{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,30]],"date-time":"2026-10-30T22:09:11Z","timestamp":1793398151232,"version":"4.5.0"},"reference-count":102,"publisher":"MDPI AG","issue":"7","license":[{"start":{"date-parts":[[2019,7,10]],"date-time":"2019-07-10T00:00:00Z","timestamp":1562716800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Medicina"],"abstract":"<jats:p>Suicide is an important public health problem. The most frequent psychiatric illnesses associated with suicide or severe suicide attempt are mood and psychotic disorders. The purpose of this paper is to provide an educational overview of suicidal behavior in individuals with schizophrenia. A lifetime suicide rate in individuals with schizophrenia is approximately 10%. Suicide is the largest contributor to the decreased life expectancy in individuals with schizophrenia. Demographic and psychosocial factors that increase a risk of suicide in individuals with schizophrenia include younger age, being male, being unmarried, living alone, being unemployed, being intelligent, being well-educated, good premorbid adjustment or functioning, having high personal expectations and hopes, having an understanding that life\u2019s expectations and hopes are not likely to be met, having had recent (i.e., within past 3 months) life events, having poor work functioning, and having access to lethal means, such as firearms. Throughout the first decade of their disorder, patients with schizophrenia are at substantially elevated suicide risk, although they continue to be at elevated suicide risk during their lives with times of worsening or improvement. Having awareness of symptoms, especially, awareness of delusions, anhedonia, asociality, and blunted affect, having a negative feeling about, or non-adherence with, treatment are associated with greater suicide risk in patients with schizophrenia. Comorbid depression and a history of suicidal behavior are important contributors to suicide risk in patients with schizophrenia. The only reliable protective factor for suicide in patients with schizophrenia is provision of and compliance with comprehensive treatment. Prevention of suicidal behavior in schizophrenia should include recognizing patients at risk, delivering the best possible therapy for psychotic symptoms, and managing comorbid depression and substance misuse.<\/jats:p>","DOI":"10.3390\/medicina55070361","type":"journal-article","created":{"date-parts":[[2019,7,10]],"date-time":"2019-07-10T11:56:51Z","timestamp":1562759811000},"page":"361","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":185,"title":["Suicide in Schizophrenia: An Educational Overview"],"prefix":"10.3390","volume":"55","author":[{"given":"Leo","family":"Sher","sequence":"first","affiliation":[{"name":"James J. Peters Veterans\u2019 Administration Medical Center, Bronx, New York, NY 10468, USA"},{"name":"Icahn School of Medicine at Mount Sinai, New York, NY 10029, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ren\u00e9 S.","family":"Kahn","sequence":"additional","affiliation":[{"name":"James J. Peters Veterans\u2019 Administration Medical Center, Bronx, New York, NY 10468, USA"},{"name":"Icahn School of Medicine at Mount Sinai, New York, NY 10029, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2019,7,10]]},"reference":[{"key":"ref_1","unstructured":"World Health Organization (2019, January 14). Preventing Suicide. A Global Imperative. WHO, 2014. Available online: http:\/\/www.who.int\/mental_health\/suicide-prevention\/world_report_2014\/en\/."},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"1372","DOI":"10.1016\/S0140-6736(09)60372-X","article-title":"Suicide","volume":"373","author":"Hawton","year":"2009","journal-title":"Lancet"},{"key":"ref_3","doi-asserted-by":"crossref","first-page":"196","DOI":"10.1007\/BF00789054","article-title":"An economic evaluation of schizophrenia-1991","volume":"30","author":"Wyatt","year":"1995","journal-title":"Soc. Psychiatry Psychiatr. Epidemiol."},{"key":"ref_4","doi-asserted-by":"crossref","first-page":"287","DOI":"10.1111\/acps.12842","article-title":"Life expectancy after the first suicide attempt","volume":"137","author":"Jokinen","year":"2018","journal-title":"Acta Psychiatr. Scand."},{"key":"ref_5","first-page":"1","article-title":"Suicide mortality in the United States, 1999\u20132017","volume":"330","author":"Hedegaard","year":"2018","journal-title":"NCHS Data Brief."},{"key":"ref_6","doi-asserted-by":"crossref","first-page":"393","DOI":"10.1016\/j.jmhg.2007.07.046","article-title":"Suicidality in men\u2014Practical issues, challenges, solutions","volume":"4","author":"Rutz","year":"2007","journal-title":"J. Men\u2019s Health Gender"},{"key":"ref_7","doi-asserted-by":"crossref","first-page":"302","DOI":"10.7326\/0003-4819-136-4-200202190-00010","article-title":"A current perspective of suicide and attempted suicide","volume":"136","author":"Mann","year":"2002","journal-title":"Ann. Intern. Med."},{"key":"ref_8","doi-asserted-by":"crossref","first-page":"337","DOI":"10.1016\/S1566-2772(01)00035-4","article-title":"Risk of suicide in mood disorders","volume":"1","author":"Sher","year":"2001","journal-title":"Clin. Neurosci. Res."},{"key":"ref_9","doi-asserted-by":"crossref","unstructured":"Br\u00e5dvik, L. (2018). Suicide risk and mental disorders. Int. J. Environ. Res. Public Health, 15.","DOI":"10.3390\/ijerph15092028"},{"key":"ref_10","doi-asserted-by":"crossref","first-page":"571","DOI":"10.1093\/schbul\/16.4.571","article-title":"Schizophrenics kill themselves too: A review of risk factors for suicide","volume":"16","author":"Caldwell","year":"1990","journal-title":"Schizophr. Bull."},{"key":"ref_11","doi-asserted-by":"crossref","first-page":"909","DOI":"10.1017\/S0033291700011910","article-title":"Early manifestations and first-contact incidence of schizophrenia in different cultures. A preliminary report on the initial evaluation phase of the WHO Collaborative Study on determinants of outcome of severe mental disorders","volume":"16","author":"Sartorius","year":"1986","journal-title":"Psychol. Med."},{"key":"ref_12","doi-asserted-by":"crossref","first-page":"700","DOI":"10.1100\/tsw.2006.146","article-title":"Alcohol and suicide: Neurobiological and clinical aspects","volume":"21","author":"Sher","year":"2006","journal-title":"Sci. World J."},{"key":"ref_13","doi-asserted-by":"crossref","first-page":"363","DOI":"10.1080\/13811118.2013.826153","article-title":"Elderly suicide with and without a history of suicidal behavior: Implications for suicide prevention and management","volume":"18","author":"Ho","year":"2014","journal-title":"Arch. Suicide Res."},{"key":"ref_14","doi-asserted-by":"crossref","first-page":"95","DOI":"10.1097\/01.yco.0000191498.69281.5e","article-title":"Suicide and deliberate self-harm in personality disorders","volume":"19","author":"Krysinska","year":"2006","journal-title":"Curr. Opin. Psychiatry"},{"key":"ref_15","doi-asserted-by":"crossref","first-page":"38","DOI":"10.1016\/j.ajp.2013.10.001","article-title":"Cluster analysis reveals risk factors for repeated suicide attempts in a multi-ethnic Asian population","volume":"8","author":"Choo","year":"2014","journal-title":"Asian J. Psychiatr."},{"key":"ref_16","doi-asserted-by":"crossref","first-page":"308","DOI":"10.1016\/j.amepre.2017.04.001","article-title":"Major physical health conditions and risk of suicide","volume":"53","author":"Ahmedani","year":"2017","journal-title":"Am. J. Prev. Med."},{"key":"ref_17","doi-asserted-by":"crossref","first-page":"1","DOI":"10.1016\/j.pneurobio.2013.06.003","article-title":"Pain and suicidality: Insights from reward and addiction neuroscience","volume":"109","author":"Elman","year":"2013","journal-title":"Prog. Neurobiol."},{"key":"ref_18","doi-asserted-by":"crossref","unstructured":"Rogers, M.L., and Joiner, T.E. (2019). Interactive effects of acute suicidal affective disturbance and pain persistence on suicide attempt frequency and lethality. Crisis, in press.","DOI":"10.1027\/0227-5910\/a000588"},{"key":"ref_19","first-page":"11","article-title":"Opioids, Suicide, Mental Disorders, and Pain","volume":"35","author":"King","year":"2018","journal-title":"Psychiatr. Times"},{"key":"ref_20","first-page":"12443","article-title":"Suicidal behavior and neurological illnesses","volume":"9","author":"Coughlin","year":"2013","journal-title":"J. Depress. Anxiety"},{"key":"ref_21","doi-asserted-by":"crossref","first-page":"430","DOI":"10.1097\/01.nmd.0000126706.53615.7b","article-title":"Suicidal behavior and mild traumatic brain injury in major depression","volume":"192","author":"Oquendo","year":"2004","journal-title":"J. Nerv. Ment. Dis."},{"key":"ref_22","doi-asserted-by":"crossref","first-page":"S39","DOI":"10.1111\/sltb.12257","article-title":"Prevention programs to augment family and child resilience can have lasting effects on suicidal risk","volume":"46","author":"Brent","year":"2016","journal-title":"Suicide Life Threat. Behav."},{"key":"ref_23","doi-asserted-by":"crossref","first-page":"341","DOI":"10.3109\/00048674.2011.560136","article-title":"Is it possible to predict suicide?","volume":"45","author":"Sher","year":"2011","journal-title":"Aust. N. Z. J. Psychiatry"},{"key":"ref_24","doi-asserted-by":"crossref","first-page":"661","DOI":"10.1093\/schbul\/sbs050","article-title":"Childhood adversities increase the risk of psychosis: A meta-analysis of patient-control, prospective-and cross-sectional cohort studies","volume":"38","author":"Varese","year":"2012","journal-title":"Schizophr. Bull."},{"key":"ref_25","doi-asserted-by":"crossref","first-page":"1423","DOI":"10.1007\/s00787-015-0760-y","article-title":"Life adversities and suicidal behavior in young individuals: A systematic review","volume":"24","author":"Serafini","year":"2015","journal-title":"Eur. Child. Adolesc. Psychiatry"},{"key":"ref_26","unstructured":"Bleuler, E. (1911). Dementia Praecox: oder Gruppe der Schizophrenien, Franz Deuticke."},{"key":"ref_27","first-page":"171","article-title":"Psychiatrische Randbemerkungen zur Zeitgeschichte","volume":"2","author":"Kraepelin","year":"1919","journal-title":"Suddeutsch. Monatshefte"},{"key":"ref_28","doi-asserted-by":"crossref","first-page":"877","DOI":"10.1001\/archneurpsyc.1939.02270230099008","article-title":"Follow-up study of five hundred patients with schizophrenia admitted to the hospital from 1913 to 1923","volume":"42","author":"Rennie","year":"1939","journal-title":"Arch. Neurol. Psychiatry"},{"key":"ref_29","doi-asserted-by":"crossref","first-page":"127","DOI":"10.1177\/026988110101500209","article-title":"Suicide and schizophrenia","volume":"15","author":"Siris","year":"2001","journal-title":"J. Psychopharmacol."},{"key":"ref_30","doi-asserted-by":"crossref","first-page":"167","DOI":"10.1111\/j.1600-0447.1994.tb01573.x","article-title":"Rates and correlates of suicide attempts in first-admission psychotic patients","volume":"90","author":"Cohen","year":"1994","journal-title":"Acta Psychiatr. Scand."},{"key":"ref_31","doi-asserted-by":"crossref","first-page":"1353","DOI":"10.1176\/ps.49.10.1353","article-title":"Factors associated with suicide attempts among patients with schizophrenia","volume":"49","author":"Gupta","year":"1998","journal-title":"Psychiatr. Serv."},{"key":"ref_32","doi-asserted-by":"crossref","first-page":"493","DOI":"10.1111\/j.1365-2850.2009.01375.x","article-title":"The development of the serious mental illness physical Health Improvement Profile","volume":"16","author":"White","year":"2009","journal-title":"J. Psychiatr. Ment. Health Nurs."},{"key":"ref_33","first-page":"126","article-title":"Schizophrenia and suicide","volume":"22","author":"Balhara","year":"2012","journal-title":"East. Asian Arch. Psychiatry"},{"key":"ref_34","doi-asserted-by":"crossref","first-page":"863","DOI":"10.1016\/j.psc.2009.08.005","article-title":"Management of schizophrenia with suicide risk","volume":"32","author":"Roy","year":"2009","journal-title":"Psychiatr. Clin. N. Am."},{"key":"ref_35","doi-asserted-by":"crossref","first-page":"418","DOI":"10.1111\/acps.12332","article-title":"Risk factors for suicide in schizophrenia: Systematic review and clinical recommendations","volume":"130","author":"Popovic","year":"2014","journal-title":"Acta Psychiatr. Scand."},{"key":"ref_36","doi-asserted-by":"crossref","first-page":"12","DOI":"10.1016\/j.schres.2016.08.009","article-title":"Lifetime suicide intent, executive function and insight in schizophrenia and schizoaffective disorders","volume":"178","author":"Verma","year":"2016","journal-title":"Schizophr. Res."},{"key":"ref_37","first-page":"14","article-title":"Suicide in schizophrenia: The Iowa Record Linkage Study","volume":"46","author":"Black","year":"1985","journal-title":"J. Clin. Psychiatry"},{"key":"ref_38","doi-asserted-by":"crossref","first-page":"503","DOI":"10.1192\/bjp.141.5.503","article-title":"Suicide in psychiatric in-patients","volume":"141","author":"Copas","year":"1982","journal-title":"Br. J. Psychiatry"},{"key":"ref_39","doi-asserted-by":"crossref","first-page":"239","DOI":"10.1177\/070674379103600401","article-title":"Mortality in a cohort of patients with schizophrenia: A record linkage study","volume":"36","author":"Newman","year":"1991","journal-title":"Can. J. Psychiatry"},{"key":"ref_40","doi-asserted-by":"crossref","first-page":"206","DOI":"10.1176\/ajp.141.2.206","article-title":"Characterization of schizophrenic patients who commit suicide","volume":"141","author":"Breier","year":"1984","journal-title":"Am. J. Psychiatry"},{"key":"ref_41","doi-asserted-by":"crossref","first-page":"171","DOI":"10.1192\/bjp.141.2.171","article-title":"Suicide in chronic schizophrenia","volume":"141","author":"Roy","year":"1982","journal-title":"Br. J. Psychiatry"},{"key":"ref_42","doi-asserted-by":"crossref","first-page":"625","DOI":"10.1016\/S0193-953X(05)70334-8","article-title":"Management of the suicidal patient with schizophrenia","volume":"20","author":"Nelson","year":"1997","journal-title":"Psychiatr. Clin. North. Am."},{"key":"ref_43","doi-asserted-by":"crossref","first-page":"932","DOI":"10.1176\/ajp.139.7.932","article-title":"Violent and suicidal behavior in psychotic adolescents","volume":"139","author":"Inamdar","year":"1982","journal-title":"Am. J. Psychiatry"},{"key":"ref_44","doi-asserted-by":"crossref","first-page":"303","DOI":"10.1192\/bjp.144.3.303","article-title":"Attempted suicide in chronic schizophrenia","volume":"144","author":"Roy","year":"1984","journal-title":"Br. J. Psychiatry"},{"key":"ref_45","doi-asserted-by":"crossref","first-page":"401","DOI":"10.1111\/j.1600-0447.1974.tb09705.x","article-title":"Treatment results achieved in psychiatric day hospital care: A follow-up of 100 patients","volume":"50","author":"Niskanen","year":"1974","journal-title":"Acta Psychiatr. Scand."},{"key":"ref_46","doi-asserted-by":"crossref","first-page":"387","DOI":"10.1097\/NMD.0000000000000296","article-title":"Suicidal behavior and mortality in first-episode psychosis","volume":"203","author":"Nordentoft","year":"2015","journal-title":"J. Nerv. Ment. Dis."},{"key":"ref_47","doi-asserted-by":"crossref","first-page":"1181","DOI":"10.1001\/archpsyc.1978.01770340031002","article-title":"Excess mortality in schizophrenia and affective disorders. Do suicides and accidental deaths solely account for this excess?","volume":"35","author":"Tsuang","year":"1978","journal-title":"Arch. Gen. Psychiatry"},{"key":"ref_48","doi-asserted-by":"crossref","first-page":"11","DOI":"10.1016\/j.schres.2010.03.022","article-title":"Suicidality before and in the early phases of first episode psychosis","volume":"119","author":"Barrett","year":"2010","journal-title":"Schizophr. Res."},{"key":"ref_49","doi-asserted-by":"crossref","first-page":"458","DOI":"10.1001\/jamapsychiatry.2018.0185","article-title":"Association of an early intervention service for psychosis with suicide rate among patients with first-episode schizophrenia-spectrum disorders","volume":"75","author":"Chan","year":"2018","journal-title":"JAMA Psychiatry"},{"key":"ref_50","doi-asserted-by":"crossref","first-page":"116","DOI":"10.3389\/fpsyt.2016.00116","article-title":"Suicide in the early stage of schizophrenia","volume":"7","author":"Ventriglio","year":"2016","journal-title":"Front. Psychiatry"},{"key":"ref_51","doi-asserted-by":"crossref","first-page":"1153","DOI":"10.1586\/ern.10.82","article-title":"Suicide in schizophrenia","volume":"10","author":"Carlborg","year":"2010","journal-title":"Expert Rev. Neurother."},{"key":"ref_52","doi-asserted-by":"crossref","first-page":"9","DOI":"10.1192\/bjp.187.1.9","article-title":"Schizophrenia and suicide: Systematic review of risk factors","volume":"187","author":"Hawton","year":"2005","journal-title":"Br. J. Psychiatry"},{"key":"ref_53","doi-asserted-by":"crossref","first-page":"81","DOI":"10.1177\/1359786810385490","article-title":"Suicide and schizophrenia: A systematic review of rates and risk factors","volume":"24","author":"Hor","year":"2010","journal-title":"J. Psychopharmacol."},{"key":"ref_54","doi-asserted-by":"crossref","first-page":"199","DOI":"10.1176\/ajp.154.2.199","article-title":"Symptoms, subtype, and suicidality in patients with schizophrenia spectrum disorders","volume":"154","author":"Fenton","year":"1997","journal-title":"Am. J. Psychiatry"},{"key":"ref_55","doi-asserted-by":"crossref","first-page":"224","DOI":"10.1136\/bmj.38881.382755.2F","article-title":"Effectiveness of antipsychotic treatments in a nationwide cohort of patients in community care after first hospitalisation due to schizophrenia and schizoaffective disorder: Observational follow-up study","volume":"333","author":"Tiihonen","year":"2006","journal-title":"BMJ"},{"key":"ref_56","doi-asserted-by":"crossref","first-page":"253","DOI":"10.1017\/S1092852917000128","article-title":"A biopsychosocial evaluation of the risk for suicide in schizophrenia","volume":"23","author":"Hettige","year":"2018","journal-title":"CNS Spectr."},{"key":"ref_57","doi-asserted-by":"crossref","first-page":"s140","DOI":"10.1192\/bjp.191.51.s140","article-title":"Suicidal behaviour and mortality in first-episode psychosis: The OPUS trial","volume":"51","author":"Bertelsen","year":"2007","journal-title":"Br. J. Psychiatry"},{"key":"ref_58","doi-asserted-by":"crossref","first-page":"231","DOI":"10.1016\/j.schres.2008.12.023","article-title":"Risk factors for suicide in schizophrenia: Findings from a Swedish population-based case-control study","volume":"108","author":"Reutfors","year":"2009","journal-title":"Schizophr. Res."},{"key":"ref_59","doi-asserted-by":"crossref","first-page":"803","DOI":"10.1093\/oxfordjournals.schbul.a007133","article-title":"Suicide in schizophrenia: A retrospective case-control study of 51 suicides","volume":"30","author":"Sinclair","year":"2004","journal-title":"Schizophr. Bull."},{"key":"ref_60","doi-asserted-by":"crossref","first-page":"533","DOI":"10.1093\/oxfordjournals.schbul.a033399","article-title":"Suicide risk in schizophrenia: An analysis of 17 consecutive suicides","volume":"25","author":"Saarinen","year":"1999","journal-title":"Schizophr. Bull."},{"key":"ref_61","doi-asserted-by":"crossref","first-page":"213","DOI":"10.1016\/S0920-9964(01)00373-5","article-title":"Panic attacks in schizophrenia","volume":"58","author":"Goodwin","year":"2002","journal-title":"Schizophr. Res."},{"key":"ref_62","doi-asserted-by":"crossref","first-page":"217","DOI":"10.1016\/j.schres.2007.09.009","article-title":"What is specific to suicide in schizophrenia disorder? Demographic, clinical and behavioural dimensions","volume":"98","author":"McGirr","year":"2008","journal-title":"Schizophr. Res."},{"key":"ref_63","doi-asserted-by":"crossref","first-page":"242","DOI":"10.4088\/JCP.v68n0209","article-title":"Predictors of suicide in first-episode affective and nonaffective psychotic inpatients: Five-year follow-up of patients from a catchment area in Vitoria, Spain","volume":"68","author":"Aldama","year":"2007","journal-title":"J. Clin. Psychiatry"},{"key":"ref_64","first-page":"128","article-title":"Do antipsychotic drugs influence suicidal behavior in schizophrenia?","volume":"40","author":"Aguilar","year":"2007","journal-title":"Psychopharmacol. Bull."},{"key":"ref_65","doi-asserted-by":"crossref","first-page":"694","DOI":"10.1097\/JCP.0b013e3182677958","article-title":"German Study Group on First-Episode Schizophrenia. Akathisia and suicidal ideation in first-episode schizophrenia","volume":"32","author":"Schennach","year":"2012","journal-title":"J. Clin. Psychopharmacol."},{"key":"ref_66","doi-asserted-by":"crossref","first-page":"292","DOI":"10.1055\/s-0032-1309004","article-title":"The relationship of Akathisia with treatment emergent suicidality among patients with first-episode schizophrenia treated with haloperidol or risperidone","volume":"45","author":"Lewitzka","year":"2012","journal-title":"Pharmacopsychiatry"},{"key":"ref_67","doi-asserted-by":"crossref","first-page":"341","DOI":"10.1002\/hup.2536","article-title":"Suicide risk and antipsychotic side effects in schizophrenia: Nested case-control study","volume":"31","author":"Reutfors","year":"2016","journal-title":"Hum. Psychopharmacol."},{"key":"ref_68","doi-asserted-by":"crossref","first-page":"81","DOI":"10.1111\/j.1600-0447.1994.tb01491.x","article-title":"Negative and depressive symptoms in suicidal schizophrenics","volume":"89","author":"Jones","year":"1994","journal-title":"Acta Psychiatr. Scand."},{"key":"ref_69","doi-asserted-by":"crossref","first-page":"428","DOI":"10.1016\/S0924-9338(01)00602-2","article-title":"Dexamethasone suppression test and suicide attempts in schizophrenic patients","volume":"16","author":"Araszkiewicz","year":"2001","journal-title":"Eur. Psychiatry"},{"key":"ref_70","doi-asserted-by":"crossref","first-page":"91","DOI":"10.1177\/1359786810385491","article-title":"A systematic review of hypothalamic-pituitary-adrenal axis function in schizophrenia: Implications for mortality","volume":"24","author":"Bradley","year":"2010","journal-title":"J. Psychopharmacol."},{"key":"ref_71","doi-asserted-by":"crossref","first-page":"940","DOI":"10.1016\/0140-6736(92)92819-2","article-title":"5-Hydroxyindoleacetic acid in cerebrospinal fluid and prediction of suicidal behaviour in schizophrenia","volume":"340","author":"Cooper","year":"1992","journal-title":"Lancet"},{"key":"ref_72","doi-asserted-by":"crossref","unstructured":"Kim, S., Choi, K.H., Baykiz, A.F., and Gershenfeld, H.K. (2007). Suicide candidate genes associated with bipolar disorder and schizophrenia: An exploratory gene expression profiling analysis of post-mortem prefrontal cortex. BMC Genom., 8.","DOI":"10.1186\/1471-2164-8-413"},{"key":"ref_73","first-page":"1427","article-title":"Comparative study on gene tags of the neurotransmission system in schizophrenic and suicidal subjects","volume":"34","author":"Molnar","year":"2010","journal-title":"Coll. Antropol."},{"key":"ref_74","doi-asserted-by":"crossref","first-page":"1711","DOI":"10.2147\/NDT.S107178","article-title":"Risk factors for suicide among patients with schizophrenia: A cohort study focused on cerebrospinal fluid levels of homovanillic acid and 5-hydroxyindoleacetic acid","volume":"12","author":"Neider","year":"2016","journal-title":"Neuropsychiatr. Dis. Treat."},{"key":"ref_75","doi-asserted-by":"crossref","first-page":"335","DOI":"10.1017\/S0033291700023618","article-title":"CSF monoamine metabolites in chronic schizophrenic patients who attempt suicide","volume":"15","author":"Roy","year":"1985","journal-title":"Psychol. Med."},{"key":"ref_76","doi-asserted-by":"crossref","first-page":"926","DOI":"10.1016\/0006-3223(90)90475-H","article-title":"CSF 5-hydroxyindoleacetic acid levels and suicide attempts in schizophrenia","volume":"27","author":"Lemus","year":"1990","journal-title":"Biol. Psychiatry"},{"key":"ref_77","doi-asserted-by":"crossref","first-page":"80","DOI":"10.1016\/j.schres.2009.04.006","article-title":"CSF 5-HIAA, attempted suicide and suicide risk in schizophrenia spectrum psychosis","volume":"112","author":"Carlborg","year":"2009","journal-title":"Schizophr. Res."},{"key":"ref_78","doi-asserted-by":"crossref","first-page":"75","DOI":"10.1016\/S0920-9964(01)00181-5","article-title":"Serotonergic function and suicidal behavior in schizophrenia","volume":"56","author":"Duval","year":"2002","journal-title":"Schizophr. Res."},{"key":"ref_79","first-page":"4","article-title":"The efficacy of atypical antipsychotics in the treatment of depressive symptoms, hostility, and suicidality in patients with schizophrenia","volume":"61","author":"Keck","year":"2000","journal-title":"J. Clin. Psychiatry"},{"key":"ref_80","doi-asserted-by":"crossref","first-page":"215","DOI":"10.1007\/s00213-004-1801-2","article-title":"Suicidality and second generation antipsychotics in schizophrenia patients: A case-controlled retrospective study during a 5-year period","volume":"175","author":"Barak","year":"2004","journal-title":"Psychopharmacology"},{"key":"ref_81","doi-asserted-by":"crossref","first-page":"82","DOI":"10.1001\/archpsyc.60.1.82","article-title":"International Suicide Prevention Trial Study Group. Clozapine treatment for suicidality in schizophrenia: International Suicide Prevention Trial (InterSePT)","volume":"60","author":"Meltzer","year":"2003","journal-title":"Arch. Gen. Psychiatry"},{"key":"ref_82","doi-asserted-by":"crossref","first-page":"931","DOI":"10.1176\/appi.ajp.158.6.931","article-title":"Impact of clozapine on completed suicide","volume":"158","author":"Sernyak","year":"2001","journal-title":"Am. J. Psychiatry"},{"key":"ref_83","doi-asserted-by":"crossref","first-page":"686","DOI":"10.1001\/jamapsychiatry.2017.1322","article-title":"Real-world effectiveness of antipsychotic treatments in a Nationwide Cohort of 29,823 patients with schizophrenia","volume":"74","author":"Tiihonen","year":"2017","journal-title":"JAMA Psychiatry"},{"key":"ref_84","doi-asserted-by":"crossref","first-page":"172","DOI":"10.1017\/S1121189X00000427","article-title":"The role of psychopharmacology in suicide prevention","volume":"18","author":"Saunders","year":"2009","journal-title":"Epidemiol. Psichiatr. Soc."},{"key":"ref_85","doi-asserted-by":"crossref","first-page":"797","DOI":"10.1016\/S2215-0366(18)30252-9","article-title":"Amisulpride and olanzapine followed by open-label treatment with clozapine in first-episode schizophrenia and schizophreniform disorder (OPTiMiSE): A three-phase switching study","volume":"5","author":"Kahn","year":"2018","journal-title":"Lancet Psychiatry"},{"key":"ref_86","doi-asserted-by":"crossref","first-page":"423","DOI":"10.1002\/pds.837","article-title":"Increased suicide attempt rate among patients interrupting use of atypical antipsychotics","volume":"12","author":"Herings","year":"2003","journal-title":"Pharmacoepidemiol. Drug Saf."},{"key":"ref_87","doi-asserted-by":"crossref","first-page":"361","DOI":"10.1097\/00004850-199911000-00007","article-title":"Structured diagnostic assessment and depot fluphenazine treatment of multiple suicide attempters in the emergency department","volume":"14","author":"Battaglia","year":"1999","journal-title":"Int. Clin. Psychopharmacol."},{"key":"ref_88","doi-asserted-by":"crossref","first-page":"235","DOI":"10.1097\/00004714-198308000-00006","article-title":"Suicide associated with akathisia and depot fluphenazine treatment","volume":"3","author":"Shear","year":"1983","journal-title":"J. Clin. Psychopharmacol."},{"key":"ref_89","first-page":"CD000307","article-title":"Depot fluphenazine for schizophrenia","volume":"2","author":"Adams","year":"2000","journal-title":"Cochrane Database Syst. Rev."},{"key":"ref_90","doi-asserted-by":"crossref","first-page":"1438","DOI":"10.1093\/schbul\/sbw043","article-title":"Mortality risk associated with long-acting injectable antipsychotics: A systematic review and meta-analyses of randomized controlled trials","volume":"42","author":"Kishi","year":"2016","journal-title":"Schizophr. Bull."},{"key":"ref_91","doi-asserted-by":"crossref","first-page":"454","DOI":"10.2174\/1871527316666170223163629","article-title":"Suicide prevention in schizophrenia: Do long-acting injectable antipsychotics (LAIs) have a role?","volume":"16","author":"Pompili","year":"2017","journal-title":"CNS Neurol. Disord. Drug Targets"},{"key":"ref_92","doi-asserted-by":"crossref","first-page":"159","DOI":"10.1111\/j.1600-0447.2006.00822.x","article-title":"Increased antidepressant use and fewer suicides in J\u00e4mtland county, Sweden, after a primary care educational programme on the treatment of depression","volume":"114","author":"Henriksson","year":"2006","journal-title":"Acta Psychiatr. Scand."},{"key":"ref_93","doi-asserted-by":"crossref","first-page":"153","DOI":"10.1080\/09540260500071608","article-title":"Antidepressant drug use and suicide prevention","volume":"17","author":"Isacsson","year":"2005","journal-title":"Int. Rev. Psychiatry"},{"key":"ref_94","doi-asserted-by":"crossref","first-page":"686","DOI":"10.1002\/pds.1579","article-title":"Association between medication and risk of suicide, attempted suicide and death in nationwide cohort of suicidal patients with schizophrenia","volume":"17","author":"Haukka","year":"2008","journal-title":"Pharmacoepidemiol. Drug Saf."},{"key":"ref_95","first-page":"534","article-title":"Critical treatment issues in suicide among schizophrenics","volume":"36","author":"Cotton","year":"1985","journal-title":"Hosp. Community Psychiatry"},{"key":"ref_96","doi-asserted-by":"crossref","first-page":"15067","DOI":"10.1038\/nrdp.2015.67","article-title":"Schizophrenia","volume":"1","author":"Kahn","year":"2015","journal-title":"Nat. Rev. Dis. Primers"},{"key":"ref_97","doi-asserted-by":"crossref","first-page":"284","DOI":"10.1521\/suli.2007.37.3.284","article-title":"Cognitive behavioral therapy reduces suicidal ideation in schizophrenia: Results from a randomized controlled trial","volume":"37","author":"Bateman","year":"2007","journal-title":"Suicide Life Threat. Behav."},{"key":"ref_98","doi-asserted-by":"crossref","first-page":"223","DOI":"10.1111\/j.1752-0606.2003.tb01202.x","article-title":"Family psychoeducation and schizophrenia: A review of the literature","volume":"29","author":"McFarlane","year":"2003","journal-title":"J. Marital Fam. Ther."},{"key":"ref_99","doi-asserted-by":"crossref","first-page":"113","DOI":"10.1017\/S2045796011000187","article-title":"Family interventions in early psychosis: Specificity and effectiveness","volume":"20","author":"Onwumere","year":"2011","journal-title":"Epidemiol. Psychiatr. Sci."},{"key":"ref_100","doi-asserted-by":"crossref","first-page":"111","DOI":"10.1097\/FCH.0000000000000178","article-title":"The relationship between expressed emotion and the probability of suicide among Turkish psychiatric outpatients: A descriptive cross-sectional survey","volume":"41","author":"Demir","year":"2018","journal-title":"Fam. Community Health"},{"key":"ref_101","doi-asserted-by":"crossref","first-page":"1057","DOI":"10.11124\/JBISRIR-2017-003361","article-title":"Effectiveness of family interventions on psychological distress and expressed emotion in family members of individuals diagnosed with first-episode psychosis: A systematic review","volume":"15","author":"Napa","year":"2017","journal-title":"JBI Database Syst. Rev. Implement. Rep."},{"key":"ref_102","doi-asserted-by":"crossref","first-page":"12","DOI":"10.4103\/0253-7176.96149","article-title":"Expressed emotion in schizophrenia: An overview","volume":"34","author":"Amaresha","year":"2012","journal-title":"Indian J. Psychol. 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