Prevalence of suicide risk factors in people at ultra-high risk of developing psychosis: a service audit.
BACKGROUND
Little data is available on the prevalence of suicide risk factors in people at ultra-high risk (UHR) of developing psychosis.


OBJECTIVE
The aim of this study was to provide an estimate of the cross-sectional prevalence of possible suicide risk factors in those attending a routine clinical service for people at UHR of developing psychosis.


METHODS
For all patients in treatment (n=34) over a 4-week period, levels of suicidal ideation and depression upon entry to the service were assessed by auditing intake scores on the Beck Depression Inventory, second edition. Level of engagement with services, social isolation, substance and alcohol misuse, ready access to means, current suicidal ideation, previous suicide attempts, current or previous self-harm, expressions of concern from others, depression, agitation, hopelessness, worthlessness, suspiciousness and fears of mental disintegration were all assessed by case note review and interview with the treating clinician.


RESULTS
There was a high prevalence of at least mild suicidal ideation (58.8%, n=20) and severe depressed mood (47%, n=16) in this client group at point of entry to the service. Seven people (20.6%) had engaged in serious self-harm (including attempted suicide) during the time they were in contact with the service. Forty-seven per cent (n=16) reported at least 27 suicide attempts between them; the mean number of attempts being 1.69 (standard deviation=1.08).


CONCLUSIONS
Suicide risk was high in this small sample of people at UHR of developing psychosis. Controlled research with larger samples and better methodology is urgently required to inform legal, ethical and scientific debates surrounding this group.
Psychosis Research Unit (PRU) Early Detection and Intervention Team (EDIT), Greater Manchester West Mental Health Foundation NHS Trust, Bury New Road, Prestwich, Manchester, UK. paulhutton@nhs.net
Paul
P
Hutton
Samantha
S
Bowe
Sophie
S
Parker
Sarah
S
Ford
D000293:Adolescent; D000328:Adult; D015928:Cognitive Behavioral Therapy; D003430:Cross-Sectional Studies; D005260:Female; D006801:Humans; D008297:Male; D008485:Medical Audit; D010555:Personality Inventory; D015995:Prevalence; D011314:Preventive Health Services; D011569:Psychiatric Status Rating Scales; D011618:Psychotic Disorders / Q000453:epidemiology* / Q000523:psychology / Q000628:therapy; D018570:Risk Assessment; D012307:Risk Factors; D013405:Suicide / Q000523:psychology / Q000706:statistics & numerical data*; D055815:Young Adult; D000092864:Suicide Prevention