Psychosis and functioning as risk factors for later suicidal activity among schizophrenia and schizoaffective patients: a disease-based interactive model.

The present research explores the relationship of positive symptoms, negative symptoms, and posthospital functioning to subsequent suicidal behavior over a 7 1/2-year period, and examines whether these patterns vary with diagnosis. The results support a multifactor model of suicide risk. Both psychosis and poor functioning show some relationship to later suicidal activity for both schizophrenic and schizoaffective patients. Psychosis may remain a risk factor for suicidal activity for schizoaffective patients, even when functioning is partialed out. This is in contrast to the schizophrenia patients, for whom funtioning seems to mediate the effects of psychosis on later suicidality. In general, adequacy of overall posthospital functioning mediates the effects of some risk factors on suicidal activity within different diagnostic groups.