Vulnerability factors in Sylvia Plath's suicide

Suicidal behavior in the older patient with schizophrenia

Little is known about treating elderly suicidal patients with schizophrenia. The purpose of this article is to review the literature dealing with this population and to discuss what is required to advance this field. Most available studies from middle-aged and older individuals suggest that risk factors include hopelessness, lower quality of life, past traumatic events, depressive symptoms, lifetime suicidal ideation and past attempts; it is not clear whether these findings are generalizable to geriatric populations. Although little treatment research has been performed in older suicidal patients with schizophrenia, an integrated psychosocial and pharmacologic approach is recommended. In addition, one recent study augmented antipsychotic treatment with an SSRI (i.e., citalopram) in a sample of middle-aged and older individuals with schizophrenia with subsyndromal depression; in that study, serotonin selective reuptake inhibitor augmentation reduced depressive symptoms and suicidal ideation. More research is required to better understand suicidal behavior in older patients with schizophrenia.

Suicide among patients with schizophrenia: a consideration of risk and protective factors

BACKGROUND

The elevated rate of suicide among patients with schizophrenia is well documented and thus frequently researched. The majority of research has focused solely on the identification of risk factors that predispose patients to attempt or commit suicide. This review serves to expand on the literature pertaining to suicide risk factors by additionally outlining how protective factors may shield against suicide within this unique patient population.

METHODS

A literature review of English-language publications pertaining to suicide among people with schizophrenia was completed using PsychINFO and MEDLINE databases between the years of 1960-2004 and 1950-2004 respectively. Special emphasis was given to studies of risk factors and protective factors for suicide.

RESULTS

Commonly supported risk factors for suicide were identified: previous attempts, severity of illness, comorbidity, social isolation, temporal relationships, and demographic characteristics. Risk factors such as a history of violence, the presence of command hallucinations, and recent tragic loss were found to warrant future study. Social support, positive coping skills, life satisfaction, and resiliency emerged as protective factors that may mitigate suicide.

CONCLUSIONS

Understanding why some patients wish to end their lives but also why some desire to live allows for more comprehensive suicide prevention.

Suicide and creativity: the case of Sylvia Plath

This article explores the idea that although much can be learned by viewing Sylvia Plath's poetry as an expression of her thinking and affect, additional insights are afforded by reversing the typical direction of effect and by viewing Plath's affect, and in particular her depression, as a result of her writing. Consistent with this interpretation is Plath's huge investment in writing. This may have contributed to the sensitivity that predisposed her to stress and depression. This perspective is tied to the existing creativity literature and interwoven and contrasted with existing descriptions of Plath's work and tragic death.