정신분열병 환자의 병식, 우울증, 충동성 및 자살시도경험이 자살행동에 미치는 영향

Abstract

Objectives : Schizophrenia is a mental disorder that has a high risk of suicide, mainly occurring in unpredictable conditions. The purpose of this study was to identify clinical characteristics for predicting the current suicidality in patients with schizophrenia. Methods In 71 schizophrenic, patients, we explored clinical characteristics of subjects with the current suicidality which is defined as the suicidality of the last one month. Clinical characteristics of subjects were assessed by the Positive and Negative Syndrome Scale (PANSS), three General awareness items in the Scale to assess Unawareness of Mental Disorder, the Global Assessment of Functioning (GAF) scale, the Beck´s Hopelessness Scale and the Barratt Impulsivity Scale. Depression was assessed using the depression item of the PANSS. We analysed which factors among these characteristics could predict the current suicidality in subjects: Results : Subjects having the current suicidality were 36. They showed earlier onsets and more suicidal attempts. And they had higher depression, positive and negative symptom scores and lower GAF score, and were more impulsive than subjects without the current suicidality. Insight, hopelessness were not significantly different between two groups. The regression model predicting the current suicidality included depression, number of past suicide attempts and motor impulsivity. Conclusions : These findings indicated that depression, previous history of suicidal attempts and impulsivity may be the predictors of the current suicidality in schizophrenic patients. Also these findings indicated the difficulty in predicting the suicide in schizophrenic patients may be due to the impulsivity. Further study will be needed to clarify the relationship between depression, previous suicide attempts, impulsivity and suicide.