Suicide Prevention Programs for Patients with Schizophrenia and Schizophrenia Spectrum Disorders: A Review of Russian Studies

Rationale. Suicide is a significant cause of death in patients with schizophrenia and schizophrenia spectrum disorders (SSDs). Therefore, developing effective methods for suicide prevention is a pressing scientific and practical challenge in psychiatric practice. Globally, various intervention programs aimed at preventing suicidal behavior in patients with schizophrenia and SSDs have been developed and are in use. The objective of this study was to search, systematize, and generalize data from Russian-language scientific sources regarding specific interventions (programs, models, strategies, and systems) aimed at preventing suicidal behavior in patients with schizophrenia and SSDs. Material and Methods. A search and analysis of Russian-language articles were conducted in the academic electronic libraries (database libraries) eLIBRARY. ru and CyberLeninka using various combinations of the following keywords: «program», «strategy», «model», «system», «prevention», «suicidal behavior», «suicide» and «schizophrenia». Results. The search did not identify any specialized suicidal behavior prevention programs developed for patients with schizophrenia and SSDs. Conclusion. According to the analysis of Russian scientific literature, there are currently no suicide prevention programs available in our country for patients with schizophrenia and SSDs. The development, approbation, and integration of such programs are essential for improving the quality of psychiatric care, enhancing treatment outcomes, and reducing mortality. This will require a comprehensive approach, including staff training, the development of specific protocols, and the creation of accessible support resources for patients. There is a clear need to develop such programs at both the regional and national levels. The existing practical experience in organizing suicide prevention measures within the general population and among patients with other mental disorders at the regional and individual institutional levels must be adapted and utilized for targeted suicide prevention programs for patients with schizophrenia and SSDs.

1. Bannikov GS, Lyubov EB, Keshchyan KL. Suicidological services of Russia: problems and reserves of development. Obshchestvennoe zdorov’e. 2022;2(1):27-34. (In Russ.). https://doi.org/10.21045/2782-1676-2021-2-1-27-34.

2. Bisaliev RV, Kalnoi VS. Estimation of a suicidal behavior prevention program for mothers of alcoholic children. Voprosy narkologii. 2010;1:74-81. (In Russ.).

3. Boev OI, Vasilenko AO, Shvydkaya SV. The experience of suicide prevention service of the Stavropol Territory. The results, lessons, prospects. Tyumenskij medicinskij zhurnal. 2015;17(4):17-21. (In Russ.).

4. Vaulin SV. Aspects of suicidal help in psychiatric in-patient clinic. Vestnik novykh meditsinskikh tekhnologii. 2011;18(2):297-301. (In Russ.).

5. Vishnevskaya OA, Petrova NN. Suicidal behavior in remission of schizophrenia. Suicidologija. 2014;1(14):35-41. (In Russ.).

6. Gaza AK, Baranov AV. The organization of the prevention of suicidal behavior in the population of the Tambov region. Suicidologija. 2016;7(3-24): 63-67. (In Russ.).

7. Granitsa AS. Application of the cognitive-behavior al approach in psychotherapy for self-harming behavior. Nevrologicheskii vestnik. 2021;53(2):10–17. (In Russ.). https://doi.org/10.17816/nb71159

8. Zhiltsova YuV, Kuleshova EA. Psychological prevention of suicidal behavior of the penal system employees. Vektory psikhologo-pedagogicheskikh issledovanii. 2024;3(04):70–79. (In Russ.).

9. Zotov PB, Nevzorova DV. Suicidal behavior of palliative care patients. Part II: assistance and prevention. Suicidologiya. 2023;14(4):108 126. (In Russ.). https://doi.org/10.32878/suicide-rus.23-14-04(53)-108-126

10. Zotov PB, Rodyashin EV, Kudryakov AYu, Hohlov MS, Yusupova EYu, Korovin KV. The system of suicide prevention in Tyumen’ region (West Siberia). Suicidologiya. 2018;9(1-30):72-80. (In Russ.).

11. Ivanets NN, Kinkulkina MA. Clinical features of depressions evolving in schizophrenic patients after reduction of acute psychosis. Rossiiskii psikhi atricheskii zhurnal. 2010;5:46-53. (In Russ.).

12. Igumnov SA, Helda AP, Osipchik SI. The system of prevention of suicide behavior: experience of Belarus. ). Suicidologiya. 2016;7(2-23):3-22. (In Russ.).

13. Kovpak AI, Kovpak DV. Social project of the association of cognitive behavioral psychotherapy «stop suicide!». Vestnik MMA. 2021;(2):32-37. (In Russ.).

14. Kozlov VA, Golenkov AV, Bulygina IE. Methods and means of medical prevention of suicide. Suicidologiya. 2023;14(2):36-58. (In Russ.). https://doi.org/10.32878/suiciderus.23-14-02(51)-36-58.

15. Linevich VL. Prevention of Suicidal Risk in People under State Protection. Psikhopedagogika v pravookhranitel’nykh organakh. 2017;(3-70):28-31. (In Russ.).

16. Lyubov EB. Risk Factors for Suicidal Behavior in Patients with Schizophrenia. Rossiiskii psikhi atricheskii zhurnal. 2018;4:24-30. (In Russ.).

17. Lyubov EB, Morev MV, Falaleyeva OI. Social-economic burden of suicides in Russia. Sotsial’naya i klinicheskaya psikhiatriy. 2013;23(2):38-44. (In Russ.).

18. Lyubov EB, Parshin AN. The clinical and economic studies of suicidal behavior. Suicidologiya. 2016;7(1-22):11-28. (In Russ.).

19. Magurdumova LG. Medical and rehabilitation assistance to persons after a suicidal attempt in out of-hospital conditions. Vestnik MMA. 2021;2:73 76. (In Russ.).

20. Panchenko EA. Features of suicide behavior in patients with schizophrenia spectrum disorders. Sibirskii vestnik psikhiatrii i narkologii. 2011;3 66:24-26. (In Russ.).

21. Patrikeeva ON, Mokhnacheva YaV, Kibitov AO. Suicidal Behavior in Patients with Schizophrenia and Schizophrenia Spectrum Disorders: A Review of Studies in the Russian Population. Psikhiatriya. 2024;22(6):89-102. (In Russ.). https://doi.org/10.30629/2618-6667-2024-22-6-89-102

22. Polozhy ВS. Modern approaches to preventive suicidology. Suicidologiya. 2021;12(1):73-79. (In Russ.). https://doi.org/10.32878/suiciderus.

23. Polozhy BS, Bannikov GS, Lyubov EB, Zotov PB, Yakhyaeva PK. Prevention of suicidal behavior among adolescents. Suicidologiya. 2021;12(3):67 87. (In Russ.). https://doi.org/10.32878/suicide-rus.21-12-03(44)-67-87.

24. Polozhy BS, Lyubov EB. Exploring suicidal behavior in Russia: problems and solutions. Zhurnal nevrologii i psikhiatrii imeni S.S. Korsakova. 2022;122(8):145–149. (In Russ.). https://doi.org/10.17116/jnevro2022122081145.

25. Polozhy BS, Panchenko EA. Differentiated approach to prevention of suicidal behavior. Rossiiskii psikhiatricheskii zhurnal. 2011;4:41-44. (In Russ.).

26. Polozhy BS, Panchenko EA. The different prevention of suicidal behavior. Suitsidologiya. 2012;1;8 12. (In Russ.).

27. Rozanov VA, Neznanov NG, Kovalev AV, Semenova NV, Shaboltas AV. Suicide prevention in the context of preventive medicine. Profilakticheskaya medicina. 2022;25(5):101–109. (In Russ.). https://doi.org/10.17116/profmed202225051101.

28. Rozanov VA, Semenova NV, Samerkhanova КМ, Vuks DО. Suicide prevention programs (systematic review of russian-language scientific sources). Suicidologiya. 2023;14(1):38-64. (In Russ.). https://doi.org/10.32878/suicide-rus.23-14-01(50)-38-64;

29. Semakina NV, Zlokazova MV. An attempt to organize multi-agency preventive, medical and psychosocial councelling for adolescents with suicidal behavior in the city of Kirov. Vyatskii meditsinskii vestnik. 2021;4-72:66-70. (In Russ.). https://doi.org/10.24412/2220-7880-2021-4-66-70.

30. Serazetdinova LG, Petrova NN, Malevanaya OV. Psychoeducation for Patients with Schizophrenia in Outpatient Practice: Clinical Experience. Obozrenie psikhiatrii i meditsinskoi psikhologii im. V.M. Bekhtereva.2012;1:37-42. (In Russ.).

31. Sivolap YuP, Portnova AA. The clean and dirty ways to reduce suicidality. Nevrologicheskii vestnik. 2021;53(2):18-25. (In Russ.). https://doi.org/10.17816/nb71327.

32. Takkueva EV. Estimation of Efficiency of the Integrative Motivational Training Program (IPMT) for Patients with Schizophrenia, Undergoing Treatment in a Psychiatric Hospital, and for those living in Residential Institutions for Psychiatric Patients (PRI). Konsul’tativnaya psikhologiya i psikhoterapiya. 2023;31(1):31—57. (In Russ.). https://doi.org/10.17759/cpp.2023310102.

33. Fedotov IA, Shitov EA, Kulikov SO. Treatment clients with suicidal behavior in various psychotherapeutic modality (literature review). Nauka molodykh. 2015;116-126. (In Russ.).

34. Khasanova AK, Kovrizhnykh IV, Mosolov SN. Antisuicidal effect of clozapine (prescribing algorithm and clinical monitoring). Sovremennaya terapiya psikhicheskikh rasstroistv. 2023;4:48–63. (In Russ.). https://doi.org/10.21265/PSYPH.2023.31.74.005

35. Shport SV, Kalashnikova AS. Public Mental Health and Peculiarities of Organization of Psychiatric and Drug Abuse Treatment Services in countries of the Commonwealth of Independent States. Voprosy ohrany psihicheskogo zdorov’ya. 2024;3(2):7–17. (In Russ.).

36. Asarnow JR, Berk M, Hughes JL, Anderson NL. The SAFETY Program: a treatment-development trial of a cognitive-behavioral family treatment for adolescent suicide attempters. J Clin Child Adolesc Psychol. 2015;44(1):194-203. https://doi.org/10.1080/15374416.2014.940624

37. Brenner LA, Capaldi V, Constans J, Dobscha S, Fuller M, Matarazzo B, McGraw K, Richter K, Sall J, Smolenski D, Williams S, Davis-Arnold S, Bahraini N. Assessment and Management of Patients at Risk for Suicide: Synopsis of the 2024 U.S. Department of Veterans Affairs and U.S. Department of Defense Clinical Practice Guidelines. Ann Intern Med. 2025;178(3):416-425. https://doi.org/10.7326/ANNALS-24-01938.

38. Bornheimer LA, Verdugo JL, Brdar NM, Im V, Jeffers N, Bushnell CB, Hoener K, Tasker M, De Weese K, Florence T, Jester JM, King CA, Taylor SF, Himle JA. A cognitive-behavioral treatment for suicide prevention among adults with schizophrenia spectrum disorders in community mental health: Study protocol for a pilot feasibility and acceptability randomized clinical trial. Pilot Feasibility Stud. 2024;10(1):99. https://doi.org/10.1186/s40814-024-01523-2.

39. Bornheimer LA, Verdugo JL, Krasnick J, Jeffers N, Storey F, King CA, Taylor SF, Florence T, Him le JA. A cognitive-behavioral suicide prevention treatment for adults with schizophrenia spectrum disorders in community mental health: Preliminary findings of an open pilot study. Soc Work Ment Health. 2023;21(5):538-560. https://doi.org/10.1080/15332985.2023.2186736.

40. Bornheimer LA, Zhang A, Li J, Hiller M, Tarrier N. Effectiveness of Suicide-Focused Psycho social Interventions in Psychosis: A Systematic Review and Meta-Analysis. Psychiatr Serv. 2020;71(8):829-838. https://doi.org/10.1176/appi.ps.201900487.

41. Chai Y, Tang JY, Ma DCF, Luo H, Chan SKW. Self-Harm and Suicide Rates Before and After an Early Intervention Program for Patients With First-Episode Schizophrenia. JAMA Netw Open. 2024;7(8):e2426795. https://doi.org/10.1001/jamanetworko-pen.2024.26795.

42. Comendador L, Cebrià AI, Sanz A, Pérez V, Palao D. Telephone-Delivered Interventions for Suicide Prevention in Schizophrenia and Related Dis orders: A Systematic Review. Healthcare (Basel). 2023;11(3):432. https://doi.org/10.3390/healthcare11030432.

43. Donker T, Calear A, Busby Grant J, van Spijker B, Fenton K, Hehir KK, Cuijpers P, Christensen H. Suicide prevention in schizophrenia spectrum disorders and psychosis: a systematic review. BMC Psychol. 2013;1(1):6. https://doi.org/10.1186/2050-7283-1-6.

44. Hor K, Taylor M. Suicide and schizophrenia: a systematic review of rates and risk factors. J Psychopharmacol. 2010;24(4Suppl):81-90. https://doi.org/10.1177/1359786810385490.

45. Hodé Y, Dubreucq J, Valladier E, Guillard Bouhet N, Lemestré S, Attal J, Canceil O, Biotteau M, Laffond P, Raynaud A, Chéreau-Boudet I, Montagne Larmurier A, Giordana JY, Saingery B, d’Amato T, Willard D. Prévention du risque suicidaire dans la schizophrénie : importance de la psychoéducation des familles [Suicidal risk prevention in schizophrenia: Importance of family psychoeducation]. Encephale. 2020;46(6):450 454. (In. French.). https://doi.org/10.1016/j.encep.2020.02.002.

46. Hode Y, Padovani R, Hikmat W, Guillard-Bouhet N, Attal J, Bralet MC, Biotteau M, Chereau Boudet I, Canceil O, Montagne Larmurier A, Roussel C, Lemestré S, Willard D. Family psychoeducation in schizophrenia and schizophrenia related disorder, treatment compliance, and suicidal risk reduction: questions about their relationship from a naturalistic observation. Front Psychiatry. 2024;15:1370566. https://doi.org/10.3389/fpsyt.2024.1370566.

47. Mann JJ, Apter A, Bertolote J, Beautrais A, Currier D, Haas A, Hegerl U, Lonnqvist J, Malone K, Marusic A, Mehlum L, Patton G, Phillips M, Rutz W, Rihmer Z, Schmidtke A, Shaffer D, Silverman M, Takahashi Y, Varnik A, Wasserman D, Yip P, Hendin H. Suicide prevention strategies: a systematic review. JAMA. 2005;294(16):2064-74. https://doi.org/10.1001/jama.294.16.2064.

48. Misdrahi D, Dupuy M, Dansou Y, Boyer L, Berna F, Capdevielle D, Chereau I, Coulon N, D’Amato T, Dubertret C, Leignier S, Llorca PM, Lançon C, Mallet J, Passerieux C, Pignon B, Rey R, Schürhoff F, Swendsen J, Urbach M, Szöke A, Godin O, Fond G; FACE-SZ (FondaMental Academic Centers of Expertise for Schizophrenia) Group. Predictors of medication adherence in a large 1-year prospective cohort of individuals with schizophrenia: insights from the multicentric FACE-SZ dataset. Transl Psychiatry. 2023;13(1):341. https://doi.org/10.1038/s41398-023-02640-x.

49. Moreno-Küstner B, Guzman-Parra J, Pardo Y, Sanchidrián Y, Díaz-Ruiz S, Mayoral-Cleries F. Excess mortality in patients with schizophrenia spectrum disorders in Malaga (Spain): A cohort study. Epidemiol Psychiatr Sci. 2021;30:e11. https://doi.org/10.1017/S2045796020001146.

50. Ran MS, Xiao Y, Fazel S, Lee Y, Luo W, Hu SH, Yang X, Liu B, Brink M, Chan SKW, Chen EY, Chan CL. Mortality and suicide in schizophrenia: 21-year follow-up in rural China. BJPsych Open. 2020 Oct 15;6(6):e121. https://doi.org/10.1192/bjo.2020.106.

51. Yang JH, Yoo J, Kang DH, Park CHK, Rhee SJ, Kim MJ, Lee SY, Shim SH, Moon JJ, Cho SJ, Kim SG, Kim MH, Lee J, Kang WS, Lee WY, Ahn YM. Development of a Clinical Guideline for Sui cide Prevention in Psychiatric Patients Based on the ADAPTE Methodology. Psychiatry Investig. 2024;21(10):1149-1166. https://doi.org/10.30773/pi.2024.0195.

52. You DK, Son JM, Hwang TY. Effectiveness of Gate keeper Training for Families of People With Men tal Disorders in Korea: A Randomized Controlled Trial. Psychiatry Investig. 2023;20(12):1185-1194. https://doi.org/10.30773/pi.2023.0114.

53. Zalsman G, Hawton K, Wasserman D, van Heerin gen K, Arensman E, Sarchiapone M, Carli V, Höschl C, Barzilay R, Balazs J, Purebl G, Kahn JP, Sáiz PA, Lipsicas CB, Bobes J, Cozman D, He gerl U, Zohar J. Suicide prevention strategies revis ited: 10-year systematic review. Lancet Psychiatry. 2016;3(7):646-59. https://doi.org/10.1016/S2215-0366(16)30030-X