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Schizophrenia Bulletin 1999 25(3):519-531;
© 1999 by Oxford University Press and the Maryland Psychiatric Research Center (MPRC)
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© Oxford University Press

Life Events and Completed Suicide in Schizophrenia: A Comparison of Suicide Victims With and Without Schizophrenia

Hannele Heilä, M.D., Martti E. Heikkinen, M.D., Ph.D., Erkki T. Isometsä, M.D., Ph.D., Markus M. Henriksson, M.D., Ph.D., Mauri J. Marttunen, M.D., Ph.D. and Jouko K. Lönnqvist, M.D., Ph.D.
Researcher, National Public Health Institute, Department of Mental Health and Alcohol Research Helsinki, Finland
Senior Researcher, National Public Health Institute, Department of Mental Health and Alcohol Research Helsinki, Finland
Chief of Research on Mood Disorders and Self-Destructive Behavior, National Public Health Institute, Department of Mental Health and Alcohol Research Helsinki, Finland
Senior Researcher, National Public Health Institute, Department of Mental Health and Alcohol Research Helsinki, Finland
Senior Researcher, National Public Health Institute, Department of Mental Health and Alcohol Research Helsinki, Finland
Research Professor and Director, National Public Health Institute, Department of Mental Health and Alcohol Research Helsinki, Finland
Associate Professor at the Tampere School of Public Health, University of Tampere Finland

Reprint requests should be sent to Dr. H. Heilä, National Public Health Institute, Department of Mental Health and Alcohol Research, Mannerheimintie 166, FIN-00300 Helsinki, Finland; e-mail: hannele.heila{at}ktl.fi

Adverse life events are an established risk factor in completed suicide. However, few studies have examined life events and suicide in schizophrenia. We investigated and compared schizophrenia suicide victims and age- and sex-matched victims without schizophrenia as part of a psychological autopsy study of all suicides in Finland over a 12-month period. Recent life events were examined retrospectively by interviewing next of kin using a structured life event questionnaire. Overall, nearly half (46%) the schizophrenia subjects had had adverse life events before suicide, significantly less than the nonschizophrenia subjects (83%). In both groups, however, suicide was preceded by life events independent of the victims' own behavior, such as death of a close person or illness in the family. Life events overall were more common among schizophrenia outpatients (52%) than inpatients (22%), and the association of life events with suicide was clearest among a subgroup of outpatients in residual phase who had used neuroleptic medication regularly. Overall, the prevalence of recent adverse life events varied between clinical subgroups of victims with schizophrenia, which may have implications for suicide prevention.

Keywords: Recent life events / suicide / schizophrenia


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