Course and Predictors of Suicidality Over the First Two Years of Treatment in First-Episode Schizophrenia Spectrum Psychosis

Abstract

The objective of this study was to investigate the course of suicidal behavior over the first 2 years of comprehensive, integrated treatment in two groups of patients with DSM-IV first episode schizophrenia spectrum psychosis, where one group was recruited through an early detection program. We have previously shown that the rate of severe suicidal behavior was lower in the earlier detected group than in the other. First episode schizophrenia is a high risk period for suicidality, but we found low rates of completed suicides and suicide attempts in both groups after 2 years in treatment, with no between-groups differences. Severe suicidality (plans and attempts) was predicted by drug abuse, dissatisfaction with life and severe suicidality at start of treatment.

Keywords:

• psychotic disorders
• schizophrenia
• suicide
• suicide attempted

Supported by the Norwegian National Research Council (#133897/320 and #154642/320), the Norwegian Department of Health and Social Affairs, the National Council for Mental Health/Health and Rehabilitation (#1997/41 and #2002/306), Rogaland County and Oslo County (Drs. Vaglum, Johannessen, Friis, Larsen, Melle, Opjordsmoen). Also funded by the Theodore and Vada Stanley Foundation, the Regional Health Research Foundation for Eastern Region, Denmark; Roskilde County, Helsefonden, Lundbeck Pharma, Eli Lilly and Janssen-Cilag Pharmaceuticals, Denmark (Drs Simonsen and Haahr). Also supported by a National Alliance for Research on Schizophrenia and Depression (NARSAD) Distinguished Investigator Award and NIMH grant MH-01654 (Dr. McGlashan) and a NARSAD Young Investigator Award (Dr. Larsen). None of the funding sources had any influence on the design and conduct of the study; collection, management, analysis, and interpretation of the data; or preparation, review, or approval of the manuscript. All authors had full access to all of the data in the study.

Notes

Note: Levels of statistical significance: *p < 0.01. Student's t-test **p < 0.01. Fischer's exact test ***p < 0.01, Mann Whitney U test.

Note: Levels of statistical significance: *p < 0.001. Student's t-test. N = 203 for QoL measures.

Note: Levels of statistical significance: *p = 0.029, **p = 0.001, ***p = 0.002, ****p = 0.006, Mann-Whitney U-test.

Note: Levels of statistical significance: Spearman's rho. *0.01 < p < 0.05, **p < 0.005, ***p < 0.0001.