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.
Bertelsen
Mette
M
Bispebjerg Hospital, Department of Psychiatry, Bispebjerg Bakke 23, 2400 Copenhagen NV, Denmark.
Jeppesen
Pia
P
Petersen
Lone
L
Thorup
Anne
A
Øhlenschlaeger
Johan
J
le Quach
Phuong
P
Christensen
Torben Østergaard
TØ
Krarup
Gertrud
G
Jørgensen
Per
P
Nordentoft
Merete
M
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