Suicidal Thinking and Behavior in First Episode Schizophrenia: Findings from the 24-Month Follow-Up of the “Parma Early Psychosis” Program

Abstract

Although suicide risk is relevant in First Episode Schizophrenia (FES), little data are reported on suicidal ideation and its longitudinal stability. Aim of this study was: (1) to evaluate incidence rates of suicide attempts, completed suicide and suicidal thinking in FES patients at baseline and along a 24-month follow-up period, (2) to investigate any relevant association of baseline suicidal ideation with psychopathology, and (3) to longitudinally monitor suicidal thinking during the 2-years of follow-up. Participants (n = 149; age = 12–35 years) were assessed with the Brief Psychiatric Rating Scale (BPRS) and the Positive and Negative Syndrome Scale. FES participants showed a 40.8% percentage of baseline suicidal ideation (i.e., BPRS item 4 cutoff score of ≥3) and a 2-year cumulative incidence rate of attempted suicide of 6.1%. One completed suicide (0.7%) was also found during the follow-up. Baseline suicidal ideation was positively correlated with depression and negatively correlated with younger age. These results support a routine monitoring of suicide risk in this young population at the point of entry into early intervention services.

Keywords:

• Early psychosis
• first episode psychosis
• first episode schizophrenia
• suicidal ideation
• suicide
• suicide risk

ACKNOWLEDGMENTS

For their facilitating technical and administrative support in the Pr-EP program, we gratefully acknowledge the “Early Psychosis” Facilitators Group Members (Sabrina Adorni, Andrea Affaticati, Anahi Alzapiedi, Paolo Ampollini, Patrizia Caramanico, Maria Teresa Fusoni, Maria Teresa Gaggiotti, Tiziana Guglielmetti, Maristella Miglioli, Mauro Mozzani, Giuseppina Paulillo, Matteo Rossi, Matteo Tonna, Fabio Vanni, and Matteo Zito), the Quality Staff Group Members (Patrizia Ceroni, Stefano Giovannelli, and Leonardo Tadonio), and the “Early Psychosis” Improvement Group Members (Patrizia Ceroni, Cristiana Damini, and Marco Lombardi) of the Parma Department of Mental Health and Pathological Addiction. We also wish to thank all the patients and family members who actively participated to the Pr-EP program. This research did not receive any specific grant from funding agencies in the public, commercial or not-for-profit sectors.

DISCLOSURE STATEMENT

No potential conflict of interest was reported by the author(s).

Additional information

Notes on contributors

Lorenzo Pelizza

Lorenzo Pelizza, Ph.D. M.D., Department of Mental Health and Pathological Addiction, Azienda USL di Parma, Parma, PR, Italy.

Clara Pellegrini

Clara Pellegrini, M.D., Psychiatric Unit, Department of Medicine and Surgery, Università di Parma, Parma, PR, Italy.

Emanuela Quattrone

Emanuela Quattrone, Psy.D., Department of Mental Health and Pathological Addiction, Azienda USL di Parma, Parma, PR, Italy.

Silvia Azzali

Silvia Azzali, Psy.D., Department of Mental Health and Pathological Addiction, Azienda USL-IRCCS di Reggio Emilia, Reggio Emilia, RE, Italy.

Giulia Landi

Giulia Landi, M.D., Pietro Pellegrini, M.D., and Emanuela Leuci, M.D., Department of Mental Health and Pathological Addiction, Azienda USL di Parma, Parma, PR, Italy.

Pietro Pellegrini

Giulia Landi, M.D., Pietro Pellegrini, M.D., and Emanuela Leuci, M.D., Department of Mental Health and Pathological Addiction, Azienda USL di Parma, Parma, PR, Italy.

Emanuela Leuci

Giulia Landi, M.D., Pietro Pellegrini, M.D., and Emanuela Leuci, M.D., Department of Mental Health and Pathological Addiction, Azienda USL di Parma, Parma, PR, Italy.