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Dissertation
Suicide in schizophrenia: an examination of at-risk subgroups
Doctor of Philosophy (Ph.D.), Medical College of Pennsylvania and Hahnemann University
May 2001
DOI:
https://doi.org/10.17918/00008333
Abstract
Suicide is the leading cause of premature death among individuals with schizophrenia. The identification of individuals who are at increased risk for suicide has proven extremely difficult. Using the Interview for Suicide in Schizophrenia, 3rd Revision (ISIS-3), this study assesses how risk for suicide in schizophrenia is understood by raters, and to identify and define subgroups of "at risk" patients based on the twenty subscales of the ISIS-3. Two hundred fifty-eight inpatients of a state hospital with a diagnosis of schizophrenia or schizoaffective disorder were interviewed using the ISIS-3. Cluster analytic techniques were performed using the subscales of the ISIS-3 as clustering variables, and four clusters with distinctly different profiles were identified. These profiles included a cluster defined primarily by "traditional" suicide risk factors such as high levels of depression, anxiety, hopelessness, suicidal ideation, and fewer reasons for living, a cluster defined by high levels of hostility and impulsivity, a cluster characterized by relatively lower levels of psychopathology and increased insight, and a cluster defined by a high incidence of command hallucinations and self-harm. These clusters were further characterized by differences in gender and diagnosis. Finally, the technique of stepwise logistic regression demonstrated that individuals judged to be at risk for suicide could be distinguished from those judged to be not at risk with a high degree of accuracy; correct classification was obtained for 85.2% of the subjects. These results show that for a chronically-ill, inpatient population, different subgroups of individuals at risk for suicide appear to exist, and can be differentiated from those judged to be "not at risk." Further investigation of these subgroup in a broader sample is warranted.
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Details
- Title
- Suicide in schizophrenia
- Creators
- Belinda Elizabeth Barnett
- Contributors
- James D. Herbert (Advisor) - Drexel University, Medical College of Pennsylvania and Hahnemann University (1993-1996, 1998-2002)
- Awarding Institution
- Medical College of Pennsylvania and Hahnemann University
- Degree Awarded
- Doctor of Philosophy (Ph.D.)
- Publisher
- Medical College of Pennsylvania and Hahnemann University; Philadelphia, Pennsylvania
- Number of pages
- vii, 60 pages
- Resource Type
- Dissertation
- Language
- English
- Academic Unit
- Clinical and Health Psychology [Historical]; Medical College of Pennsylvania and Hahnemann University (1993-1996, 1998-2002); College of Nursing and Health Professions (2000-2002)
- Other Identifier
- 991021888830704721