Clinical and Psychopathological Typology of Suicidal Behavior in Youth Schizophrenia

Background: suicidal behavior in schizophrenia is a key factor in the poor prognosis and is characterized by high prevalence, especially in the  first years after the onset of the disease. In schizophrenia, suicide risk is shaped not so much by individual factors as by their complex interactions. The use of screening scales and formalized algorithms for assessing suicide risk is associated with a high rate of false positives. This justifies the need for a typological analysis of suicidal patterns in patients with juvenile schizophrenia to study pathogenesis and to optimize preventive and therapeutic approaches. The aim was to develop a clinical and psychopathological typology of suicidal behavior patterns in patients with schizophrenia in adolescence. Patients and Methods: 52 patients were examined using a continuous sampling method. The study included patients aged 16 to 25 years with an established diagnosis of schizophrenia (ICD-10 F20) at onset of disease. The Calgary Depression Schizophrenia Scale (CDSS) was used to assess the severity of depressive symptoms. The Positive and Negative Symptom Scale (PANSS) was used to assess the severity of positive and negative symptoms. The Beck Hopelessness Inventory (BHS) was used to measure the degree of negative attitudes toward the future. Results: based on an analysis of the clinical and psychopathological characteristics, three clinical patterns of suicidal behavior were developed. In the first group (n = 25; 48.1%), suicidal behavior was primarily due to the presence of psychopathological symptoms. In the second group (n = 17; 32.7%), suicidal behavior was due to a reaction to the illness and dissatisfaction with quality of life. In the third group (n = 10; 19.2%), patients exhibited psychopathic-like impulsive suicidal behavior associated with a traumatic event. Patterns of correlation between the identified types and the psychopathological characteristics of juvenile schizophrenia were determined. Conclusions: the typology of suicidal behavior in patients with juvenile schizophrenia forms the basis for the creation of personalized prevention programs aimed at early detection of the threat of selfaggression, increasing treatment adherence, and reducing the likelihood of repeated suicide attempts.

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