The sequence of questioning about suicidal ideas should move sensitively and progressively on to what is a distressing topic for the patient. The way to introduce the topic of suicide is to progress from the patient's dysphoric state to symptoms of hopelessness and then to morbid thinking and suicide. The interviewer must determine if the patient has made actual plans regarding a method of suicide as well as their reasons for living. Abnormal phenomena The interviewer checks for psychotic symptoms such as auditory hallucinations or delusions of persecution. Suicide in schizophrenia can sometimes be in response to command hallucinations instructing the patient to perform specific acts, particularly violent or destructive acts.
Some schizophrenic patients kill themselves to escape from frightening imaginary persecutors.
Further information It is always good practice to interview a close family member as suicidal patients are more likely to communicate their suicidal thoughts to those who are closest to them. Those who require a short period of removal from stress, because their coping resources are temporarily exhausted. The most basic principle is that most suicide victims end their lives in the midst of a psychiatric episode and accurate diagnosis and careful management of the acute psychiatric illness could significantly alter the suicide risk.