–369, 1961.Google Scholar
  13. 13.
    Roy A: Suicide in chronic schizophrenia. Br J Psychiatry 141: 171–177, 1982.CrossRefGoogle Scholar
  14. 14.
    Drake R, Gates C, Cotton P, et al: Suicide among schizophrenics: who is at risk? J Nery Ment Dis 172: 613–617, 1984.CrossRefGoogle Scholar
  15. 15.
    Shaffer J, Perlin S, Schmidt C, et al: The reduction of suicide in schizophrenia. J Nery Ment Dis 159: 349–355, 1974.CrossRefGoogle Scholar
  16. 16.
    Roy A, Mazonson A, Pickar D: Attempted suicide in chronic schizophrenia. Br J Psychiatry 144: 303–306, 1984.PubMedCrossRefGoogle Scholar
  17. 17.
    Pokorny A: Prediction of suicide in psychiatric patients. Arch Gen Psychiatry 40: 249–257, 1983.CrossRefGoogle Scholar
  18. 18.
    Drake R, Cotton P: Depression, hopelessness, and suicide in chronic schizophrenia. Br J Psychiatry 148: 554–559, 1986.Google Scholar
  19. 19.
    Allebeck P, Varla E, Kristjansson E, Wistedt B: Risk factors for suicide among patients with schizophrenia. Acta Psychiatr Scand 76: 414–419, 1987.PubMedCrossRefGoogle Scholar
  20. 20.
    McGlashan T: The Chestnut Lodge follow-up study: Part II: Long-term outcome of schizophrenia and the affective disorders. Arch Gen Psychiatry 41: 586–601, 1984.Google Scholar
  21. 21.
    Inamdar S, Lewis D, Siomopolous G, et al: Violent and suicidal behaviour in psychotic adolescents. Am J Psychiatry 139: 932–935, 1982.Google Scholar
  22. 22.
    Wilkinson G, Bacon N: A clinical and epidemiological survey of parasuicide and suicide in Edinburgh schizophrenics. Psychol Med 14: 899–912, 1984.Google Scholar
  23. 23.
    Small G, Rosenbaum J: Nine psychiatric patients who leaped from a height. Can J Psychiatry 29: 139–131, 1984.Google Scholar
  24. 24.
    Asberg M, Traskman L, Thoren P: 5-HIAA in the cerebrospinal fluid. Arch Gen Psychiatry 33: 1193–1197, 1976.PubMedCrossRefGoogle Scholar
  25. 25.
    Roy A, Agren A, Pickar D, et al: Reduced cerebrospinal fluid concentrations of homovanillic acid and homovanillic acid to 5-hydroxyindoleacetic acid ration in depressed patients: relationship to suicidal behaviour and dexamethasone nonsuppression. Am J Psychiatry 143: 1539–1545, 1986.Google Scholar
  26. 26.
    van Praag H: CSF 5-HIAA and suicide in nondepressed schizophrenics. Lancet 2: 977–978, 1983.Google Scholar
  27. 27.
    Ninan P, van Kammen D, Scheinin M, et al: Cerebrospinal fluid 5-HIAA in suicidal schizophrenia patients. Am J Psychiatry 141: 566–569, 1984.Google Scholar
  28. 28.
    Roy A, Ninan P, Mazonson A, et al: CSF monoamine metabolites in chronic schizophrenic patients who attempt suicide. Psychol Med 15: 335–340, 1985.Google Scholar
  29. 29.
    Pickar D, Roy A, Breier A, et al: Suicide and aggression in schizophrenia: neurobiologic correlates, in Psychobiology of Suicidal Behaviour. Edited by Mann J, Stanley M. Annals of the New York Academy of Sciences, 487: 189–196, 1986.Google Scholar
  30. 30.
    Roy A, Schreiber J, Mozonson A, et al: Suicidal behavior in chronic schizophrenic patients: a follow-up study. Can J Psychiatry 31: 737–740, 1986.Google Scholar
  31. 31.
    Roy A, Virkkunen M, Guthrie S, Linnoila M: Indices of serotonin and glucose metabolism in violent offenders, arsonists, and alcoholics, in Psychobiology of Suicidal Behaviour. Edited by Mann J, Stanley M. Annals of New York Academy of Sciences, 487: 202–220, 1986.Google Scholar
  32. 32.
    Levy A, Kurtz N, Kling A: Association between cerebral ventricular enlargement and suicide attempts in chronic schizophrenia. Am J Psychiatry 141: 438–439, 1984.PubMedGoogle Scholar
  33. 33.
    Boronow J, Pickar D, Nina P, et al: Atrophy limited to the third ventricle in chronic schizophrenic patients. Arch Gen Psychiatry 42: 266–271, 1985.Google Scholar
  34. 34.
    Potkin S, Weinberger D, Linnoila M, et al: Low CSF 5hycroxyindoleacetic acid in schizophrenic patients with enlarged cerebral ventricles. Am J Psychiatry 140: 2125, 1983.Google Scholar
  35. 35.
    Lehman H, Ban T: Nature and frequency of the suicide syndrome, twenty years ago and today in the English-speaking community of the Province of Quebec. Laval Med 38: 93–95, 1967.Google Scholar
  36. 36.
    Cheng L: Paper presented at Annual Meeting of Royal College of Physicians and Surgeons, Toronto, Canada.Google Scholar
  37. 37.
    Hogan T, Awad G: Pharmacotherapy and suicide risk in schizophrenia. Can J Psychiatry 28: 277–281, 1983.Google Scholar
  38. 38.
    Breier A, Astrachan B: Characterization of schizophrenic patients who commit suicide. Am J Psychiatry 141: 296–209, 1984.Google Scholar
  39. 39.
    Nyman A, Jonson J: Patterns of self destructive behaviour in schizophrenia. Acta Psychiatr Scand 72: 252–262, 1986.CrossRefGoogle Scholar
  40. 40.
    Cohen S, Leonard C, Farberow N, et al: Tranquilizers and suicide in the schizophrenic patients. Arch Gen Psychiatry 11: 312–321, 1964.CrossRefGoogle Scholar
  41. 41.
    Warnes H: Suicide in schizophrenia. Dis Nery Syst 29, 35–40, 1986.Google Scholar
  42. 42.
    Yarden P: Observations on suicide in chronic schizophrenics. Compr Psychiatry 15: 325–333, 1974.CrossRefGoogle Scholar
  43. 43.
    Levy S, Southcombe R: Suicide in a state hospital for the mentally ill. J Nery Ment Dis 117: 504–514, 1953.CrossRefGoogle Scholar
  44. 44.
    Virkkunen M: Suicide in schizophrenia and paranoid psychosis. Acta Psychiatr Scand (Suppl) 250: 1–305, 1974.Google Scholar
  45. 45.
    Planasky K, Johnson R: The occurrence and characteristics of suicidal preoccupations and acts in schizophrenia. Acta Psychiatr Scand 47: 473–483, 1971.CrossRefGoogle Scholar
  46. 46.
    Prasad A: Attempted suicide in hospitalized schizophrenics. Acta Psychiatr Scand 74: 41–42, 1986.CrossRefGoogle Scholar
  47. 47.
    Prasad A, Kellner P: Suicidal behaviour in schizophrenic day patients. Acta Psychiatr Scand 77: 488–490, 1988.CrossRefGoogle Scholar
  48. 48.
    Allebeck P, Varla A, Wistedt B: Suicide and violent death among patients with schizophrenia. Acta Psychiatr Scand 74: 43049, 1986.CrossRefGoogle Scholar
  49. 49.
    Drake R, Gates C, Whitaker A, Cotton P: Suicide among schizophrenics: a review. Comp Psychiatry 26: 90–100, 1985.CrossRefGoogle Scholar
  50. 50.
    Drake R, Gates C, Cotton P: Suicide among schizophrenics: a comparison of attempters and completed suicides. Br J Psychiatry 149: 784–787, 1986.Google Scholar
  51. 51.
    Cotton P, Drake R, Gates C: Critical treatment issues in suicide among schizophrenics. Commun Psychiatry 36: 534–536, 1985.Google Scholar
  52. 52.
    Prasad A, Kumar R: Suicide Life Threatening Behaviour 1988, in press.Google Scholar

Copyright information

© Springer Science+Business Media New York 1989

Authors and Affiliations

  • Alec Roy
    • 1
  1. 1.National Institute of Mental HealthBethesdaUSA

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