Predictors of suicide-related behaviors during treatment following a first episode of psychosis: the contribution of baseline, past, and recent factors

Fedyszyn, I. E., Robinson, J., Harris, M. G., Paxton, S. J. and Francey, S. (2012) Predictors of suicide-related behaviors during treatment following a first episode of psychosis: the contribution of baseline, past, and recent factors. Schizophrenia Research, 140 1-3: 17-24. doi:10.1016/j.schres.2012.06.022


Author Fedyszyn, I. E.
Robinson, J.
Harris, M. G.
Paxton, S. J.
Francey, S.
Title Predictors of suicide-related behaviors during treatment following a first episode of psychosis: the contribution of baseline, past, and recent factors
Journal name Schizophrenia Research   Check publisher's open access policy
ISSN 0920-9964
1573-2509
Publication date 2012-09
Sub-type Article (original research)
DOI 10.1016/j.schres.2012.06.022
Volume 140
Issue 1-3
Start page 17
End page 24
Total pages 8
Place of publication Amsterdam, The Netherlands
Publisher Elsevier
Collection year 2013
Language eng
Formatted abstract
Background: Suicide-related behaviors (suicide attempts and suicides) are common in the early phase of psychotic disorders. Studies have examined risk factors among baseline and historical (i.e., past) variables, yet little is known about recent characteristics that increase suicide risk during treatment for first-episode
psychosis (FEP). This study had two aims: first, to determine the relative importance of baseline, past, and recent variables to the prediction of suicide-related behaviors in patients with FEP; second, to identify recent characteristics that exert most influence on suicide risk levels and which could become foci of preventive interventions.

Methods: This was a case–control study of 180 patients from a cohort entering a specialist FEP service between 1/12/2002 and 30/11/2005. Data for 72 cases and 108 matched controls were obtained via medical record audit. Multivariate logistic regression models assessed the contribution of baseline, past, and recent
domains. Suicide attempt or suicide during treatment was the outcome variable.

Results:
The strongest risk factors for suicide-related behaviors were: baseline depressive symptoms, baseline  suicidal ideation/intent, past negative events, past non-suicidal self-injurious behavior, recent negative events, recent depressive symptoms, and recent non-suicidal self-injurious behavior. However, when these
were entered into a hierarchical logistic regression model, only recent non-suicidal self-injurious behavior (AOR=72.96, pb0.001), and recent negative events (AOR=1.90, p=0.003) remained significant predictors. The final model accurately classified 75.5% of cases and 89.2% of controls, and explained 72.0% of variance in the suicide attempt status.

Conclusions:
Since recent negative events and recent non-suicidal self-injurious behavior were the strongest predictors of suicide-related behaviors during treatment for FEP, psychiatric services could consider incorporating psychosocial interventions addressing affect regulation, interpersonal effectiveness, stress management and
problem solving, alongside case management and pharmacotherapy, to help to reduce the rates of suicide attempts and suicides in first-episode patients.
Keyword Suicide attempt
First-episode psychosis
Suicide prevention
Suicide risk
Distal factors
Q-Index Code C1
Q-Index Status Confirmed Code
Institutional Status UQ

Document type: Journal Article
Sub-type: Article (original research)
Collections: Official 2013 Collection
School of Public Health Publications
 
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