Suicidal thoughts and suicide attempts are among the classic symptoms of schizophrenic disorder. According to statistics, about 40% of people with schizophrenia attempt suicide at least once, and in half of the cases, they are successful.
At the same time, many patients decide to take such a step after hospitalization. These may seem strange as they begin to improve. The reason is that in the favorable period of the disease, the intellect increases, with it the criticality in assessing the situation. Thoughts of hopelessness are born, and the aggravation is bound to return. There comes the effect of the realization of personal disintegration and, along with it, despair. One begins to understand that this illness is with him forever, and he will never be able to be cured to the end.
During this period, it is very important to respond promptly and help the patient cope with the onset of despair. To do this, you need to understand what is happening to it and timely recourse to specialists.
What types of personalities with the schizophrenic disorder are especially prone to suicide?
- Autistic – the person isolates himself from contact with the outside world, gradually develops depression, and forms persistent pessimistic views. Decadent moods are born. He feels that he has lost the meaning of his life. In this clinical picture, the desire for suicide is persistent and almost always realized.1
- Psychotic – in this case, suicide in schizophrenia occurs as a result of psychosis. The patient hears voices that urge him to commit suicide. This illness is accompanied by delusions, hallucinations, and increased anxiety. Often the voices have a religious character and call for sacrificing one’s life to God, and sometimes they order one to go out the open window or take pills, even prompting one where they lie. Against the background of this symptomatology, the strongest emotional tension develops. The person believes that suicide is a way out of suffering and a solution to his problems.2
Symptoms that a person may be suicidal in schizophrenia include:
- Frequent psychosis and psychotic episodes;
- Extensive productive symptomatology;
- pronounced depressive moods;
- Recent inpatient treatment;
- Abuse of drugs and alcohol;
- Overdoses from taking neuroleptics and other medications.
What other signs indicate suicidal tendencies in schizophrenic patients and can lead to a sad outcome? Some of these have been established by several studies. Let’s take a look at them.
A recent study found that adolescents with schizophrenic spectrum disorders are likelier to exhibit suicidal tendencies and suicidal behavior. The risks in older patients are much lower.
Prolonged absence of treatment for psychosis
Experts say that neglected and prolonged psychosis is one of the most common risk factors. When schizophrenia is not properly treated and prevented over the long term, an adverse outcome almost always follows. According to research, patients admitted at a late stage of disease development are more likely than others to attempt suicide, even in an inpatient setting.
Several patterns of gender behavior in patients with schizophrenic disorders have now been identified. According to one of them, men are more susceptible to suicidal moods. It is confirmed by statistical data.
The research showed that only one-fifth of the patients who attempted suicide were in a good living situation. In the remaining cases, different factors contributed to the decision to commit suicide.
Most often, these were problems of a family nature. Severe loneliness, misunderstandings, and conflicts acted as provocative factors. On the contrary, life in a strong and stable family acts as a means of protection for people with schizophrenic tendencies.
In the second place, after family problems are financial difficulties; for example, there is always a significant increase in suicide rates during periods of economic crisis. People with schizophrenic deviations commit a considerable share of them. Loss of job, lack of means for a comfortable life, and necessity of austerity negatively influence the unstable psyche, and the result can be tragic.
In addition, among the stressful situations in life, experts call the loss of loved ones, moving to a new place of residence, etc.
Strange as it may seem, people with higher education show the greatest suicidal tendencies. Despite the decline in critical faculties inherent in schizophrenia, their cognitive functions remain less impaired than those of patients with an initially low level of education.
Research suggests that psychomotor speed, higher attention span, verbal and working memory, and speech fluency are associated with a greater risk of suicide in patients.
The situation unfolds in such a way that preserved self-consciousness makes it impossible not to understand what is happening. In addition, a higher level of thinking facilitates planning skills, and very often, patients with a good IQ invent elaborate plans and methods of withdrawal from life.
Physical and mental health trauma
Very often, a suicidal episode can be related to a shock or trauma experienced. Various factors come into play here. For example, if a person has undergone some surgery, they will be in a state of limitation for a long time. Social drift and physical pain in light of a psychotic disorder can provoke psychosis with suicidal tendencies under certain circumstances.
The situation will be a little different with psychiatric trauma. Any traumatic life situation will almost certainly lead to suicidal thoughts in people with schizophrenic pathology of consciousness.
Causes of suicide in mental health cases
Psychiatrists identify several syndromes directly related to suicidal episodes in a patient’s clinical picture. Among them:
- Depressive syndrome against a background of progressive schizophrenia;
- Endogenous depression – a condition that has no external causes and depends solely on physiological factors;
- Reactive depression – pathology in the background of external negative circumstances;
- Bipolar disorder – is an affective disorder in which different phases alternate with each other. Elevated moods easily turn into severe apathy towards everything around them. Such patients often talk about their unwillingness to go on living, about the pain they inflict on loved ones by their inadequate actions;
- Physiological depressive syndrome in the elderly – is based on atrophic processes that occur in the brain, as well as the onset of cognitive impairment and the accompanying thoughts of their helplessness;
- Endocrine disorders are associated with hormonal malfunctions.
How can you tell if a patient wants to commit suicide?
If a person with schizophrenic disorder is in your environment, you should always pay special attention to his condition. It is important to listen to what and how he says.
The precursors of suicide can include:
- Bad moods;
- Frequent statements and discussions of suicide – even if they are presented as a joke;
- A sense that an exacerbation is imminent;
- Panic attacks.
If a person is active in social networks, it is worth checking his pages. You can usually trace the decadent moods at the very beginning.
How to Suicide Prevention?
Suicidal episodes in patients with schizophrenia, unfortunately, are not uncommon. And preventing them can be quite difficult. A special approach and the most careful monitoring are needed. In most cases, an inpatient setting is preferable.
If concerns arise that the person wants to commit suicide, you should immediately go to a psychiatric clinic. Supervision is much more difficult in a domestic setting. In an inpatient setting, the patient will receive medication and psychotherapy support. In many cases, timely hospitalization helps to prevent a sad outcome.
Remember that even one suicide attempt means the patient will almost certainly try to repeat it. Such patients should be treated with the utmost care throughout their lives.
Suicide in schizophrenia: real cases from case studies
- Male, 23 years old – Bad heredity: father suffered from depression, consumed alcohol, and hung himself at 36. Mother was a strong-willed woman, an entrepreneur, who suppressed her son and subjected him to her control. He was brought up on the principle of dominating hyperopic care.
The boy finished school and entered the higher educational institution per his mother’s wishes. He studied academically on the average level and did not show any interest in his studies. He did not have any serious relationships. All of his sexual partners were 5-10 years older. He was found hanged in his dorm room. Before his death, he had sent all of his friends and relatives a farewell message with the text: “Forgive me, but I can’t go on.
- The girl is 19 years old – Since early childhood, she was registered with a psychotherapist. She was seen at parties where they smoked hash and used other illegal drugs. During one of the parties, she experienced a sudden fear – she began to feel that someone or something awful was hiding behind the wall and wanted to harm her. Fleeing her hallucination, she ran out onto the balcony and jumped off, dying on the spot.
- Male, 36 years old – Diagnosed the schizophrenic disorder at age 14. It did not interfere with the patient’s daily life. He graduated from college and got a job. At age 35, after a severe infectious disease, he began hearing voices that told him he was being watched. The patient told his loved ones that everything around him seemed fake and that it looked like someone was putting on a purpose show. As a result, he left work, locked himself in his apartment, and was afraid to go outside for a long time, even to the grocery store. After the sick man’s mother informed him of her intention to call a psychiatric ambulance for him, he went into the bathtub and slit his wrists. Doctors arrived in time and were able to resuscitate him at the hospital.
- Man, 33 years old – Schizophrenia was inherited from his father, who drowned himself in the river when his son was ten. Since then, the patient has been obsessed with ending his life the same way as his father. He attempted suicide during the May holidays and went to drown himself under the influence of alcoholic beverages. He was resurrected and then admitted to a psychiatric clinic for long-term treatment.
Suicide is one of the main causes of early loss of life in patients with schizophrenic disabilities. The number of suicide attempts can be quite high. The main factor in preventing suicidal episodes is timely antipsychotic treatment. Comprehensive research is underway to regulate psychosocial and therapeutic measures aimed at suicide prevention among patients with schizophrenia.