Predictors of suicide attempt in treatment in first episode psychosis

Background: Little is known about the factors associated with suicidal behaviour in treatment amongst young people experiencing first episode psychosis (FEP). The aim of this paper is to describe the demographic, diagnostic, premorbid, and entry characteristics, of FEP patients who attempt suicide during the course of treatment at a specialist first-episode psychosis service. Methods: Data were collected via extensive file audit. The sample comprises 668 young people who received a specialist first-episode psychosis service from EPPIC, Victoria, Australia, between 1998 and 2000. Results: Patients who attempted suicide during treatment were significantly younger, had fewer years of education, were more likely to have a diagnosis of major depressive disorder with psychotic features, or a substance use disorder. Premorbid factors associated with suicide attempt in treatment included poorer functioning, a longer duration of untreated psychosis, an earlier age of onset of psychosis, exposure to a traumatic event, and having a past psychiatric diagnosis. At entry to service, patients who attempted suicide demonstrated greater severity of symptoms and poorer functioning than those who did not attempt suicide while in treatment. Conclusions: The clinical implications of these findings will be discussed with particular attention being given to the role of early intervention services in devising treatment strategies and reducing risk of suicide attempts in treatment