The presented study constitutes one

The presented study constitutes one in only a few examples of
naturalistic drug trials in psychosis with thorough suicidality
reporting. We want to warn against underestimating the risk
contributed by hallucinations on suicidal ideation, plans and
attempts, although it may not contribute to suicides on a group
level [21]. The suffering and human cost due to suicide attempts
may be substantial and the prevention of suicide ideation and
attempts in themselves is in its own term highly important.
Positive symptoms of schizophrenia are generally responsive to
antipsychotic medication particularly in first episode patients
where the suicide risk is high [10,35]. This is in the opinion of the
authors an important aspect to consider in the timing of initiation
and choice of antipsychotic medication [35]. Hallucinations and
particularly the impact of voices in patients with schizophrenia are
also amenable to cognitive behavioural interventions [43,54].
Some authors have argued for the need for more qualitative
information about AVHs as a risk factor for suicide and that the
scarcity of qualitative data may be a component in the heterogeneous
results of the quantitative data [50]. Studies indicate that
AVHs only contribute to depression and suicidality where they
lead to increased distress, due to interpersonal schema or where
the patient experiences less control [6,9]. Future research should
aim to study prospective data and qualitative aspects of AVHs and
their impact on suicidal symptomatology in patients suffering
from schizophrenia