The goal of the study was to examine schizophrenic patients’ relationship with their illness and its influence on completed suicide. To do so, we studied the impact of awareness of illness, of illness and treatment acceptance, of the family’s acceptance and support and of illness-related events (i.e. those “generated” by the illness) on completed suicide. The study design was a case-controlled psychological autopsy study in which a group of 29 schizophrenic and schizoaffective patients who committed suicide were compared to a group of 33 living controls. The results indicate that a negative relation with one’s illness does increase suicide risk as reflected by the refusal to accept one’s illness, illness-related events and depression. Prevention strategies should focus on increasing illness acceptance and on the appropriate detection and treatment of depression.