Short communication
Suicide attempts in schizophrenia and affective disorders with relation to
some specific demographical and clinical characteristics
Daniel J. Müller
a,b,c,
*, Katrin Barkow
b
, Svetlana Kovalenko
b,d
, Stephanie Ohlraun
b,e
,
Heiner Fangerau
b,f
, Heike Kölsch
b
, Matthias R. Lemke
g
, Tilo Held
g,h
, Markus M. Nöthen
i,j
,
Wofgang Maier
b
, Reinhard Heun
b
, Marcella Rietschel
b,e
a
Centre for Addiction and Mental Health, Neurogenetics Section, University of Toronto, 250 College Street, M5T 1R8 Toronto, ON, Canada
b
Department of Psychiatry, University of Bonn, Sigmund-Freud-Str. 25, 53105 Bonn, Germany
c
Clinic for Psychiatry and Psychotherapy, Charité Medecine Berlin, Campus Charité Mitte, Schumannstr. 20/21, 10117 Berlin, Germany
d
Clinic for Psychiatry and Psychotherapy, University Clinic Carl Gustav Carus, Technical University of Dresden, Fetscherstrasse 74, 01307 Dresden
e
Central Institute of Mental Health, J5, 68159 Mannheim, Germany
f
Institute for the History of Medecine, Heinrich-Heine-University Düsseldorf, Universitätsstrasse 1, 40225 Düsseldorf, Germany
g
Mental State Hospital Rheinische Kliniken Bonn, Kaiser-Karl-Ring 5, 53111 Bonn, Germany
h
Fliedner Clinic Berlin, Charlottenstraße 65, 10117 Berlin-Mitte, Germany
i
Life & Brain Center, University of Bonn, Sigmund-Freud-Str. 25, 53105 Bonn, Germany
j
Institute of Human Genetics, University of Bonn, Wilhelmstr. 31, 53111 Bonn, Germany
Received 12 November 2003; accepted 12 May 2004
Available online 25 September 2004
Abstract
Demographical and clinical characteristics have been reported to modulate the risk for suicide. This study analysed demographical and
clinical characteristics with respect to lifetime suicide attempts in 500 individuals affected with schizophrenic or affective disorders. Suicide
attempts were associated with poor premorbid social adjustment, low age at onset, low scores on the “Global Assessment Scale” and childles-
sness in females.
© 2004 Elsevier SAS. All rights reserved.
Keywords: Suicide; Attempts; Risk factors; Schizophrenia; Affective disorders; Gender differences
1. Introduction
The aetiology of suicide is complex and may clinically
be classified as continuum that ranges from suicidal idea-
tion and suicide plans towards (non-violent or violent)
attempted and completed suicide (for review see [12]). Ove-
rall, suicide has a strong association with mental disorders
[7], particularly with schizophrenia and affective disorders
[22,26]. However, despite considerable efforts in research and
progresses in drug treatment over the last decades, suicide
rates have not dropped significantly in patients with schi-
zophrenia or affective disorders [15,21]. Patients suffering
from such diagnoses seem to be at increased risk for suicide
in the presence of an early-disturbed psychosocial adjust-
ment [17] and distinct demographic characteristics (e.g. male
gender, [6–14]), while one of the most potent risk factor for
inpatients is given by a history of previous suicide attempts
[25,20]. Protective factors include being young, non-white,
female and pregnancy or motherhood [12,1,9], despite the
risk of postpartum depression and psychosis. Inclusion of
demographic factors such as age proved to increase the pre-
dictive ability of suicide risk assessment scales (e.g. ‘Suicide
Assessment Scale’; SUAS) in suicide attempters [19]. Howe-
ver, demographical and clinical risk factors may differ impor-
tantly between genders as evidenced for example by a study
from Qin et al. [23], who performed joint and separate ana-
lyses with demographical (or socioeconomic) and clinical (or
health) characteristics in a population based sample inclu-
ding patients who committed suicide compared to controls.
For both genders, a history of hospitalised mental
* Corresponding author. Tel.: +1-416-535-8501x4421;
fax: +1-416-979-4666.
E-mail address: daniel_mueller@camh.net (D.J. Müller).
European Psychiatry 20 (2005) 65–69
www.elsevier.com/locate/eurpsy
0924-9338/$ - see front matter © 2004 Elsevier SAS. All rights reserved.
doi:10.1016/j.eurpsy.2004.06.024