Schizophrenia is strongly linked to a higher-than-normal chance of suicide and suicide attempts.
Suicide prevention can be hard to do, because people with schizophrenia can sometimes act on suicidal thoughts impulsively and without warning. So it’s essential that health care workers, family members, and friends be aware and know what to do.
Risk Factors for Suicide in Schizophrenia Patients
People with schizophrenia are more likely to commit suicide if they are young, male, white, and never married.
The condition is also more likely if someone did well in his everyday life before he was diagnosed with schizophrenia, developed depression after the diagnosis, has a history of alcohol or other substance abuse, and a history of past suicide attempts.
The classic person with schizophrenia who attempts suicide may:
- Be a male under age 30
- Have a higher IQ
- Have been a high achiever as a teen and young adult
- Be painfully aware of schizophrenia's effect on him
Suicide is also more likely in someone who is:
- Socially isolated
- Living in a hospital
- In worsening health
- Suffering from a recent loss or rejection
- Lacking support from other people
- Having family stress or instability
- Fearing that their mental condition could worsen
- Too dependent on treatment or has lost faith in it
Suicide among people with schizophrenia is also linked to:
- Long-term illness or chronic pain
- Family history of suicide
- Past or present history of depression
- Drug abuse
- Being very upset and impulsive
- Suicidal thoughts
- Greater number of prescriptions for schizophrenia medications and antidepressants
- Negative attitudes toward medication and not following their treatment plan
- Not being able to work and being dependent on others
In general, the core symptoms of psychosis -- hallucinations and delusions -- seem to have a weaker link to suicide than symptoms such as:
- Negative outlook on life
- Sense of worthlessness
- Awareness that schizophrenia is negatively affecting how the person thinks
What to Watch For
Keep an eye out for signs that the person feels hopeless or that they have suffered a loss.
You might think that someone who’s in the hospital is going to be OK. But sometimes, suicide risk goes up when the person leaves the hospital. This can happen if they see staffers and other patients as the central people in their life, and then feel hopeless without them.
Whenever anyone has schizophrenia, it’s important to pay close attention to feelings of hopelessness and suicidal thoughts and behaviors. This is especially true for people who start to realize how serious their condition is.
Becoming more aware of their illness can prompt some people to take better care of themselves. But it can lead to suicidal thoughts in others. That’s especially likely in younger people who used to have healthy lives and now recognize how much they've lost.
Keep in mind that many antidepressants and antipsychotic drugs carry warnings of increased risk for suicidal thinking and behavior in young adults, adolescents, and children.
If you know someone who is thinking or talking about suicide, get them help. You can call 911 or a crisis line, such as the National Suicide Prevention Lifeline at 800-273-8255.
If someone has schizophrenia and is not suicidal now, they need:
- Treatment for any depression symptoms
- Improvement in how well they follow their schizophrenia treatment
- People who can closely watch them, especially if they’ve had significant losses
- A safety plan that prepares for any failure to develop effective means of coping or a worsening of symptoms