From ideation to attempt: A study of suicidality and its correlates amongst patients with schizophrenia in a resource-poor country

S Afr J Psychiatr. 2022 Jan 27:28:1547. doi: 10.4102/sajpsychiatry.v28i0.1547. eCollection 2022.

Abstract

Background: There is increasing evidence that patients with schizophrenia have high tendency to commit suicide. However, such an act is usually preceded by suicidal behaviours (or suicidality) such as suicidal ideations, suicidal intent, suicidal plans and suicidal attempt. If any of this suicidal behaviour spectrum is missed, then suicide results. In spite of the relevance of such behaviours in the management and prognosis of schizophrenia, there is a paucity of research on the patterns and correlates of suicidal behaviours amongst this population group in sub-Saharan Africa.

Aim: This study assessed the prevalence and pattern of suicidality and its relationship with certain sociodemographic and clinical variables.

Setting: The study was conducted at the outpatient psychiatric clinic of the Lagos University Teaching Hospital, Idi-Araba, Lagos State.

Methods: Suicidal behaviours were assessed amongst 160 randomly selected patients with schizophrenia over a six-month period. The prevalence, pattern and correlates of suicidal behaviour amongst them were also assessed. Data were collated and processed with the eighteenth version of Statistical Package for Social Sciences (SPSS 18).

Results: About 43.1% of the participants exhibited suicidal behaviour. Of these, 5.8% exhibited suicidal plans whilst 75.4% attempted suicide. In terms of severity, one tenth (10%) of those who expressed suicidal behaviour exhibited severe suicidal tendencies. Participants who earned lesser income were more likely to exhibit suicidal behaviour. The same pattern was observed for medication adherence viz a viz suicidal behaviour.

Conclusions: The study brings to the fore the tendency of patients with schizophrenia to commit suicide, hence the need to screen for suicidal behaviour before suicide eventually occurs.

Keywords: schizophrenia; suicidal attempt; suicidal behaviours; suicidal ideation; suicidal plan.