The evolution of depression and suicidality in first episode psychosis.
OBJECTIVE
To have a clearer understanding of the ebb and flow of depression and suicidal thinking in the early phase of psychosis, whether these events are predictable and how they relate to the early course of psychotic symptoms.


METHODS
Ninety-two patients with first episode psychosis (FEP) completed measures of depression, including prodromal depression, self-harm and duration of untreated psychosis. Follow-up took place over 12 months.


RESULTS
Depression occurred in 80% of patients at one or more phases of FEP; a combination of depression and suicidal thinking was present in 63%. Depression in the prodromal phase was the most significant predictor of future depression and acts of self-harm.


CONCLUSIONS
Depression early in the emergence of a psychosis is fundamental to the development of future depression and suicidal thinking. Efforts to predict and reduce depression and deliberate self-harm in psychosis may need to target this early phase to reduce later risk.
Upthegrove
Rachel
R
Birmingham and Solihull Mental Health Foundation Trust, Early Intervention Service, Aston, Birmingham, UK. rachel.upthegrove@bsmhft.nhs.uk
Birchwood
M
M
Ross
K
K
Brunett
K
K
McCollum
R
R
Jones
L
L
D000208:Acute Disease; D000293:Adolescent; D000328:Adult; D015897:Comorbidity; D003866:Depressive Disorder / Q000175:diagnosis* / Q000453:epidemiology / Q000523:psychology*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007406:Interview, Psychological; D008297:Male; D011569:Psychiatric Status Rating Scales; D011618:Psychotic Disorders / Q000175:diagnosis* / Q000453:epidemiology / Q000523:psychology*; D012189:Retrospective Studies; D012307:Risk Factors; D016728:Self-Injurious Behavior / Q000175:diagnosis* / Q000453:epidemiology / Q000523:psychology*; D059020:Suicidal Ideation; D055815:Young Adult