Prevalence and Factors Associated with Suicidal Ideation in Institutionalized Patients with Schizophrenia

• Main Authors: Chong BTW, Wahab S, Muthukrishnan A, Tan KL, Ch’ng ML, Yoong MT
• Format: Article
• Language: English
• Published: Dove Medical Press 2020-11-01
• Series: Psychology Research and Behavior Management
• Subjects: ideation; institutionalized; schizophrenia; suicidal thoughts
• Online Access: https://www.dovepress.com/prevalence-and-factors-associated-with-suicidal-ideation-in-institutio-peer-reviewed-article-PRBM

Benedict Tak Wai Chong,1 Suzaily Wahab,1 Arunakiri Muthukrishnan,2 Kok Leong Tan,3 May Lee Ch’ng,3 Mei Theng Yoong1 1Department of Psychiatry, Faculty of Medicine, Universiti Kebangsaan Malaysia Medical Centre (UKMMC), Kuala Lumpur, Wilayah Persekutuan 56000, Malaysia; 2Department of Psychiatry, Hospital Bahagia Ulu Kinta, Tanjung Rambutan, Perak Darul Ridzwan 31250, Malaysia; 3Department of Community Medicine, School of Medicine, International Medical University (IMU), Kuala Lumpur, Wilayah Persekutuan 57000, MalaysiaCorrespondence: Suzaily WahabDepartment of Psychiatry, Universiti Kebangsaan Malaysia Medical Centre (UKMMC), Jalan Yaacob Latif, Bandar Tun Razak, Kuala Lumpur, Wilayah Persekutuan 56000, MalaysiaTel [phone]Email [e-mail]: The shorter life expectancy and increased risk of suicide in patients with schizophrenia have been well documented. However, study outcomes on suicidality in this special population have been few to date. This study investigated the prevalence and factors associated with suicidal ideation in a population of institutionalized patients with schizophrenia.Methods: Two hundred fifty-six patients with schizophrenia between the age of 18 and 65 years were randomly recruited. This cross-sectional study utilised the Calgary Depression Scale for Schizophrenia (CDSS), the Positive and Negative Syndrome Scale (PANSS) and the Psychotic Symptom Rating Scale (PSYRATS-AH). Univariate analysis was performed using an independent t-test or chi-square test, followed by binary logistic regression to determine the factors associated with increased suicidal risks.Results: The socio-demographic factors associated with suicidal ideation included level of education (p=0.039); secondary-level education (OR=5.76, 95% CI:1.49, 22.34, p=0.011) and tertiary-level education (OR=9.30, 95% CI: 1.80, 48.12, p=0.008) posed a greater risk. A history of attempted suicide (OR=2.09, 95% CI: 1.01, 4.36, p=0.049) and the presence of co-morbid physical illnesses (OR=2.07, 95% CI: 1.02, 4.21, p=0.044) were also found to be associated with a suicidal ideation. Other significant factors associated with suicidal thoughts were concurrent depression (OR=9.68, 95% CI: 3.74, 25.05, p< 0.001) and a higher PSYRATS score in emotional characteristics of auditory hallucinations (OR=1.13, 95% CI: 1.06, 1.21, p< 0.001).Conclusion: Suicide in schizophrenia appears to be more closely associated with certain socio-demographic factors and affective symptoms. Appropriate screening and treatment addressing these challenges must be emphasized if suicidal thoughts and actions are to be reduced.Keywords: ideation, institutionalized, schizophrenia, suicidal thoughts