Case-Control Study of the Relationship of Functioning to Suicide in a Community-Based Sample of Individuals with Schizophrenia in China

Suicide is a leading cause of premature death among people with schizophrenia. Some studies indicate that increased difficulties in functioning are associated with suicidality in persons with schizophrenia. We conducted a secondary analysis of 74 suicides (cases) and 24 accidental deaths (controls) among persons with schizophrenia identified in a national psychological autopsy study in China. Between cases and controls, we compared the effect of schizophrenia on work, daily activities, emotions, social relationships and self-care at the time the illness was most severe. There was no difference in the overall maximum dysfunction associated with the illness between groups. None of the 5 measures (work, activities, emotions, relationships, self-care) were different between the two groups. This study of individuals with DSM-IV schizophrenia who died by suicide in a non-western culture only partially supports findings from clinical studies in western cultures.