Society for Social Work and Research

Sixteenth Annual Conference Research That Makes A Difference: Advancing Practice and Shaping Public Policy
11-15 January 2012 I Grand Hyatt Washington I Washington, DC

117P Quality of Life and Suicide In Schizophrenia; What We Don't Know Can Hurt Us

Saturday, January 14, 2012
Independence F - I (Grand Hyatt Washington)
* noted as presenting author
Anthony Fulginiti, MSW, Ph.D. Student, University of Southern California, Los Angeles, CA
John S. Brekke, PhD, Frances Larson Professor of Social Work Research, Associate Dean of Research, University of Southern California, Los Angeles, CA
Background: Individuals diagnosed with schizophrenia have a suicide rate that is greater than 8-fold the rate of the general population. Unfortunately, research pertaining to the relationship between quality of life and suicide has generally been restricted to suicide in the end-of-life care context. Quality of life appears especially well-suited as a target of investigation in suicide risk for individuals with schizophrenia because it is an illness that has profound effects on quality of life.

Purpose: The current study aimed to explore the relationship between various quality of life indices and suicide risk in an outpatient sample of individuals with schizophrenia. Specifically, the study sought to (1) examine differences on a range of quality of life measures in groups with and without evidence of current suicidality and (2) examine quality of life differences between groups of individuals classified by current and historical suicide status.

Methods: We used pooled data from two NIMH-funded studies investigating the psychosocial rehabilitation of individuals with serious mental illness. All individuals with a diagnosis of schizophrenia (N=223) were selected for analysis. The Satisfaction with Life Scale (SLS), the Role Functioning Scale (RFS) and the Brief Psychiatric Rating Scale (BPRS) were used to measure subjective and objective quality of life indices. Evidence of current suicidality was determined by a non-zero rating of suicidality on the BPRS. History of suicide attempt was measured using self-report.

Two stages of analysis were conducted in the study. In the first stage, we compared suicide and non-suicide groups on quality of life measures. In the second stage, we examined quality of life differences in groups based on current and historical suicide status. In stage two we analyzed differences among four groups: (i) current and historical suicide, (ii) current suicide only, (iii) history suicide only, and (iii) no suicide.

Results: In the first stage of analysis, a series of t-tests revealed significant differences between the suicide and non-suicide groups on general life satisfaction (t=2.760, p<.01), satisfaction with social relationships (t=2.364, p<.01), satisfaction with present self/life (t=4.032, p<.001) and psychiatric symptom severity (t=-4.436, p<.001). In each case, the suicide group was more impaired. In the second stage of analysis, ANOVA and subsequent post hoc tests showed differences on general life satisfaction, satisfaction with self/present life and psychiatric symptom severity between the group evidencing current and historical suicide risk and groups with either a history-only or no evidence of suicidality.

Conclusions and Implications: Findings from the first stage of analysis suggest that both subjective (i.e. life satisfaction) and objective (i.e. psychiatric symptom severity) quality of life indices may aid in distinguishing between the suicidal and non-suicidal groups with schizophrenia. Findings from the second stage of analysis suggest that lower life satisfaction and higher psychiatric symptom severity may be more indicative of current suicidality as opposed to historical risk. It is argued that quality of life may be able to aid in detecting “under-the-radar” suicide risk, propel collaborative efforts with consumers and delineate targets for suicide intervention for the highly vulnerable population of individuals with schizophrenia.