A systematic review of suicide rating scales in schizophrenia

In spite of a substantial number of suicides in patients with schizophrenia, this area of research has until very recently been the Cinderella of schizophrenia research. Both clinical and research practices have been hampered by a lack of assessment tolls specifically designed to measure suicidality in patients with schizophrenia. This has partly been because of uncertainty about what constitutes reliable risk factors for suicide in schizophrenia. A literature search following evidence-based guidelines was carried out. A number of relevant articles were found, which were then critically reviewed. The majority of rating scales used for patients with schizophrenia were actually based--at least partly--on patients with other diagnoses than schizophrenia (affective conditions, schizoaffective disorder). This procedure could result in misleading conclusions as a result of the heterogeneity of the different mental illnesses. We conclude that, at present, only one rating scale measuring suicidality specifically designed for patients with schizophrenia (the InterSePT-scale) is based on both sound methodology and has clinical relevance. Suicide in patients with schizophrenia remains a pressing problem in the treatment of this high-risk group.