Suicidal behaviours during treatment for first-episode psychosis: towards a comprehensive approach to service-based prevention

Fedyszyn, Izabela E., Robinson, Jo, Harris, Meredith G., Paxton, Susan J., Francey, Shona and Edwards, Jane (2013) Suicidal behaviours during treatment for first-episode psychosis: towards a comprehensive approach to service-based prevention. Early Intervention in Psychiatry, 8 4: 387-395. doi:10.1111/eip.12084


Author Fedyszyn, Izabela E.
Robinson, Jo
Harris, Meredith G.
Paxton, Susan J.
Francey, Shona
Edwards, Jane
Title Suicidal behaviours during treatment for first-episode psychosis: towards a comprehensive approach to service-based prevention
Journal name Early Intervention in Psychiatry   Check publisher's open access policy
ISSN 1751-7885
1751-7893
Publication date 2013-08-22
Sub-type Article (original research)
DOI 10.1111/eip.12084
Open Access Status
Volume 8
Issue 4
Start page 387
End page 395
Total pages 9
Place of publication Richmond, VIC, Australia
Publisher Wiley-Blackwell
Collection year 2014
Language eng
Formatted abstract
Aim: Suicidal behaviours (suicide attempts and suicides) are common among individuals experiencing, or having recently experienced, a first-episode psychosis (FEP). Current interventions for suicidal behaviours are crisis driven and focused on hospital admission of patients at imminent risk of ending their lives. This paper aims to describe ideas for universal, selective and indicated strategies that may complement existing practices to suicide risk management in first-episode patients.

Methods: Key findings from the Suicidal Behaviours in FEP Project were used to develop suggested interventions. The project examined the temporal course of suicide risk, common characteristics of suicidal behaviours and predictors of suicidal behaviours in 699 patients with FEP.

Results: Key findings included: (i) 12% of FEP cohort engaged in suicidal behaviours during treatment (up to 3 years); (ii) first month of treatment conferred the highest suicide risk; (iii) 64% of suicidal behaviours were overdoses, usually on antipsychotics; (iv) 20% of suicidal behaviours occurred on psychiatric units and all involved hanging/strangulation; (v) most suicidal behaviours were impulsive, precipitated by psychosocial stressors and with serious intent; and (vi) proximal non-suicidal self-injurious behaviour and proximal negative life events were the strongest predictors.

Conclusion: Comprehensive approach by mental health services to prevention of suicidal behaviours among first-episode patients could be facilitated by: delineating safe quantities of prescribed medications available to outpatients; regular audits of fixtures on inpatient units; enhancing risk recognition by family members; routinely monitoring suicide risk levels; developing crisis cards with all new FEP patients to facilitate help seeking during distress; and skills training programs targeting distress tolerance, interpersonal effectiveness and problem-solving.
Keyword First-episode psychosis
Suicidal behaviour
Suicidal patient
Suicide prevention
Suicide risk
Q-Index Code C1
Q-Index Status Confirmed Code
Institutional Status UQ

Document type: Journal Article
Sub-type: Article (original research)
Collections: Official 2014 Collection
School of Public Health Publications
 
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Created: Tue, 18 Mar 2014, 12:29:12 EST by Nyree Divitini on behalf of Health LinQ