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. 2025 Jul 1;25(1):600.
doi: 10.1186/s12888-025-07059-w.

The association of age of onset on suicide attempts in patients with chronic schizophrenia: a cross-sectional study

Quanfeng Zhu #  1 , Jinjin Wang #  1 , Yan Wang  2 , Xiang-Yang Zhang  3
Affiliations

The association of age of onset on suicide attempts in patients with chronic schizophrenia: a cross-sectional study

Quanfeng Zhu et al. BMC Psychiatry. .

Abstract

Background: There are differences in some clinical symptoms among patients with schizophrenia at different ages of onset. However, the association of age at onset on the prevalence and associated factors of suicide attempts in schizophrenia is still unclear.

Methods: A total of 949 patients with chronic schizophrenia in stable phase were enrolled. The onset of schizophrenia at or before age of 25 years was regarded as youth-onset (YO), and the onset after age of 25 years was regarded as non-youth-onset (NYO). Insomnia Severity Index (ISI), Positive and Negative Syndrome Scale (PANSS), Interpersonal Reactivity Index (IRI), Toronto Alexithymia Scale (TAS), Mini-mental State Examination (MMSE), and Repeatable Battery for the Assessment of Neuropsychological Status (RBANS) were used to assess insomnia, psychotic symptoms, empathy, narration, and cognitive abilities of the subjects, respectively.

Results: There was no significant difference in the prevalence of suicide attempts between patients with YO and NYO (P > 0.05). Among YO patients, those with suicide attempts had significantly higher PANSS total scores, positive factor scores, excitability/hostility factor scores, and depression/anxiety factor scores (all P < 0.001), with the positive factor scores (P < 0.001, β = 0.18, OR = 1.19, 95%CI:1.10-1.30) and depression/anxiety factor scores (P < 0.001, β = 0.23, OR = 1.26, 95%CI:1.13-1.41) being independent risk factors for suicide attempts. However, the risk of suicide attempts in NYO patients was not significantly correlated with these factors.

Conclusions: There was no significant difference in the prevalence of suicide attempts between YO and NYO schizophrenic patients, whereas there was a significant difference in their associated influencing factors.

Keywords: Non-youth-onset; Schizophrenia; Suicide attempts; Youth-onset.

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Conflict of interest statement

Declarations. Ethics approval and consent to participate: The authors assert that all procedures involving human subjects/patients adhered to the Declaration of Helsinki, and were approved by the Ethics Committee of Institute of Psychology, Chinese Academy of Sciences (approval number: H18031), and each participating subject had signed a written informed consent form. Consent for publication: Not applicable. Competing interests: The authors declare no competing interests.

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