title: Depressive symptoms and suicidal behavior after first-episode psychosis: A comprehensive systematic review.
abstract: Depressive symptoms and suicidal behavior are common among patients that suffered a first-episode psychosis. We searched Web of KnowledgeSMand Pubmed® for English and Portuguese original articles investigating prevalence of depressive symptoms and/or suicidal behavior and associated factors after first-episode psychosis. We included 19 studies from 12 countries, 7 studied depressive symptoms and 12 suicidal behavior. The findings confirm that depressive symptoms and suicidal behavior have high rates in the years after first-episode psychosis. Factors identified as being associated with depressive symptoms after first-episode psychosis were anomalies of psychosocial development, poor premorbid childhood adjustment, greater insight, loss, shame, low level of continuing positive symptoms and longer duration of untreated psychosis. Suicidal behavior was associated with previous suicide attempt, sexual abuse, comorbid polysubstance use, lower baseline functioning, longer time in treatment, recent negative events, older patients, longer duration of untreated psychosis, higher positive and negative psychotic symptoms, family history of severe mental disorder, substance use, depressive symptoms and cannabis use. Data also indicate that treatment and early intervention programs reduce depressive symptoms and suicidal behavior after first-episode psychosis. Future research should overcome some methodological discrepancies that exist between studies and limit generalization of current findings.
authors.affiliation: Faculdade de Medicina, Universidade de Lisboa, Av. Prof. Egas Moniz, 1649-028 Lisboa, Portugal; First-Episode Psychosis Program, Department of Psychiatry, Hospital Vila Franca de Xira, Estrada Nacional N1, 2600-009 Vila Franca de Xira, Portugal. Electronic address: Ricardo.Coentre@netc.pt.
authors.forename: Ricardo
authors.initials: R
authors.lastname: Coentre
authors.affiliation: Department of Psychiatry, Hospital Vila Franca de Xira, Estrada Nacional N1, 2600-009 Vila Franca de Xira, Portugal; CEDOC, Chronic Diseases Research Centre, Nova Medical School, Faculdade de Ciências Médicas, New University of Lisbon, Campo Mártires da Pátria, 1169-056 Lisboa, Portugal.
authors.forename: Miguel Cotrim
authors.initials: MC
authors.lastname: Talina
authors.affiliation: Faculdade de Medicina, Universidade de Lisboa, Av. Prof. Egas Moniz, 1649-028 Lisboa, Portugal.
authors.forename: Carlos
authors.initials: C
authors.lastname: Góis
authors.affiliation: Faculdade de Medicina, Universidade de Lisboa, Av. Prof. Egas Moniz, 1649-028 Lisboa, Portugal.
authors.forename: Maria Luísa
authors.initials: ML
authors.lastname: Figueira
mesh_terms: D000328:Adult; D015897:Comorbidity; D003863:Depression / Q000453:epidemiology / Q000523:psychology*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D015995:Prevalence; D011618:Psychotic Disorders / Q000523:psychology*; D012307:Risk Factors; D019966:Substance-Related Disorders / Q000523:psychology; D059020:Suicidal Ideation; D013406:Suicide, Attempted / Q000523:psychology*
keywords: Duration of untreated psychosis; First-episode psychosis; Schizophrenia; Suicide; Suicide attempts