title: Prevalence and risk factors for suicidal behavior in young people presenting with first-episode psychosis in Hong Kong: a 3-year follow-up study.
abstract: OBJECTIVE
  Individuals with first-episode psychosis (FEP) have markedly elevated risk for suicide. Previous research investigating risk factors of suicidal behavior in FEP mainly focused on western populations. This study aimed to examine the prevalence, and pretreatment and early illness predictors of suicidal behavior in Chinese FEP patients.
  
  
  METHODS
  Seven hundred participants aged 15-25 years consecutively enrolled in a territory-wide treatment program for FEP in Hong Kong from July 2001 to August 2003 were studied. Baseline and 3-year follow-up variables were collected via systematic medical file review. Suicidal behavior evaluated in this study comprised suicide attempt and completed suicide.
  
  
  RESULTS
  Seventy-four (10.6%) participants attempted suicide before treatment. Ten percent (n = 70) exhibited suicidal behavior and 1% (n = 7) committed suicide during 3-year follow-up. The majority of post-treatment suicidal behaviors (51.4%) occurred in the first year of follow-up. Jumping from a height was the most common method of committing suicide. Multivariate regression analysis indicated that previous suicide attempt, history of substance abuse and poorer baseline functioning were significantly associated with an increased risk for suicidal behavior after treatment initiation.
  
  
  CONCLUSIONS
  In a large representative cohort of Chinese young FEP patients, the rates of suicidal behavior before and after treatment and risk factors for post-treatment suicidal behavior were comparable to the findings of previous research on early psychosis conducted in western populations. Close monitoring of high-risk patients with history of attempted suicide or substance abuse, and enhancement of psychosocial functioning may help reduce suicide risk in the early stage of psychotic illness.
authors.affiliation: Department of Psychiatry, Queen Mary Hospital, The University of Hong Kong, Pokfulam, Hong Kong, changwc@hku.hk.
authors.forename: Wing Chung
authors.initials: WC
authors.lastname: Chang
authors.forename: Emily S M
authors.initials: ES
authors.lastname: Chen
authors.forename: Christy L M
authors.initials: CL
authors.lastname: Hui
authors.forename: Sherry K W
authors.initials: SK
authors.lastname: Chan
authors.forename: Edwin Ho Ming
authors.initials: EH
authors.lastname: Lee
authors.forename: Eric Y H
authors.initials: EY
authors.lastname: Chen
mesh_terms: D000293:Adolescent; D000328:Adult; D005260:Female; D005500:Follow-Up Studies; D006723:Hong Kong / Q000453:epidemiology; D006801:Humans; D008297:Male; D015999:Multivariate Analysis; D015995:Prevalence; D011618:Psychotic Disorders / Q000453:epidemiology / Q000523:psychology*; D012307:Risk Factors; D019966:Substance-Related Disorders / Q000453:epidemiology; D013405:Suicide / Q000523:psychology* / Q000706:statistics & numerical data; D013406:Suicide, Attempted / Q000523:psychology* / Q000706:statistics & numerical data; D055815:Young Adult