Insight in schizophrenia and risk of suicide: a systematic update

TY - JOUR

T1 - Insight in schizophrenia and risk of suicide

T2 - a systematic update

AU - López-Moríñigo, Javier D

AU - Ramos-Ríos, Ramón

AU - David, Anthony S

AU - Dutta, Rina

N1 - Copyright © 2012 Elsevier Inc. All rights reserved.

PY - 2012/5

Y1 - 2012/5

N2 - Background: Suicide has been shown to represent the major single cause of premature death among patients with schizophrenia spectrum disorders. Insight has been proposed to increase such risk. However, this subject has not been sufficiently investigated, and inconclusive results have been reported.Objective: The objective of this study is to systematically examine the role of insight in the risk of suicide attempts and completed suicide among patients with schizophrenia and related disorders.Method: Articles assessing insight and suicidality in patients with schizophrenia spectrum disorders published between 1977 and 2010 were reviewed. A MEDLINE search strategy was used to identify studies using keywords. Application of meta-analytic techniques to selected studies was not possible because of important methodological differences between them.Results: Fifteen studies met predetermined selection criteria. Ten failed to demonstrate a positive association between insight and risk for suicide.Discussion: There is little evidence to support the suggestion that insight may represent a risk factor for suicide in patients with schizophrenia. If there is an association between such risk and insight, it appears to be mediated by other variables such as depression and, above all, hopelessness. Further studies with larger samples and longer follow-up periods in naturalistic conditions, in which insight should be evaluated from a multidimensional approach, are required to analyze this issue in depth, given the crucial implications that it may have on the development of a model for suicide prevention in schizophrenia. (C) 2012 Elsevier Inc. All rights reserved.

AB - Background: Suicide has been shown to represent the major single cause of premature death among patients with schizophrenia spectrum disorders. Insight has been proposed to increase such risk. However, this subject has not been sufficiently investigated, and inconclusive results have been reported.Objective: The objective of this study is to systematically examine the role of insight in the risk of suicide attempts and completed suicide among patients with schizophrenia and related disorders.Method: Articles assessing insight and suicidality in patients with schizophrenia spectrum disorders published between 1977 and 2010 were reviewed. A MEDLINE search strategy was used to identify studies using keywords. Application of meta-analytic techniques to selected studies was not possible because of important methodological differences between them.Results: Fifteen studies met predetermined selection criteria. Ten failed to demonstrate a positive association between insight and risk for suicide.Discussion: There is little evidence to support the suggestion that insight may represent a risk factor for suicide in patients with schizophrenia. If there is an association between such risk and insight, it appears to be mediated by other variables such as depression and, above all, hopelessness. Further studies with larger samples and longer follow-up periods in naturalistic conditions, in which insight should be evaluated from a multidimensional approach, are required to analyze this issue in depth, given the crucial implications that it may have on the development of a model for suicide prevention in schizophrenia. (C) 2012 Elsevier Inc. All rights reserved.

KW - Risk

KW - Humans

KW - Adult

KW - Suicide

KW - Schizophrenic Psychology

KW - Aged

KW - Middle Aged

KW - Adolescent

KW - Male

KW - Female

U2 - 10.1016/j.comppsych.2011.05.015

DO - 10.1016/j.comppsych.2011.05.015

M3 - Article

C2 - 21821236

SN - 0010-440X

VL - 53

SP - 313

EP - 322

JO - Comprehensive Psychiatry

JF - Comprehensive Psychiatry

IS - 4

ER -