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Predictors of patients with high suicidality during the post discharge period in the early phase of schizophrenia

Amresh Shrivastava, Robbie Campbell, Megan Johnston, Avinash Desousa, Nilesh Shah, Sagar Karia.

Abstract
Background: Suicide is seen in 20-25% patients with psychiatric disorder and suicide is most common in the phase when discharge occurs from a psychiatric hospital.

Objective: The purpose of this study was to investigate the nature of suicidal risk, which might be present among sufferers from early psychosis at the time of discharge from hospital.

Materials and Methods: 60 patients diagnosed with schizophrenia admitted to a psychiatric facility were participants for the study. Psychopathology was assessed by Brief Psychiatric Rating Scale (BPRS) and Hamilton Depression Rating Scale (HDRS) while current level of stress / functioning was assessed by Global Assessment of Functioning scale (GAF). The level of suicidality was assessed using Scale of Impact of Suicidality - Management, Assessment and Planning of Care (SIS-MAP). On the basis of the scores on the SIS-MAP the patients were divided into two groups low severity of Suicidality (SIS-MAP < 30) and high severity of suicidality (SIS-MAP ≥ 30).

Results: It was found that the 2 groups did not differ in suicidality, which was measured by the SIS-MAP. We also compared low and high SIS-MAP scorers in the entire sample. It was found that male gender, older age of onset of illness, presence of alcohol dependence and cannabis abuse with greater acuity of the clinical state were predictive of higher suicidality scores (p < 0.02 on all factors mentioned).

Conclusion: Certain factors like gender, age of onset of illness and presence of substance abuse may be greater acuity in predicting suicide risk in the post discharge phase of schizophrenia.

Key words: suicide attempt, suicidality, SIS-MAP, GAF, HDRS, BPRS, post discharge, schizophrenia



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