Suicide in the first episode of schizophrenia

Uvod: Samomor je razširjen javnozdravstveni in družbeni problem in je eden izmed vodilnih vzrokov smrti med pacienti s shizofrenijo. Samomorilno vedenje je lahko prisotno v različnih fazah shizofrenije. Namen diplomskega dela je narediti sistematični pregled literature in analizo podatkov obstoječih raziskav o samomorilnosti v prvi epizodi shizofrenije. Metode: Za sistematičen pregled literature smo uporabili zbirke podatkov PubMed, ScienceDirect, UpToDate in SAGE. V analizo smo vključili vse vire, objavljene od leta 2010 do 2020. Rezultati: Pri analizi virov so bile identificirane tri glavne teme: stopnja samomorilnosti v prvi epizodi shizofrenije, dejavniki tveganja za samomor v prvi epizodi shizofrenije in ukrepi preprečevanja samomorilnosti pri pacientih s shizofrenijo. Razprava in sklep: Samomor je eden vodilnih vzrokov za prezgodnjo smrt med osebami s shizofrenijo in z motnjami psihotičnega spektra. Najpomembnejši dejavniki tveganja za samomor pri pacientih s prvo epizodo shizofrenije so starost pacienta ob pojavu psihotičnih simptomov, trajanje nezdravljene psihoze oziroma časovna zakasnitev pri vstopu do sistema duševnega zdravstvenega varstva z začetkom zdravljenja, demografske značilnosti, psihopatologija ter razumevanje in sprejemanje lastne bolezni. V vseh fazah je potrebno redno izvajanje temeljitega nadzora s sistematično oceno tveganja, ki bi olajšala zgodnje odkrivanje primerov z visokim tveganjem, na podlagi katerih bi uvedli ukrepe za preprečevanje samomorov.Theoretical framework: Suicide is a widespread, as well as increasing public health and social issue. It is one of the leading causes of death concerning patients suffering from schizophrenia. Suicidal behaviour can be present during different stages of the illness. This thesis aims to systematically review the literature and analyse data of existing researches regarding suicide in the first episode of schizophrenia. Research methods: For the systematic review of the literature we used the databases PubMed, ScienceDirect, UpToDate, and SAGE. The analysis includes all the sources published between the years 2010 and 2020. Results: Through source analysis, three major themes were identified: suicide rate during the first episode of schizophrenia, suicide risk factors during the first episode of schizophrenia, and measures aimed at preventing suicide in patients with schizophrenia. Discussion and conclusion: Suicide is one of the leading causes of premature deaths among persons with schizophrenia and the spectrum of psychotic disorders. For patients in the first episode of schizophrenia, the most important risk factors of suicide are the age of the patients when psychotic symptoms appear, the duration of untreated psychosis, or the postponement of entry to the mental health care system with the initiation of treatment, the demographic characteristics, psychopathology, together with the understanding and acceptance of one\u27s illness. That is why it is important to regularly surveil patients with a systematic risk assessment in all stages of the disease. This would improve early detection of higher-risk patients and thereafter the measures for suicide prevention could be implemented