Suicide is a common occurrence in schizophrenia and is seen in all phases of the illness. Early identification of patients who are more likely to attempt suicide may help in suicide prevention among patients with schizophrenia. The present study was aimed at determining the clinical differences and differences in demographic and risk factors in patients with schizophrenia that attempt suicide and those that do not. Methods: A total of 200 consecutive follow-up patients having schizophrenia were assessed clinically for variables related to suicide and suicidal behaviour in the outpatient department of a tertiary psychiatry centre. All patients were administered the Positive and Negative Symptom Scale (PANSS) for schizophrenia to assess clinical symptoms and severity while the Clinical Global Impression – Severity (CGI-S) scale was also used. Results: Out of the 200 patients studied, 38% (n = 76) patients had made one severe suicide attempt by excluding parasuicide or deliberate self-harm at least once, and 9.5% (n = 19) had attempted suicide more than three times. More patients with a suicide attempt showed good clinical outcome (CGI ≥ 3) (42.1% versus 33.0%, χ 2 = 1.040, p = 0.301). The patients who attempted suicide were predominantly male, with a mean age of 34.2 years. Lesser number of them was single (32.89% vs. 43.5%, χ 2 = 1.814, p = 0.178). Their duration of illness was shorter (9.6 years versus 11.4 years, t = 2.8841, p = 0.0043) and more patients with attempted suicide had higher scores on negative symptoms scales of PANSS (t=2.1122, p = 0.035) at the time of assessment. Conclusions: The findings in our research warrant the need studying suicide in schizophrenia in larger samples and to replicate our findings and also determine methods to reduce the incidence of suicide in schizophrenia via interventional programmes. ASEAN Journal of Psychiatry, Vol. 17 (2): July – December 2016: XX XX.

Objective: Clozapine is seen as a gold standard for treatment refractory schizophrenia; however, it is not recommended for the treatment of first-episode psychosis mainly due to concerns of severe side effects. An indicator for response holds tremendous clinical value to select patients who can benefit from clozapine, safely. EEG abnormality has been reported to be one such parameter, yet the definite conclusion of the nature of EEG changes and its predictive value remains undetermined. The present study was undertaken to examine electroencephalographic (EEG) abnormalities and clinical response subsequent to clozapine therapy in schizophrenia. Methods: A total of 80 first-episode patients were recruited for a 12 week study, from a tertiary care centre in Mumbai, India. First episode was defined as an illness of less than 2 years duration and first hospitalization since illness. EEG abnormalities, psychopathology, and positive and negative symptoms were examined at baseline and again after 12 weeks of clozapine treatment. Results: There were some types of EEG abnormalities found in pretreatment state in at least two-thirds of patients. The number of patients showing EEG abnormality at the end of the 12 weeks of treatment increased significantly, which included theta (θ) frequency, slow waves, and sharp waves. Symptomatically, significant improvement was seen in both positive as well as negative symptoms scores. However, there was no significant correlation between EEG changes and clinical outcome. Conclusion: There was significant abnormality in the number of patients exhibiting EEG abnormalities. Baseline pretreatment EEG abnormalities were present in a considerable number of patients, and these EEG abnormalities did not significantly correlate with clinical improvement, except suggesting a trend towards such correlation.
Electroencephalography