Discussion
The 1-year rate of suicide attempts for patients with schizophrenia
in this study was nearly 2% (n = 32), which is much
lower than the 45% lifetime suicide-attempt rate reported for
Turkish patients with schizophrenia (Evren & Evren 2004) or
the 6-year suicide-attempt rate of 38% reported for US
patients with schizophrenia (Roy & Pompili 2009). Our
lower suicide-attempt rate is likely due to our inventory
assessing only suicide attempts in the previous year. However,
our rate is closer to the lifetime suicide-attempt rate of 7Æ5%
reported for rural patients with schizophrenia in mainland
China (Ran et al. 2003). The much lower lifetime suicideattempt
rate in Ran’s study than in the two western studies
(Evren & Evren 2004, Roy & Pompili 2009) might have been
due to the Chinese cultural stigma associated with suicide and
mental illness (Ma et al. 2010), which might have contributed
to underreporting by Taiwanese people with schizophrenia.
Although our study found a low rate of attempted suicide
in the previous year, suicide attempts were significantly
predicted by four indicators: self-harm incidents, violent
incidents towards others, follow-ups by mental health clinics
and involuntary hospitalisations, all in the previous year.
Overall, the first two and the final predictors are consistent
with the previous reports (Haukka et al. 2008, Robinson
et al. 2010) that these predictors have traits related to violent
behaviours towards self or others (Rogers 2008). This finding
may be explained by the association between patients’
suicidal behaviours and their high impulsivity (Iancua et al.
2010). This explanation is consistent with the correlation
outcomes, which indicate that violent incidents towards
others were significantly related to suicide attempts, selfharm,
involuntary hospitalisations and receiving treatment in
an acute ward.
DiscussionThe 1-year rate of suicide attempts for patients with schizophreniain this study was nearly 2% (n = 32), which is muchlower than the 45% lifetime suicide-attempt rate reported forTurkish patients with schizophrenia (Evren & Evren 2004) orthe 6-year suicide-attempt rate of 38% reported for USpatients with schizophrenia (Roy & Pompili 2009). Ourlower suicide-attempt rate is likely due to our inventoryassessing only suicide attempts in the previous year. However,our rate is closer to the lifetime suicide-attempt rate of 7Æ5%reported for rural patients with schizophrenia in mainlandChina (Ran et al. 2003). The much lower lifetime suicideattemptrate in Ran’s study than in the two western studies(Evren & Evren 2004, Roy & Pompili 2009) might have beendue to the Chinese cultural stigma associated with suicide andmental illness (Ma et al. 2010), which might have contributedto underreporting by Taiwanese people with schizophrenia.Although our study found a low rate of attempted suicidein the previous year, suicide attempts were significantlypredicted by four indicators: self-harm incidents, violentincidents towards others, follow-ups by mental health clinicsand involuntary hospitalisations, all in the previous year.Overall, the first two and the final predictors are consistentwith the previous reports (Haukka et al. 2008, Robinsonet al. 2010) that these predictors have traits related to violentbehaviours towards self or others (Rogers 2008). This findingmay be explained by the association between patients’suicidal behaviours and their high impulsivity (Iancua et al.2010). This explanation is consistent with the correlationoutcomes, which indicate that violent incidents towardsothers were significantly related to suicide attempts, selfharm,involuntary hospitalisations and receiving treatment inan acute ward.
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