Suicidal behavior in adolescents with first-episode psychosis.
BACKGROUND
Studies have reported an increased risk for suicide in adults with schizophrenia, but limited data on younger populations are available.


OBJECTIVE
We hypothesize that first-episode psychosis is associated with an increased risk of suicidal behavior in adolescents.


METHODS
A retrospective study was conducted with patients (n=102) diagnosed with psychosis not otherwised specified (NOS), schizophreniform disorder, schizoaffective disorder or schizophrenia within six months prior to admission. A control group consisting of ninety-eight patients with other (nonpsychosis) psychiatric diagnoses admitted to the same unit was matched by age, gender and ethnicity. All patients and controls were administered the Brief Psychiatric Rating Scale-Children version to assess severity of psychiatric symptoms and suicidality, and medical records were used to assess suicidal behavior and possible risk factors.


RESULTS
When compared to controls, patients with psychosis had over twice as many suicide attempts overall (p<0.01). The 32% incidence of suicide attempts reported in this cohort is nearly double what is reported in adults with psychosis. Depressive symptoms were significantly correlated with increased suicide attempts (p<0.05).


CONCLUSIONS
There was no significant difference between the number of pediatric psychosis inpatients versus nonpsychotic psychiatric inpatients who attempted suicide. There was, however, a significant difference between the total number of attempts between groups, illustrating that children and adolescents with psychosis are more likely than nonpsychotic psychiatric inpatients to have repeat, or multiple, suicide attempts. Longer duration of untreated psychosis, ADHD and depressive symptoms were found to be the strongest risk factors for patients with psychosis.
Falcone
Tatiana
T
Department of Psychiatry, Cleveland Clinic Department of Neurology, Neurological Institute, Cleveland Clinic Foundation, 9500 Euclid Avenue P57, Cleveland, OH 44195, USA. falcont1@ccf.org
Mishra
Leenu
L
Carlton
Erin
E
Lee
Catherine
C
Butler
Robert S
RS
Janigro
Damir
D
Simon
Barry
B
Franco
Kathleen
K
D000046:Academic Medical Centers / Q000706:statistics & numerical data; D000293:Adolescent; D010054:Brief Psychiatric Rating Scale; D015331:Cohort Studies; D003430:Cross-Sectional Studies; D003863:Depression / Q000175:diagnosis / Q000453:epidemiology; D005260:Female; D006760:Hospitalization / Q000706:statistics & numerical data; D006801:Humans; D015994:Incidence; D008297:Male; D009820:Ohio; D011618:Psychotic Disorders / Q000175:diagnosis / Q000453:epidemiology*; D012189:Retrospective Studies; D012306:Risk; D012559:Schizophrenia / Q000175:diagnosis / Q000453:epidemiology*; D013406:Suicide, Attempted / Q000706:statistics & numerical data*