Suicide attempt in first-episode psychosis: A 7.4year follow-up study

Robinson, J.; Harris, M.G.; Harrigan, S.M.; Henry, L.P.; Farrelly, S.; Prosser, A.; Schwartz, O.; Jackson, H.; McGorry, P.D.

doi:10.1016/j.schres.2009.10.009

« Previous Next »Schizophrenia Research
Volume 116, Issue 1 , Pages 1-8, January 2010

Suicide attempt in first-episode psychosis: A 7.4year follow-up study

J. Robinson
- Orygen Youth Health and Research Centre, Early Psychosis Prevention and Intervention Centre (EPPIC), 35 Poplar Road, Parkville Victoria 3052, Melbourne, Australia
- Corresponding author. Tel.: +61 3 9342 2866; fax: +61 3 9342 2941.
M.G. Harris
- The University of Queensland, School of Population Health, Qld 4072, Australia
S.M. Harrigan
- Orygen Youth Health and Research Centre, Early Psychosis Prevention and Intervention Centre (EPPIC), 35 Poplar Road, Parkville Victoria 3052, Melbourne, Australia
L.P. Henry
- Orygen Youth Health and Research Centre, Early Psychosis Prevention and Intervention Centre (EPPIC), 35 Poplar Road, Parkville Victoria 3052, Melbourne, Australia
S. Farrelly
- Orygen Youth Health and Research Centre, Early Psychosis Prevention and Intervention Centre (EPPIC), 35 Poplar Road, Parkville Victoria 3052, Melbourne, Australia
A. Prosser
- Orygen Youth Health and Research Centre, Early Psychosis Prevention and Intervention Centre (EPPIC), 35 Poplar Road, Parkville Victoria 3052, Melbourne, Australia
O. Schwartz
- Orygen Youth Health and Research Centre, Early Psychosis Prevention and Intervention Centre (EPPIC), 35 Poplar Road, Parkville Victoria 3052, Melbourne, Australia
H. Jackson
- School of Behavioural Science, The University of Melbourne, Grattan Street, Parkville Victoria 3052, Melbourne, Australia
P.D. McGorry
- Orygen Youth Health and Research Centre, Early Psychosis Prevention and Intervention Centre (EPPIC), 35 Poplar Road, Parkville Victoria 3052, Melbourne, Australia

Received 15 June 2009; received in revised form 5 October 2009; accepted 10 October 2009. published online 28 October 2009.

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 7years following commencement of treatment. The key predictor of future suicide attempt was previous self-harm, indicating that interventions for self-harm are required.

Keywords: First-episode psychosis, Suicide attempt