Suicide and Violent Behavior in Psychotic Inpatients

Introduction: This study compares the association between psychosis, suicide, and violent behavior in patients admitted and discharged from the psychiatric ward. Methods: This study used a cross-sectional design. The experimental study was done with all the psychotic patients fulfilling the inclusion criteria upon admission and discharge from a teaching hospital in Malaysia. The study was conducted for a duration of five months from March to July 2022. Psychotic patients with various diagnoses based on the DSM-5 were interviewed. PANSS score was used upon admission and discharge to look at the severity of psychosis. Suicide behavior was assessed using SBQ-R while violent behavior was assessed using MOAS. Sample size consist of 100 consecutive psychotic patients. Results: Suicide behavior was noted to be present in patients no matter the severity of psychosis. Upon discharge, even after the improvement of psychosis, patients were still at risk of suicide behavior. Violent behavior was noted to be present in most of the patients in the PANSS group (except for the moderately ill patients) no matter the severity of psychosis. However, upon discharge from the psychiatric ward, we can see that all patients went home not having violent behavior. This concludes that, when psychosis improves, the risk of having violent behavior reduces. Conclusions: Further exploration on the reasons of why suicide behavior persists in psychotic patients has to be done by clinicians. It is dangerous for clinicians to make assumptions that psychotic patients presenting with suicide behavior are solely due to the psychosis.