Written informed consent was obtained from the patients. Approval from the Institute Ethics Committee of NIMHANS was obtained before initiating the study. All psychiatric patients presenting to the EPAC Service of NIMHANS from June 2011 to May 2012, with identified suicidal risk, and who were aged 17-60, were approached to participate in the study. The study is based on a sample of 120 psychiatric patients with suicidal risk who were admitted to the Emergency Psychiatry and Acute Care (EPAC) Service at National Institute of Mental Health and Neuro Sciences (NIMHANS), Bengaluru, India. This study aims to bridge this research gap in the Indian context. There is, therefore, a need for research in the Indian context that is based on a sample of psychiatric patients (with suicidal risk and who have been admitted to a tertiary psychiatric care center) that examines the comparative differences in the clinical correlates of suicide attempt between the significantly important mental illnesses. A hospital-based study in India found that about one-fourth (24%) of schizophrenia patients had suicidal ideation. Another Indian study reported a 4.7% rate of attempted suicide in schizophrenia. In this context, an Indian study found that the prevalence of suicide attempts in major depressive disorder was 16.6%. The authors suggest that command hallucinations, though not an independent risk factor, increased the risk in those already vulnerable to suicide.Īlthough suicide is one of the major causes for mortality among psychiatric patients, in the Indian context research efforts in this area have been sparse. A review of risk factors for schizophrenia and suicide by Hawton et al., identified seven robust risk factors, including previous depressive disorder, previous suicide attempts, drug misuse, agitation or motor restlessness, fear of mental disintegration, poor treatment adherence, and recent loss. Hopelessness plays a more important role in schizophrenia than its relationship with suicidality, and a history of hopelessness and demoralization is common among schizophrenics. reports that 71% of Finnish schizophrenics who committed suicide had a history of suicide attempts. in their study of schizophrenic patients who had committed suicide found that 93% of these individuals had engaged in previous suicidal behaviors as compared to 23% of the patients who died by other means of death. Suicide attempts are also an important risk factor for suicide in schizophrenia. Suicide attempt is the most strong predictor of committed suicide, particularly in patients with mood disorder. Between 25% and 50% of patients with bipolar disorder make suicide attempts during their lives, while suicide rates among schizophrenics fall in the broad range of 5-13%. Suicide rates in bipolar patients are among the highest of any psychiatric disorder. Patients with ADs are at a higher risk of suicide relative to the general population with depression and bipolar manic-depression being the most common psychiatric conditions associated with suicide. The most common psychiatric illnesses in the background of suicide are the affective disorder (AD) of unipolar major depression and the non-AD of schizophrenia. Suicidal patients are commonly encountered in psychiatric practice, and attempted suicide and suicidal ideation are often a cause of emergency treatment and psychiatric hospitalization.
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