# Association between the onset timing of suicidal ideation and the means of severe suicide attempts in patients with schizophrenia

## TL;DR

This study examines when suicidal thoughts begin in schizophrenia patients and how it relates to the severity of suicide attempts.

## Contribution

The study identifies how the timing of suicidal ideation affects the choice of severe suicide methods in schizophrenia patients.

## Key findings

- Patients with prior-to-same-day suicidal ideation were more likely to use severe suicide methods.
- Same-day suicidal ideation was linked to severe methods when driven by hallucinations and delusions.
- A recent suicide attempt history was associated with less severe methods in the prior-to-same-day group.

## Abstract

To investigate the timing of the onset of suicidal ideation in patients with schizophrenia, the severity of suicide attempts, and associated factors.

A total of 273 patients with schizophrenia visiting the emergency department for suicide attempts between January 2003 and December 2021 were included in this study. The participants were categorized into two groups: the same‐day (SD) group and the prior‐to‐same‐day (PSD) group, based on the timing of the onset of suicidal ideation. Data were collected on patient demographics and psychiatric symptoms observed at the time of visit. Additionally, information regarding suicidal motives and the means used for suicide attempts was analyzed to explore the relationship between the timing of suicidal ideation, the severity of suicide attempt means, and associated factors.

The PSD group was significantly more likely to select severe means of suicide attempts compared to the SD group (p = 0.03). In the SD group, a strong positive association was identified between the use of severe suicide means and suicidal motives linked to hallucinations and delusions (odds ratio [OR] = 2.01, 95% confidence interval [CI] 1.01–4.03, p = 0.049). Conversely, in the PSD group, a negative association was observed between the history of suicide attempts within the past year and selection of severe means (OR = 0.32, 95% CI 0.12–0.86, p = 0.023).

The timing of suicidal ideation significantly influences the severity of suicide attempt means. These findings provide critical insights for enhancing suicide risk assessment and intervention strategies in patients with schizophrenia.

This study investigated the timing of suicidal ideation onset, the severity of suicide attempts, and related factors in schizophrenia patients.