Suicide attempt in first-episode psychosis: A 7.4 year follow-up study

J. Robinson, M. G. Harris, S. M. Harrigan, L. P. Henry, S. Farrelly, A. Prosser, O. Schwartz, H. Jackson, P. D. McGorry

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Background: Individuals with first-episode psychosis demonstrate high rates of suicide attempt (SA). Aims: 1) To examine the prevalence of, and risk factors for, SA in a first-episode psychosis (FEP) cohort over a 7.4 year follow-up period. 2) To investigate differences between single versus multiple suicide attempters. Methods: This study reports baseline and follow-up data from a naturalistic, prospective follow-up of 413 FEP patients treated at a specialist early psychosis centre. Assessments were conducted at treatment entry, initial symptom remission or stabilization, and long term follow-up. Binary logistic regression models were used to assess unadjusted and adjusted associations between early illness and sociodemographic characteristics and two outcome measures: any SA during follow-up; and multiple SAs. Results: Follow-up data were available for 282 participants. Sixty-one (21.6%) made a suicide attempt over the follow-up period, including 12 successful suicides. The following baseline risk factors increased the risk of any SA: history of self-harm (OR = 4.27; p < 0.001), suicidal tendencies (OR = 2.30; p = 0.022), being depressed for > 50% of the initial psychotic episode (OR = 2.49; p = 0.045), and hopelessness (OR = 2.03; p = 0.030). History of problem alcohol use increased the risk of multiple SAs (OR = 4.43; 95% CI (1.05-18.7); p = 0.043). Discussion: The prevalence of suicide attempt in this study exceeds reports from short-term FEP studies but is comparable to longer term follow-up studies, indicating that risk remains elevated for at least 7 years following commencement of treatment. The key predictor of future suicide attempt was previous self-harm, indicating that interventions for self-harm are required.

Original languageEnglish
Pages (from-to)1-8
Number of pages8
JournalSchizophrenia Research
Issue number1
Publication statusPublished - Jan 2010
Externally publishedYes


  • First-episode psychosis
  • Suicide attempt

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