Prevalence and correlates of suicidal ideation in chronic patients with schizophrenia: a hospital-based cross-sectional study

ABSTRACT

Background

Prior studies seeking to identify factors associated with suicide in patients with schizophrenia have reported important, though limited, and controversial findings. Our aims were to examine the prevalence of suicidal ideation (SI) and investigate the relationship between SI and a variety of factors (such as insomnia, religious coping, previous life experiences, dependency in daily living activities, positivity) in patients with schizophrenia.

Method

This was a cross-sectional study carried out among Lebanese patients with schizophrenia during January 2022.

Results

Out of 196 patients, 17.3% had SI. Multivariable logistic regression found that more loneliness (aOR = 1.43) and more severe insomnia (aOR = 1.08) were substantially related with increased odds of reporting SI, whereas having more positive life experiences (aOR = 0.83) was associated with lower odds of occurrence of SI. Positive/negative religious coping, activities of daily living and positivity showed no significant association with SI in our sample and context.

Conclusion

Findings showed that SI is highly prevalent in chronic patients with schizophrenia. The study identified three important factors (insomnia, loneliness, and positive experiences in life) associated with SI in schizophrenia, which could be targeted in prevention and intervention strategies.

Key Points

What is already known about this topic:

1. Individuals diagnosed with schizophrenia have a significant decrease in life expectancy compared to the general population, with suicide being the main factor contributing to the high early mortality risk in this patient group.

2. Suicide rates continue to occur at these alarming rates among schizophrenia patients, with an estimated lifetime risk of suicide of 5% to 10%, which accounts for 12% of all deaths in schizophrenia.

3. Although efforts to prevent suicide among patients with schizophrenia should first and foremost begin with the detection of suicidal ideation’s risk factors, these are still poorly explored and understood.

What this topic adds:

1. This study extended prior research in a complex and culturally sensitive topic that has long been under-studied among patients with schizophrenia, by investigating relationships between suicidal ideation and a range of personal, clinical and environmental factors, using an understudied population from Lebanon.

2. Suicidal ideation had a prevalence of 17.3% in our patients with schizophrenia, and were significantly associated with insomnia, more loneliness (but not lack of social support), and more positive experiences in life.

3. Effective suicide preventive strategies among patients with schizophrenia need to further rely on interventions aimed at reducing loneliness, treating insomnia and restoring healthy sleep patterns, as well as helping patients build positive experiences into their lives.

KEYWORDS:

• Insomnia
• loneliness
• positive life experiences
• schizophrenia
• suicidal ideation

Disclosure statement

No potential conflict of interest was reported by the author(s).