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Am J Psychiatry 1997; 154:1235-1242
Copyright © 1997 by American Psychiatric Association
Suicide and schizophrenia: a nationwide psychological autopsy study on age- and sex-specific clinical characteristics of 92 suicide victims with schizophrenia
H Heila, ET Isometsa, MM Henriksson, ME Heikkinen, MJ Marttunen and JK Lonnqvist
Department of Mental Health and Alcohol Research, National Public Health Institute, Helsinki, Finland. Heila@ktl.fi
OBJECTIVE: The authors examined the clinical characteristics of suicide
victims with schizophrenia in the general population of Finland. METHOD: As
part of the nationwide National Suicide Prevention Project in Finland, all
suicides over a 12-month period of persons with DSM-III- R schizophrenia
were investigated by using the psychological autopsy method. Clinical
characteristics and their variation with age, sex, and illness duration
were examined. RESULTS: Among all suicide victims, 7% (N = 92) were
identified as having suffered schizophrenia. Suicides occurred throughout
the course of schizophrenia. Both active illness (78%) and depressive
symptoms (64%) were highly prevalent immediately before suicide, and a
history of suicide attempts (71%) was also common. Women were more likely
than men to have committed suicide during an acute exacerbation of the
illness. Marked variation in depressive symptoms, alcoholism, and suicide
methods was found among sexes and age groups. Alcoholism was most common
among middle-aged men (45%), whereas middle-aged women had a high rate of
depressive symptoms (88%). Younger male subjects most often used violent
suicide methods. CONCLUSIONS: Suicide may occur at any point during the
course of schizophrenia. The results indicate clinically important
variation in depression, alcoholism, and suicide methods among suicide
victims with schizophrenia. This suggestion of age- and sex-specific risk
factors for suicide in schizophrenia needs further investigation.
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