Most experienced clinicians know that suicide is a danger in schizophrenia. About 30 years ago, one of the wisest, Professor Nolan D. C. Lewis, (1927) wrote, " among the frank mental disorder groups, apparently suicide occurs more often among dementia praecox patients than in any other types. The reaction usually happening during the earlier stages of the conflict before regression has proceeded far enough to attenuate the reality principle to any extent." Some years later, he noted (1933) that while the danger of suicide in depressive states now seemed to be widely understood, far less attention had been paid to its occurrence in dementia praecox. A study of text books supports this contention for they have remarkably little l.o say on this topic. Indeed, generally speaking from the late 19th century on, they have dealt briefly with the whole question of suicide which does not even appear in the index of one widely read book purporting to deal with the day to day work of psychiatry.

Lewis (1889), Kraft Ebing (1904), Kraepelin (1904), Jelliffe and White (1919), Bleuler (1924, 1950), Muncie (1939), Oikon (1945), Hall (1949), Henderson and Gilliespie (1951), Noyes (1954), Strecker and Ebaugh (1951), and even Jaspers (1963) although paying attention to suicide in the affective psychoses says little or nothing about it in schizophrenia. Skottowe (1934) who gives an extremely dear, sensible, detailed and highly perceptive account of handling suicidal tendencies in depressions, does not mention this as a danger in schizophrenia, nor does he suggest that it is a likely or even probable outcome of this illness.