Suicidality and Survivability in Schizophrenia

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To the Editor:
It is estimated that 50% of schizophrenics attempt suicide, and 10% to 15% complete it. This highlights the importance of maintaining vigilance to patients who are at risk, ensuring treatment adherence, aggressive treatment of affective symptoms, and, if feasible, empowering patients with coping/problem-solving skills (Li and Zhang, 2012). With chronic suicidality in schizophrenia, clozapine is the only antipsychotic that is Food and Drug Administration approved for this indication, as shown by Meltzer, 1999. Here, we would portray vectors of suicidality in schizophrenia.
As if ruled, risk factors in schizophrenia are more or less the same as in other disorders, that is, interplay of static and dynamic variables. Static variables entail demographic variables (male, old, and Caucasian), medical comorbidities, trait vulnerability, etc. Dynamic variables entail clinical variables (e.g., therapeutic alliance) and situational variables (e.g., access to lethal weapons).
Notwithstanding, there remain a host of risk factors that are germane to schizophrenia (Westermeyer et al., 1991), in particular, that merit special consideration.
On the other hand, survivability is tied to abhorrence (e.g., religiosity), anchorage (social support), adaptability (coping skills), alternative solution seeking (problem-solving skills), and stoicism.
Although still preliminary to suggest as surrogate biomarkers of suicidality in schizophrenia, various studies demonstrated an association with RNA editing of human 5HT2C receptor gene, COMT L allele, and septum cavum pellucidi on neuroimaging.
Monitoring of suicide risk can be enhanced by use of standardized measures for individuals with schizophrenia. Of these rating scales, the Schizophrenia Suicide Risk Scale and the InterSePT Scale for Suicidal Thinking are in common use.
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