Citation

Robinson J, Harris MG, Harrigan SM, Henry LP, Farrelly S, Prosser A, Schwartz O, Jackson H, McGorry PD. Schizophr. Res. 2010; 116(1): 1-8.

Affiliation

Orygen Youth Health and Research Centre, Early Psychosis Prevention and Intervention Centre (EPPIC), 35 Poplar Road, Parkville Victoria 3052, Melbourne, Australia.

Copyright

(Copyright © 2010, Elsevier Publishing)

DOI

10.1016/j.schres.2009.10.009

PMID

19864115

Abstract

BACKGROUND: Individuals with first-episode psychosis demonstrate high rates of suicide attempt (SA). AIMS: 1) To examine the prevalence of, and risk factors for, SA in a first-episode psychosis (FEP) cohort over a 7.4year follow-up period. 2) To investigate differences between single versus multiple suicide attempters. METHODS: This study reports baseline and follow-up data from a naturalistic, prospective follow-up of 413 FEP patients treated at a specialist early psychosis centre. Assessments were conducted at treatment entry, initial symptom remission or stabilization, and long term follow-up. Binary logistic regression models were used to assess unadjusted and adjusted associations between early illness and sociodemographic characteristics and two outcome measures: any SA during follow-up; and multiple SAs. RESULTS: Follow-up data were available for 282 participants. Sixty-one (21.6%) made a suicide attempt over the follow-up period, including 12 successful suicides. The following baseline risk factors increased the risk of any SA: history of self-harm (OR=4.27; p<0.001), suicidal tendencies (OR=2.30; p=0.022), being depressed for >50% of the initial psychotic episode (OR=2.49; p=0.045), and hopelessness (OR=2.03; p=0.030). History of problem alcohol use increased the risk of multiple SAs (OR=4.43; 95% CI (1.05-18.7); p=0.043). DISCUSSION: The prevalence of suicide attempt in this study exceeds reports from short-term FEP studies but is comparable to longer term follow-up studies, indicating that risk remains elevated for at least 7 years following commencement of treatment. The key predictor of future suicide attempt was previous self-harm, indicating that interventions for self-harm are required.

Language: en