A biopsychosocial evaluation of the risk for suicide in schizophrenia

CNS Spectr. 2018 Aug;23(4):253-263. doi: 10.1017/S1092852917000128. Epub 2017 May 24.


The risk of suicide is greatly increased in individuals with schizophrenia. Previous research has identified several potential risk factors for suicidal behavior in schizophrenia, although their ability to independently predict suicide is limited. The objective of this review was to systematically analyze and identify the interaction between the proposed risk factors in the literature that may predict suicidal behavior in schizophrenia. Articles that explored suicidal behavior and suicide risk in schizophrenia that were published between 1980 and August of 2015, indexed in PubMed, MEDLINE, and Scopus were systematically reviewed. Many studies proposed a range of biopsychosocial risk factors that may independently lead to suicide in schizophrenia. These risk factors appear to be mainly related to stress, a history of suicidal behavior, and psychotic symptoms. It is clear, however, that many of these factors do not act independently and in fact require the reciprocal interaction of several of them to pose a risk for suicide in schizophrenia. Independently, the power of many risk factors to predict suicide is limited. Future studies should continue to adopt a multidimensional approach by considering the interaction of several factors in assessing the risk for suicide in schizophrenia.

Keywords: Schizophrenia; childhood trauma; genetics; stress; suicide.

Publication types

  • Research Support, Non-U.S. Gov't
  • Review

MeSH terms

  • Humans
  • Schizophrenia / diagnosis*
  • Schizophrenia / epidemiology
  • Schizophrenic Psychology*
  • Suicide, Attempted / prevention & control
  • Suicide, Attempted / psychology*
  • Suicide, Attempted / statistics & numerical data