Suicidal behaviour and mortality in first-episode psychosis: the OPUS trial.
BACKGROUND
Those with first-episode psychosis are at high-risk of suicide.


OBJECTIVE
To identify predictive factors for suicidal thoughts, plans and attempts, and to investigate the rate of suicides and other deaths during the 5 years after first diagnosis and initiation of treatment.


METHODS
A longitudinal, prospective, 5-year follow-up study of 547 individuals with first-episode schizophrenia spectrum psychosis. Individuals presenting for their first treatment in mental health services in two circumscribed urban areas in Denmark were included in a randomised controlled trial of integrated v. standard treatment. All participants were followed in the Danish Cause of Death Register for 5 years. Suicidal behaviour and clinical and social status were assessed using validated interviews and rating scales at entry, and at 1- and 2-year follow-ups.


RESULTS
Sixteen participants died during the follow-up. We found a strong association between suicidal thoughts, plans and previous attempts, depressive and psychotic symptoms and young age, and with suicidal plans and attempts at 1- and 2-year follow-up.


CONCLUSIONS
In this first-episode cohort depressive and psychotic symptoms, especially hallucinations, predicted suicidal plans and attempts, and persistent suicidal behaviour and ideation were associated with high risk of attempted suicide.
Bispebjerg Hospital, Department of Psychiatry, Bispebjerg Bakke 23, 2400 Copenhagen NV, Denmark.
Mette
M
Bertelsen
Pia
P
Jeppesen
Lone
L
Petersen
Anne
A
Thorup
Johan
J
Øhlenschlaeger
Phuong
P
le Quach
Torben Østergaard
TØ
Christensen
Gertrud
G
Krarup
Per
P
Jørgensen
Merete
M
Nordentoft
D000293:Adolescent; D000328:Adult; D003695:Delivery of Health Care / Q000379:methods; D019033:Delivery of Health Care, Integrated / Q000379:methods; D003863:Depression / Q000523:psychology; D004812:Epidemiologic Methods; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D011618:Psychotic Disorders / Q000523:psychology* / Q000628:therapy; D012559:Schizophrenia / Q000628:therapy; D012565:Schizophrenic Psychology; D013405:Suicide / Q000523:psychology*; D013406:Suicide, Attempted / Q000523:psychology