The Relationship Between Suicide Attempts and Ideation with Depression, Insight, and Internalized Stigmatization in Schizophrenia

BACKGROUND: Suicidal behavior is quite common in schizophrenia and various risk factors for suicide have been reported. The aim of this study was to examine the relationship between suicide attempts and ideation with depression, insight, and internalized stigmatization in patients with schizophrenia. METHOD: Thirty-six patients with a history of suicide attempts and 52 patients without suicide attempts who were diagnosed as schizophrenia according to DSM-5 diagnostic criteria were included in this study. According to the score which they obtained from the eighth item of the Calgary Depression Scale for Schizophrenia, patients were divided into two groups: not suicidal ideations (zero points) and suicidal ideations (one, two, or three points). Sociodemographic information form, Positive and Negative Syndrome Scale, Calgary Schizophrenia Depression Scale, Schedule for Assessing the Three-Component of Insight, The Internalized Stigma of Mental Illness Scale, and The Suicide Ideation Scale were applied to all of the patients who participated in the study. RESULTS: Patients with suicide attempts were more likely to be single and had higher the Internalized Stigma of Mental Illness Scale scores compared to patients without suicide attempts. Patients with suicidal ideation had higher Positive and Negative Syndrome Scale total scores, higher Calgary Schizophrenia Depression Scale scores, and higher the Internalized Stigma of Mental Illness Scale scores than those without suicidal ideation. There was a strong, positive correlation between the Suicide Ideation Scale and Calgary Schizophrenia Depression Scale, as well as there was a moderate, positive correlation between Positive and Negative Syndrome Scale, the Internalized Stigma of Mental Illness Scale, and the Suicide Ideation Scale in the suicidal ideation group. In regression analysis, depression was found to be a predictor of suicidal ideation. CONCLUSION: Depression and internalized stigma were risk factors for suicide in schizophrenia. Risk factors need to be carefully assessed to prevent suicide in schizophrenia.