Psychiatria i Psychologia Kliniczna (Mar 2010)
Suicidal ideation and quality of life in patients with a first episode of schizophrenia
Abstract
Introduction: Risk of suicide in patients with schizophrenia is 20- to 50-fold higher than in the general population. The impact of suicidal behaviour on quality of life rarely was a subject of in-depth analysis. The issue is particularly important in patients after first psychiatric hospitalisation, since the risk of suicide is very high during the first postdischarge months. The aim of this study was to analyse correlations between presence of suicidal ideations prior to first hospitalisation and quality of life of patients with schizophrenia during the first post-hospitalisation year. Material and method: Overall, 86 patients were enrolled in the study. Suicidal ideations and behaviours were assessed based on interviews with patients and their relatives, as well as on medical records. The patients’ quality of life was evaluated one month (1st exam) and after one year (2nd exam) after discharge. Quality of life was assessed using the WHOQOL questionnaire and the SFS scale. Psychopathological symptoms were evaluated using the PANSS inventory. Results: Prior to first hospitalisation, suicidal ideations were present in 39.5% of our patients. Persons with suicidal thoughts presented more severe psychopathological symptoms (1st exam; p=0.05). Both examinations revealed differences in the patients’ quality of life. Lack of suicidal ideations was associated with a better quality of life as assessed by the WHOQOL questionnaire in the following domains: general well-being (1st and 2nd exam), state of health (1st exam), Mental (1st and 2nd exam), Physical (1st exam), Environmental domains (1st exam) and Work/Employment (SFS scale, 1st and 2nd exam). A correlation was noticed between suicidal ideation and change in quality of life (WHOQOL) in domains Social relationships and Environmental. An improvement of quality of life in this domain was noticed in persons with suicidal ideations. Conclusions: Suicidal ideations prior to first psychiatric hospitalisation constitute an important predictive factor for a worse quality of life in patients with schizophrenia one year after discharge from hospital.
