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The relationship between suicide and violence in schizophrenia: analysis of the Clinical Antipsychotic Trials of Intervention Effectiveness (CATIE) dataset

Witt, Katrina, Hawton, Keith and Fazel, Seena 2014, The relationship between suicide and violence in schizophrenia: analysis of the Clinical Antipsychotic Trials of Intervention Effectiveness (CATIE) dataset, Schizophrenia research, vol. 154, no. 1-3, pp. 61-67, doi: 10.1016/j.schres.2014.02.001.

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Title The relationship between suicide and violence in schizophrenia: analysis of the Clinical Antipsychotic Trials of Intervention Effectiveness (CATIE) dataset
Author(s) Witt, Katrina
Hawton, Keith
Fazel, Seena
Journal name Schizophrenia research
Volume number 154
Issue number 1-3
Start page 61
End page 67
Total pages 7
Publisher Elsevier
Place of publication Amsterdam, The Netherlands
Publication date 2014-04
ISSN 0920-9964
Keyword(s) Schizophrenia
Psychosis
Violence
Suicide
Risk factors
Risk assessment
Summary Background

Suicide and violence often co-occur in the general population as well as in mentally ill individuals. Few studies, however, have assessed whether these suicidal behaviors are predictive of violence risk in mental illness.

Aims

The aim of this study is to investigate whether suicidal behaviors, including suicidal ideation, threats, and attempts, are significantly associated with increased violence risk in individuals with schizophrenia.

Method

Data for these analyses were obtained from the Clinical Antipsychotic Trials of Intervention Effectiveness (CATIE) trial, a randomized controlled trial of antipsychotic medication in 1460 adults with schizophrenia. Univariate Cox regression analyses were used to calculate hazard ratios (HRs) for suicidal ideation, threats, and attempts. Multivariate analyses were conducted to adjust for common confounding factors, including: age, alcohol or drug misuse, major depression, antisocial personality disorder, depression, hostility, positive symptom, and poor impulse control scores. Tests of discrimination, calibration, and reclassification assessed the incremental predictive validity of suicidal behaviors for the prediction of violence risk.

Results

Suicidal threats and attempts were significantly associated with violence in both males and females with schizophrenia with little change following adjustment for common confounders. Only suicidal threats, however, were associated with a significant increase in incremental validity beyond age, diagnosis with a comorbid substance use disorder, and recent violent behavior.

Conclusions

Suicidal threats are independently associated with violence risk in both males and females with schizophrenia, and may improve violence risk prediction.
Language eng
DOI 10.1016/j.schres.2014.02.001
Field of Research 170101 Biological Psychology (Neuropsychology, Psychopharmacology, Physiological Psychology)
Socio Economic Objective 920209 Mental Health Services
HERDC Research category C1.1 Refereed article in a scholarly journal
ERA Research output type C Journal article
Copyright notice ©2014, The Authors
Persistent URL http://hdl.handle.net/10536/DRO/DU:30080886

Document type: Journal Article
Collection: School of Health and Social Development
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