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Psychiatric patients who have shown suicidal behavior (SB) are belived to be at a particularly high risk of suicide. However, the number of studies that have sought ways to prevent suicide in this patient population is limited. The present study investigated the diagnosis and SB-related characteristics of psychiatric inpatients showing suicidal behavior prior to admission. One-hundred and fifty-seven eligible subjects were recruited from patients consecutively admitted to a large psychiatric facility during a 20-month period in 2006 and 2007, and underwent extensive research interviews. Percentages of diagnoses based on the Structured Clinical Interview for DSM-IV, Clinician Version (SCID-I, CV) in this series were: affective disorders, 62%; anxiety disorders, 55%; substance use disorders, 38%; psychotic disorders, 27%; and eating disorders, 10%. Eighty-seven percent of the subjects were diagnosed as having some type of personality disorder (PD) in the SCID-II interview. Borderline PD was diagnosed in 56% of the subjects, making it the most frequent type of PD in this series. Frequent SB in these subjects involved: self-cutting, 40%; overdosing, 32%; self-strangulation, 14%; and jumping, 11%. Step-wise logistic regression analyses were conducted to examine the association of dichotomized SB-related clinical characteristics with diagnostic categories (affective disorders, psychotic disorders, substance use disorders, anxiety disorders, and cluster A, B and C PDs). The analysis demonstrated that three diagnostic categories were dominant in the association with clinical characteristics. Cluster B PD was associated with a history of overdosing, greater aggressiveness, interpersonal and life-situational life events, and childhood maltreatment (physical abuse and neglect). Anxiety disorders were related to histories of overdosing, dissociative symptoms in SB, excessive worry concerning life problems, and childhood neglect. Affective disorders were mainly associated with the characteristics of SB or SB-related symptoms: severe depressive symptoms and hopelessness, potentially fatal SB before admission such as self-strangulation, and dissociative symptoms in SB, though they did not show a significant relationship with pre-SB characteristics such as life events or childhood maltreatment. These findings will be helpful to develop treatment guidelines, SB-prevention strategies, and future research regarding suicidal psychiatric patients.

Work-Personality means a person's motivation, values and attitude toward labor, general abilities which make his/her work performance efficient, which can be grasped through observation of behavior patterns in working situations. Problems connected with Work-Personality may cause schizophrenics some vocational difficulties. The author made out a "Work-Personality Insufficiency (WPI) Rating Scale" with 15 items, in order to estimate the employability of schizophrenics, and examined its inter-rater reliability by means of ANOVA-ICC and the results were sufficient enough. Then, WPI was applied to 71 schizophrenic outpatients of Tokyo Metropolitan Chubu Comprehensive Mental Health Center (Occupational Training Unit). Also positive and negative symptoms were estimated at admission, and some indicies of historical data were collected. These data were examined statistically as shown below. (1) Construct validity was verified through factor analysis of scores at admission. (2) By comparison of admission scores between two groups of employed and unemployed at discharge, the average score of employed was significantly low (p < 0.01), and the correlation between the discharge state and the total WPI score was significantly high (r = 0.472, p < 0.01), which proved predict validity. (3) The total score of negative symptoms correlated to WPI scores. Also the total score of positive symptoms correlated to some components of WPI scores. (4) By comparison of WPI scores between at admission and at discharge, reduction of disability was seen mainly in interpersonal area, which meant the improvement of patients' adaptability to work situation. Work performance in the narrow sense, however, seemed to make little development, which meant the limited effect of prevocational training with limited time. (5) Indicies of historical data had no relations to outcome and WPI, which showed the difficulty of predicting vocational prognosis from these variables directly. From above, the author concluded that WPI could be utilized to the vocational issues of prolonged schizophrenic patients, and discussed the predictors of vocational prognosis.