Schizophrenia and Suicide: Systematic Review of Risk Factors

Essay by Cmoxey July 2007

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This paper is a review of the article, Schizophrenia and Suicide: Systematic Review of Risk Factors, taken from, The British Journal of Psychiatry. The article starts out by explaining that p person with schizophrenia has a greatly increased risk for suicide. For the most art the risk factors are similar to the general population, but there are some risk factors that are specific to the people with the disorder. In this article they wanted to focus entirely on studies that would most likely provide valid estimates of risk factors which ended up being cohort and case-control studies. Studies were selected for review of they met the following criteria: patient diagnosis of schizophrenia including all of the subtypes, at least ninety percent of the participants had to be aged sixteen years or older, had to be already involved in cohort studies, with a minimum follow up period of one year, case-control studies, and specific risk factors for suicide were investigated.

The identified studies were categorized using the following order to reflect strength of the study design: (1) prospective cohort study; (2) retrospective cohort study; (3) nested case-control study; (4) case control with similar patient groups; (5) case control study in which the status of the controls were unclear or different. Data was extracted from reports independently based on the following variables: (a) socio-demographic, and (b) clinical history.

Study results were combined using the DerSimmonian and Laird random effects method of meta-analysis. Between studies heterogeneity was tested using Cochran's Q method. A sensitivity analysis was performed including only the strongest designs, to determine whether the magnitude and significance of risk factors was dependant on including results from studies smaller in design. In the end twenty-nine case studies were identified that met the review criteria.

Suicide risk was associated with...