SUICIDAL BEHAVIOR IN SCHIZOPHRENIA

自杀是精神分裂症患者死亡的主要原因， 终生患病风险估计为16至40倍， 一般人口。 自杀风险的流行病学研究 精神分裂症几乎完全集中在总人口统计学上， 具有预测自杀风险特异性的临床变量。 临床、心理社会和环境的综合评估 需要变量来充分识别和测试 精神分裂症的自杀风险 迄今为止， 采用前瞻性研究方法， 心理病理学、心理社会功能和环境压力因素 精神分裂症的自杀行为 因此，我们建议进行一次2- 对200名DSM-III-R患者进行了为期1年的随访研究 精神分裂症患者，包括100名“高危”精神分裂症患者，50名 “理想者”和50名“低风险”非自杀患者。 本研究将 评估自杀行为的风险与（1）临床 特征，包括情感障碍和绝望-风险 在情感性精神障碍的自杀研究中已经确定的因素; （2）社会心理因素--人际问题解决能力， 压力性生活事件和社会/家庭因素，如高表达 情感和社会支持。 通过在正在进行的 我们的自杀研究支持的横断面和回顾性研究 MHCRC，本研究将遵循这一独特且特征明确的队列 在他们处于最高自杀风险的时期， 通过跟踪这一独特且特征良好的患者样本，我们将 能够区分状态和特质相关的心理社会和临床 风险因素，并前瞻性地评估其相对重要性 预测自杀行为 这项全面的临床研究和 心理社会变量将为改善 临床风险评估和开发临床有效的 心理社会治疗干预。

Suicide is a leading cause of death among patients with schizophrenia, with lifetime morbid risk estimates ranging from 16 to 40 times that of the general population. Epidemiologic studies of risk for suicide in schizophrenia have focused almost exclusively on gross demographic and clinical variables with specificity for predicting suicide risk. Comprehensive assessment of clinical, psychosocial, and environmental variables is needed to adequately identify and test putative predictors of risk for suicide in schizophrenia. No study to date has concurrently examined, using prospective study methods, the influence of psychopathology, psychosocial functioning, and environmental stressors on suicidal behavior in schizophrenia. Therefore, we propose to conduct a 2- year follow-up study of a well-characterized cohort of 200 DSM-III-R Schizophrenia Disorder patients, including 100 "high-risk" attempters, 50 "ideators", and 50 "low risk" non-suicidal patients. This study will assess risk for suicidal behavior associated with (1) clinical characteristics, including affective symptomatology and hopelessness--risk factors already identified in studies of suicide in affective disorders; and (2) psychosocial factors--interpersonal problem-solving skills, stressful life events, and social/familial factors such as high Expressed Emotion and social support. By adding a follow-up component to the ongoing cross-sectional and retrospective studies now supported by our Suicide MHCRC, this study will follow this unique and well-characterized cohort through the posthospital period when they are at highest risk for suicide. By following this unique and well-characterized patient sample, we will be able to differentiate state- and trait-related psychosocial and clinical risk factors and prospectively assess their relative importance in predicting suicidal behavior. This comprehensive study of clinical and psychosocial variables will provide an empirical basis for improved clinical risk assessment and for the development of clinically effective psychosocial treatment interventions.