Prevalence of Depression and Suicidality in Schizophrenia - A Cross Sectional Study

Chris Abraham; C Jayakrishnaveni

Chris Abraham Institute of Mental Health, Madras Medical College, Chennai, Tamil Nadu, India
C Jayakrishnaveni Institute of Mental Health, Madras Medical College, Chennai, Tamil Nadu, India

Keywords: Calgary Depression Scale for Schizophrenia score, Depression,, Schizophrenia,, Suicidal ideation

Abstract

Background: Schizophrenia is a major mental illness with outcomes ranging from complete recovery to severe disability. Suicide is the most devastating outcome of schizophrenic illness. Around 25% of patients with schizophrenia suffer from comorbid depression. Hence, this study was conducted to find out the prevalence of suicidal ideation and its associated factors among schizophrenia patients and to determine the association between depression and suicidal ideation.
Aim: The aim of the study was to study the prevalence of depression and suicidality in schizophrenia.
Methodology: This was a cross-sectional study of 100 patients with schizophrenia carried out at the Institute of Mental Health, Chennai. Study tools used were semi-structured pro forma which included the social-demographic questionnaire, Calgary Depression Scale for Schizophrenia, and Positive and Negative syndrome scale (PANSS).
Results: About 11 and 23 participants were found to be having suicidal ideation and depression, respectively. Marital status, educational status, insight, and past suicide attempts were significantly associated with the presence of suicidal ideation with P = 0.015, 0.001, 0.019, and 0.001, respectively. PANSS score (P = 0.001) and prevalence of depression (P = 0.001) were significantly higher among patients with suicidal ideation.
Conclusion: Individuals suffering from schizophrenia are at high risk for making suicidal attempts, when accompanied by depressive symptoms and psychiatrists must intervene aggressively and early. More attention should be reserved for the high-risk group which includes those with a history of suicidal attempts and those having an insight into their illness.

Author Biographies

Chris Abraham, Institute of Mental Health, Madras Medical College, Chennai, Tamil Nadu, India

Junior Resident, Department of Psychiatry,

C Jayakrishnaveni, Institute of Mental Health, Madras Medical College, Chennai, Tamil Nadu, India

Associate Professor, Department of Psychiatry,

References

1. Harris EC, Barraclough B. Suicide as an outcome for mental disorders.
A meta-analysis. Br J Psychiatry 1997;170:205-28.
2. Palmer BA, Pankratz VS, Bostwick JM. The lifetime risk of suicide in
schizophrenia: A reexamination. Arch Gen Psychiatry 2005;62:247-53.
3. Nielsen RE, Uggerby AS, Jensen SO, McGrath JJ. Increasing mortality gap
for patients diagnosed with schizophrenia over the last three decades--a
Danish nationwide study from 1980 to 2010. Schizophr Res 2013;146:22-7.
4. Siris SG. Suicide and schizophrenia. J Psychopharmacol 2001;15:127-35.
5. Hawton K, Sutton L, Haw C, Sinclair J, Deeks JJ. Schizophrenia and
suicide: Systematic review of risk factors. Br J Psychiatry 2005;187:9-20.
6. Siris SG. Depression in schizophrenia: Perspective in the era of “Atypical”
antipsychotic agents. Am J Psychiatry 2000;157:1379-89.
7. Tsuang MT, Woolson RF, Fleming JA. Premature deaths in schizophrenia
and affective disorders. An analysis of survival curves and variables
affecting the shortened survival. Arch Gen Psychiatry 1980;37:979-83.
8. Appleby L, Dennehy JA, Thomas CS, Faragher EB, Lewis G. Aftercare and
clinical characteristics of people with mental illness who commit suicide:
A case-control study. Lancet 1999;353:1397-400.
9. Radomsky ED, Haas GL, Mann JJ, Sweeney JA. Suicidal behavior in
patients with schizophrenia and other psychotic disorders. Am J Psychiatry
1999;156:1590-5.
10. Kaplan KJ, Harrow M. Psychosis and functioning as risk factors for later
suicidal activity among schizophrenia and schizoaffective patients: A diseasebased
interactive model. Suicide Life Threat Behav 1999;29:10-24.
11. Minkoff K, Bergman E, Beck AT, Beck R. Hopelessness, depression, and
attempted suicide. Am J Psychiatry 1973;130:455-9.
12. Dhavale HS, Nayak S. Study of suicide attempts in schizophrenics. Arch
Indian Psychiatry 2005;7:23-33.
13. Kuo CJ, Tsai SY, Lo CH, Wang YP, Chen CC. Risk factors for completed
suicide in schizophrenia. J Clin Psychiatry 2005;66:579-85.
14. Harkavy-Friedman JM. Suicide attempts in schizophrenia: The role
of command auditory hallucinations for suicide. J Clin Psychiatry
1994;55:252-4.
15. Amador XF, Strauss DH, Yale SA, Flaum MM, Endicott J, Gorman JM.
Assessment of insight in psychosis. Am J Psychiatry 1993;150:873-9.