Am J Psychiatry 1996; 153:1185-1188
Copyright © 1996 by American Psychiatric Association
Suicidal behavior in schizophrenia and its relationship to awareness of illness
XF Amador, JH Friedman, C Kasapis, SA Yale, M Flaum and JM Gorman
Department of Psychiatry, College of Physicians and Surgeons of Columbia University, New York, NY 10032, USA.
OBJECTIVE: Suicidal behavior is prevalent in individuals with
schizophrenia. Although a relationship between greater awareness of illness
and suicidal behavior has been posited, the question has not been
systematically studied. The purpose of this study was to examine the
relationship between suicidal behavior and various aspects of insight in
218 patients with schizophrenia. METHOD: Patients who were participating in
the DSM-IV field trial for schizophrenia were assessed with the Scale to
Assess Unawareness of Mental Disorder and an instrument that was developed
for the field trial study that measured multiple aspects of
psychopathology, including suicidal behavior. RESULTS: The prevalence of
suicidal thoughts and behavior found in this study was consistent with
previous published reports. Schizophrenia patients with recurrent suicidal
thoughts and behavior were generally more aware of their negative symptoms
and delusions than were nonsuicidal patients. Contrary to expectations,
general awareness of having a mental disorder did not predict suicidal
behavior. CONCLUSIONS: The notion that insight may be associated with
greater suicidality was partially supported.
