Suicidal behaviour and schizophrenia: promising preventative and curative biopsychosocial interventions

This article reviews the literature dealing with the treatment of at-risk patients with schizophrenia and suicidal behaviour. With the purpose of assisting mental health professionals to better understand some of the treatment challenges. The treatment of suicidal patients with a diagnosis of schizophrenia involves careful assessment of risk factors and formulation of a comprehensive safety plan involving biopsychosocial interventions. Although there is at least modest evidence suggesting that antipsychotic medications protect against suicidal risk, the evidence appears to be most favourable for second-generation antipsychotics, particularly clozapine. In addition, treating depressive symptoms in patients with schizophrenia is an important component of suicide risk reduction. This includes building patients’ social support networks and teaching positive coping skills. Furthermore, both psychosocial and pharmacological approaches applied in the long term should help minimize the risk of suicide. Further research is needed to more effectively personalize the treatment of suicidal thoughts and behaviours and the prevention of suicide in patients with schizophrenia.