Transcultural differences in suicide attempters: Analysis on a high-risk population of patients with schizophrenia or schizoaffective disorder

Altamura, A.C.; Mundo, E.; Bassetti, R.; Green, A.; Lindenmayer, J.P.; Alphs, L.; Meltzer, H.Y.

doi:10.1016/j.schres.2006.08.023

« Previous Next »Schizophrenia Research
Volume 89, Issue 1 , Pages 140-146, January 2007

Transcultural differences in suicide attempters: Analysis on a high-risk population of patients with schizophrenia or schizoaffective disorder

A.C. Altamura
- Department of Pychiatry, Department of Clinical Sciences “Luigi Sacco”, University of Milan, Italy
- Corresponding author. Department of Clinical Sciences “Luigi Sacco”, University of Milan, Via G.B. Grassi 74, 20157 Milan, Italy. Tel.: +39 02 39042904; fax: +39 02 39042510.
E. Mundo
- Department of Pychiatry, Department of Clinical Sciences “Luigi Sacco”, University of Milan, Italy
R. Bassetti
- Department of Pychiatry, Department of Clinical Sciences “Luigi Sacco”, University of Milan, Italy
A. Green
- Department of Psychiatry, Dartmouth Medical School, Hanover, NH, United States
J.P. Lindenmayer
- Manhattan Psychiatric Center–Nathan Kline Institute for Psychiatric Research, Wards Island, NY, United States
L. Alphs
- Pfizer Inc, Ann Arbor, Mich, United States
H.Y. Meltzer
- Department of Psychiatry, Vanderbilt University, Nashville, Tenn, United States

Received 18 April 2006; received in revised form 17 August 2006; accepted 31 August 2006. published online 15 November 2006.

Abstract

The aim of the study was to investigate transcultural differences between schizophrenia spectrum disorder patients who did or did not attempt suicide. DSM-IV schizophrenia (N=609) or schizoaffective disorder (N=371) patients who participated in the multicentre International Suicide Prevention Trial (InterSePT) were studied. Patients were sub-divided into 5 groups according to the different geographical regions of recruitment: North America (NA), Europe (EUR), East Europe (EEUR), South Africa (SAf), and South America (SA). The main lifetime clinical variables were compared, within each group, between attempters and non-attempters. The presence of comorbid substance abuse disorder and smoking was associated with suicide attempts in all the geographical groups considered (NA: χ₁²=7.575, p<0.01 and χ₁²=69.549, p<0.0001; EUR: χ₁²=55.068, p<0.0001, and χ₁²=48.431, p<0.0001; EEUR: χ₁²=164.628, p<0.000, and χ₁²=5.127, p<0.01; SA: χ₁²=30.204, p<0.0001 and χ₁²=11.710, p=0.001) except for SAf. For the other clinical variables various differences were found across the different groups. Variables related to suicide behavior were similar across the five groups investigated, with differences only in the age at the first suicide attempt (earlier in the NA sample) and the number of lifetime suicide attempts (higher in the NA sample). Results from this study show that, while some suicide-related clinical characteristics in schizophrenia patients are consistent worldwide suggesting the influence of stable biological traits, other variables may vary across different geographical areas suggesting environmental influences.