Trajectories of suicidality during a 2-year early-intervention program for first-episode psychosis: A longitudinal study.

Little is known about the individual course of suicidal ideations and attempts (i.e., suicidality) after treatment initiation. We examined the trajectories of suicidality and associated risk factors over a 2-year early intervention program for first-episode psychosis in 450 patients (age range 18-35 years at admission) consecutively admitted from 2003 to 2017. Suicidality was assessed via systematic file review, while sociodemographic and clinical variables were assessed at admission. Latent class growth modelling identified three trajectories: low (69.6 %), initially high (22.9 %), and persistently high (7.6 %) suicidality. Patients who were younger, lived alone and were diagnosed with affective psychosis were significantly more likely to follow the initially high trajectory. Patients who attempted suicide up to 3 months before admission, lived alone and presented lower levels of the PANSS excited factor were significantly more likely to follow the persistently high trajectory. Attempting suicide up to 3 months before admission distinguished persistently high and initially high suicidality trajectories. Suicide risk during early intervention program for first-episode psychosis is heterogenous, with acute and enduring suicidal risk, suggesting the need to adapt suicide prevention strategies to these different risk profiles.

Informations de copyright

Copyright © 2024. Published by Elsevier B.V.

Déclaration de conflit d'intérêts

Declaration of competing interest ML reports grants from Roche Canada, grants from Otsuka Lundbeck Alliance, grants and personal fees from Janssen, and personal fees from Otsuka Canada, Lundbeck Canada, and Boehringer Ingelheim outside the submitted work. RJ reports receipt of grants, speaker and consultant honoraria from Janssen, Lundbeck, Otsuka, Pfizer, Shire, Perdue, HLS, and Myelin, and royalties from Henry Stewart Talks. The other authors declare no conflict of interest.