Depression is the single most important cause of suicide among individuals with schizophrenia. Most suicides in this population occur within the first ten years of illness. Individuals at the highest risk of attempting suicide often exhibit a remitting and relapsing course, good insight into their condition, poor response to medication, social isolation, hopelessness, and a stark discrepancy between past achievements and current functioning. Patients with these characteristics and concurrent depression are at critical risk for suicide.