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Assessment and treatment of suicide risk in schizophrenia

Schizophrenic patients at risk of suicide are more likely to be young, male, white, never married, with post-psychotic depression, and a history of substance abuse and suicide attempts. Hopelessness, social isolation, awareness of illness and hospitalization are also related to suicide risk. Deteriorating health with a high level of premorbid functioning, recent loss or rejection, limited external support, family stress or instability are other features that have been reported in schizophrenic patients who commit suicide. Atypical antipsychotics, especially clozapine, have emerged as important tools in the therapeutic armamentarium. Psychosocial intervention and psychotherapy may play an important role in the management of suicide risk, especially if such interventions help the patient face daily difficulties, loneliness and conflicts inside the family.