Risk factors associated with suicide attempts in patients with schizophrenia: an observational study from South India

Background: As a suicide attempt is an important predictor of suicide in patients with schizophrenia, it is essential to assess risk factors to prevent suicides. This study aimed to assess the clinical factors and reasons associated with suicide attempts in patients with schizophrenia. A chart review of the patients diagnosed with schizophrenia from January 2014 to December 2019 was conducted at a tertiary hospital in South India. Socio-demographic and clinical details were extracted using a pro-forma. Details of suicide attempts were collected for all the patients. Results: Out of 300 patients, 54 patients (18%) had at least one suicide attempt. Comorbid depression (p < 0.001,φ = 0.32) and substance abuse (p = 0.043,φ = 0.1) were significantly more in patients with suicide attempts. The group with suicide attempts had a significantly higher record of poor treatment compliance (p = 0.001, φ = 0.19). The most common methods of suicide attempts were drug overdose and consumption of poison (20.3% each). The most common reasons were the presence of depressive symptoms (24.1%) and delusions (24.1%). Hallucinations contributed to 22.2% of the suicide attempts. Conclusions: Suicide attempts were common among schizophrenia patients in up to 18%. Evaluation and early treatment of depressive symptoms and substance abuse and improvement of treatment adherence may help prevent suicide in patients with schizophrenia.