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A biopsychosocial evaluation of the risk for suicide in schizophrenia

Published online by Cambridge University Press:  24 May 2017

Nuwan C. Hettige ,
Ali Bani-Fatemi ,
Isaac Sakinofsky  and
Vincenzo De Luca
Nuwan C. Hettige
Affiliation:
Group for Suicide Studies, Centre for Addiction and Mental Health, Toronto, Ontario, Canada Institute of Medical Science, University of Toronto, Toronto, Ontario, Canada
Ali Bani-Fatemi
Affiliation:
Group for Suicide Studies, Centre for Addiction and Mental Health, Toronto, Ontario, Canada Institute of Medical Science, University of Toronto, Toronto, Ontario, Canada
Isaac Sakinofsky
Affiliation:
Department of Psychiatry, University of Toronto, Toronto, Ontario, Canada Psychiatry and Public Health Sciences, University of Toronto, Toronto, Ontario, Canada Head, High Risk Consultation Clinic, Centre for Addiction and Mental Health, Toronto, Ontario, Canada
Vincenzo De Luca*
Affiliation:
Group for Suicide Studies, Centre for Addiction and Mental Health, Toronto, Ontario, Canada Department of Psychiatry, University of Toronto, Toronto, Ontario, Canada
*
*Address correspondence to: Vincenzo De Luca, Centre for Addiction and Mental Health, Department of Psychiatry, University of Toronto, 250 College Street, Toronto, Ontario, Canada M5T 1R8. (E-mail:vincenzo_deluca@camh.net)
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Abstract

The risk of suicide is greatly increased in individuals with schizophrenia. Previous research has identified several potential risk factors for suicidal behavior in schizophrenia, although their ability to independently predict suicide is limited. The objective of this review was to systematically analyze and identify the interaction between the proposed risk factors in the literature that may predict suicidal behavior in schizophrenia. Articles that explored suicidal behavior and suicide risk in schizophrenia that were published between 1980 and August of 2015, indexed in PubMed, MEDLINE, and Scopus were systematically reviewed. Many studies proposed a range of biopsychosocial risk factors that may independently lead to suicide in schizophrenia. These risk factors appear to be mainly related to stress, a history of suicidal behavior, and psychotic symptoms. It is clear, however, that many of these factors do not act independently and in fact require the reciprocal interaction of several of them to pose a risk for suicide in schizophrenia. Independently, the power of many risk factors to predict suicide is limited. Future studies should continue to adopt a multidimensional approach by considering the interaction of several factors in assessing the risk for suicide in schizophrenia.

Keywords

Schizophreniasuicidestressgeneticschildhood trauma
Type
Review Article
Information
CNS Spectrums , Volume 23 , Issue 4 , August 2018 , pp. 253 - 263
Copyright
© Cambridge University Press 2017 

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