Citation

Misdrahi D, Denard S, Courtet P. Ann. Med. Psychol. (Paris) 2011; 169(7): 426-428.

Copyright

(Copyright © 2011, Societe Medico-Psychologique, Publisher Elsevier Publishing)

DOI

10.1016/j.amp.2011.06.008

PMID

unavailable

Abstract

Suicide is the leading cause of premature death in patients with schizophrenia. Suicide risk is increased during the early stages of the disease, especially the first year after diagnosis. In this population, the coexistence of a mood disorder is an identified risk factor for suicide.

RESULTS from literature are consensual about the association between a good level of insight and an increased risk of suicide. The hypothesis that the association between insight and suicide risk is linked to the existence of depressive symptoms or hopelessness remains to be confirmed. A study of 61 patients assessed the clinical and cognitive dimensions of insight and confirms the association between a high level of insight and suicide risk. Patients who received a psycho-educational intervention had better insight. These data raise an apparent paradox. If the alteration of insight is a recognized factor of poor prognosis in schizophrenia, improve awareness of the disease should be one of the main therapeutic goals. However, a good insight is also associated with significant adverse effects. Among the programs of health education, interventions, which target and modify negative beliefs about psychotic disorders, may have an effect on reducing the risk of suicide. Regardless of the intervention model aimed at improving insight, maintaining an optimal therapeutic alliance is probably the best way to reduce the risk of suicide. © 2011 Elsevier Masson SAS.

Language: fr

Keywords

human; suicide; Suicide; health education; prognosis; Schizophrenia; psychotherapy; schizophrenia; risk assessment; risk factor; hopelessness; article; disease association; health program; Insight; risk reduction; introspection; clinical assessment; health belief; adverse outcome