Schizophrenia and suicide
This is not from a peer reviewed journal but is a review of high quality
studies. It's quite a short article. The two tables are interesting.
It's easy to criticise this article of course but I'm too tired.
There are lists of factors associated with completed suicide in
schizophrenia in Table 2.
"
Recent suicide ideation, fear of mental disintegration, drug misuse or
dependence, recent depression, recent loss, poor compliance with
treatment, and history of suicide attempt all occurred much more often
with suicide cases than with controls (Table 2, which has odds ratios
from the paper as well as the more useful relative risk). Hallucination
was the only factor that occurred less frequently.
"
Table 1 is interesting because it's a list of factor not associated with
or with limited associations with suicide in schizophrenia. The results
in this table are contrary to what I knew. I think they'll be derived
from one of the papers referenced at the bottom of the article. I
thought delusions and command hallucinations were associated with
completed suicide, as was impulsivity. Perhaps they're associated with
suicide attempts, somewhat like the biblical story of Abraham (or
Ibrahim if you're Muslim) where the command hallucination stopped at the
point where he was going to kill his son.
It's been my own experience of suicide and self-harm related to the
other consciousness or non-corporeal entity that is part of my life and
my being for it to usually 'protect', e.g. consciously I'll aggressively
cut myself however there is an unconscious (external control) force that
holds me back from making a really damaging cut. It's like throwing a
ball as hard as you can but an invisible force holds back the hand as
the ball is thrown. My self-harm isn't ritualistic or done with care. It
is done with intent to fight back against the controlling force with the
only thing I seem to have: my existence. It also serves to show the
controlling force what it is doing to me. I've been prolific and
inventive with my self-harm techniques but have been held back from
serious damage most of the time.
There are a handful of occassions where the self-harm/suicide got pretty
serious. There was one night where I was going through a particularly
bad phase. It was during the period where the thought of dying was my
happy thought. I was self-harming regularly to fight against the
controlling force. Scar upon bloody scar covered my left forearm. I was
woken one night by my cat using her litter tray, but I knew it was the
force. It woke me up and I went straight to the sink in my room, grabbed
a knife and sliced my forearm. On that occassion it was as though my
entitiy was asleep or not holding me back. The gash was large and cut
through the skin to the muscle underneath. It's healed over now but the
open, unstitched scar is plain to see. It's about an inch wide by half
an inch.
What the fuck am I babbling about? Well....maybe most people with a
diagnosis on the schizophrenia spectrum's unconsciousness or controlling
entity or god or voice in their head or delusion or spirits or whatever
may not want the person to die even though they bring them to the very
edge which is why the factors for suicide attempts and completed suicide
may be different to what was expected.
I know I've got a lot more reading around to find out what the strong
evidence says.
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