Interactions between mood and paranoid symptoms affect suicidality in first-episode affective psychoses.

Humans Suicidal Ideation Suicide Affective Disorders, Psychotic / psychology Psychotic Disorders / psychology Bipolar Disorder / psychology
Early intervention First-episode Mood Paranoid symptom Psychosis Suicide

Journal

Schizophrenia research
ISSN: 1573-2509
Titre abrégé: Schizophr Res
Pays: Netherlands
ID NLM: 8804207

Informations de publication

Date de publication:
04 2023
Historique:
received: 31 08 2021
accepted: 28 12 2022
medline: 18 4 2023
pubmed: 22 2 2023
entrez: 21 2 2023
Statut: ppublish

Résumé

Suicide prevention is a major challenge in the treatment of first-episode affective psychoses. The literature reports that combinations of manic, depressive and paranoid symptoms, which may interact, are associated with an increased risk of suicide. The present study investigated whether interactions between manic, depressive and paranoid symptoms affected suicidality in first-episode affective psychoses. We prospectively studied 380 first-episode psychosis patients enrolled in an early intervention programme and diagnosed with affective or non-affective psychoses. We compared intensity and presence of suicidal thoughts and occurrence of suicide attempts over a three-year follow-up period and investigated the impact of interactions between manic, depressive and paranoid symptoms on level of suicidality. At 12 months follow-up, we observed a higher level of suicidal thoughts and higher occurrence of suicide attempts among the affective psychoses patients compared to non-affective psychoses patients. Combined presence of either depressive and paranoid symptoms, or manic and paranoid symptoms, was significantly associated with increased suicidal thoughts. However, the combination of depressive and manic symptoms showed a significant negative association with suicidal thoughts. This study suggests that paranoid symptoms combined with either manic or depressive symptoms are associated with an increased risk of suicide in first-episode affective psychoses. Detailed assessment of these dimensions is therefore warranted in first-episode affective patients and integrated treatment should be adapted to increased suicidal risk, even if patients do not display full-blown depressive or manic syndromes.

Sections du résumé

BACKGROUND
Suicide prevention is a major challenge in the treatment of first-episode affective psychoses. The literature reports that combinations of manic, depressive and paranoid symptoms, which may interact, are associated with an increased risk of suicide. The present study investigated whether interactions between manic, depressive and paranoid symptoms affected suicidality in first-episode affective psychoses.
METHODS
We prospectively studied 380 first-episode psychosis patients enrolled in an early intervention programme and diagnosed with affective or non-affective psychoses. We compared intensity and presence of suicidal thoughts and occurrence of suicide attempts over a three-year follow-up period and investigated the impact of interactions between manic, depressive and paranoid symptoms on level of suicidality.
RESULTS
At 12 months follow-up, we observed a higher level of suicidal thoughts and higher occurrence of suicide attempts among the affective psychoses patients compared to non-affective psychoses patients. Combined presence of either depressive and paranoid symptoms, or manic and paranoid symptoms, was significantly associated with increased suicidal thoughts. However, the combination of depressive and manic symptoms showed a significant negative association with suicidal thoughts.
CONCLUSIONS
This study suggests that paranoid symptoms combined with either manic or depressive symptoms are associated with an increased risk of suicide in first-episode affective psychoses. Detailed assessment of these dimensions is therefore warranted in first-episode affective patients and integrated treatment should be adapted to increased suicidal risk, even if patients do not display full-blown depressive or manic syndromes.

Identifiants

DOI: 10.1016/j.schres.2022.12.035 PMID: 36801515
pubmed: 36801515
pii: S0920-9964(22)00482-0
doi: 10.1016/j.schres.2022.12.035
pii:
doi:

Types de publication

Journal Article Research Support, Non-U.S. Gov't

Langues

eng

Sous-ensembles de citation

IM

Pagination

62-67

Informations de copyright

Copyright © 2022. Published by Elsevier B.V.

Déclaration de conflit d'intérêts

Declaration of competing interest None.

Auteurs

Julie Ramain (J)

Service of General Psychiatry, Treatment and Early Intervention in Psychosis Programme (TIPP Lausanne), Lausanne University Hospital and University of Lausanne, Switzerland; Training and Research Institute in Mental Health (IFRSM), Neuchâtel Centre of Psychiatry, Neuchâtel, Switzerland. Electronic address: julie.ramain@cnp.ch.

Philippe Conus (P)

Service of General Psychiatry, Treatment and Early Intervention in Psychosis Programme (TIPP Lausanne), Lausanne University Hospital and University of Lausanne, Switzerland.

Philippe Golay (P)

Service of General Psychiatry, Treatment and Early Intervention in Psychosis Programme (TIPP Lausanne), Lausanne University Hospital and University of Lausanne, Switzerland; Institute of Psychology, Faculty of Social and Political Sciences, University of Lausanne, Switzerland.

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Classifications MeSH

questionsmedicales.fr › Eucaryotes › Animaux › Chordés › Vertébrés › Mammifères › Eutheria › Primates › Haplorhini › Catarrhini › Hominidae › Humains › Interactions between mood and paranoid...
questionsmedicales.fr › Sciences sociales › Sociologie › Problèmes sociaux › Suicide › Idéation suicidaire › Interactions between mood and paranoid...
questionsmedicales.fr › Sciences sociales › Sociologie › Problèmes sociaux › Suicide › Interactions between mood and paranoid...
questionsmedicales.fr › Troubles mentaux › Schizophrénie et troubles avec traits psychotiques › Troubles affectifs psychotiques › Interactions between mood and paranoid...
questionsmedicales.fr › Troubles mentaux › Schizophrénie et troubles avec traits psychotiques › Troubles psychotiques › Interactions between mood and paranoid...
questionsmedicales.fr › Troubles mentaux › Troubles de l'humeur › Troubles bipolaires et apparentés › Trouble bipolaire › Interactions between mood and paranoid...