Self-harm in first-episode psychosis.
BACKGROUND
Little is known about self-harm occurring during the period of untreated first-episode psychosis.


OBJECTIVE
To establish the prevalence, nature, motivation and risk factors for self-harm occurring during the untreated phase of first-episode psychosis.


METHODS
As part of the AESOP (Aetiology and Ethnicity in Schizophrenia and Other Psychoses) study, episodes of self-harm were identified among all incident cases of psychosis presenting to services in south-east London and Nottingham over a 2-year period.


RESULTS
Of the 496 participants, 56 (11.3%) had engaged in self-harm between the onset of psychotic symptoms and first presentation to services. The independent correlates of self-harm were: male gender, belonging to social class I/II, depression and a prolonged period of untreated psychosis. Increased insight was also associated with risk of self-harm.


CONCLUSIONS
Self-harm is common during the pre-treatment phase of first-episode psychosis. A unique set of fixed and malleable risk factors appear to operate in those with first-episode psychosis. Reducing treatment delay and modifying disease attitudes may be key targets for suicide prevention.
Harvey
Samuel B
SB
Department of Psychological Medicine, Institute of Psychiatry, King's College London, Weston Education Centre, 10 Cutcombe Road, London SE5 9RJ, UK. s.harvey@iop.kcl.ac.uk
Dean
Kimberlie
K
Morgan
Craig
C
Walsh
Elizabeth
E
Demjaha
Arsime
A
Dazzan
Paola
P
Morgan
Kevin
K
Lloyd
Tuhina
T
Fearon
Paul
P
Jones
Peter B
PB
Murray
Robin M
RM
D000293:Adolescent; D000328:Adult; D003863:Depression / Q000453:epidemiology / Q000523:psychology; D004739:England / Q000453:epidemiology; D004812:Epidemiologic Methods; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009042:Motivation; D011618:Psychotic Disorders / Q000453:epidemiology / Q000523:psychology*; D016728:Self-Injurious Behavior / Q000453:epidemiology / Q000209:etiology*; D012737:Sex Factors; D012923:Social Class