期刊
SCHIZOPHRENIA RESEARCH
卷 126, 期 1-3, 页码 11-19出版社
ELSEVIER
DOI: 10.1016/j.schres.2010.11.021
关键词
Suicide; Risk factors; Epidemiology; Schizophrenia; Psychosis
类别
资金
- Medical Research Council, London, UK
- British Medical Association, Psychiatry Research Trust, London, UK
- Chief Scientist Office, Scottish Government, Edinburgh, Scotland, UK [CZH/4/110]
- Medical Research Council [G0601686] Funding Source: researchfish
- MRC [G0601686] Funding Source: UKRI
Background: Much remains unknown about whether there are early risk factors for suicide in psychosis. Aim: The aim of the study was to determine whether there are any identifiable early symptom clusters, aetiological factors or illness course markers for suicide in first episode psychosis. Method: A total of 2132 patients with first episode psychosis presenting to secondary care services in London (1965-2004; n = 1474), Nottingham (1997-1999; n = 195) and Dumfries and Galloway (1979-1998; n = 463) were traced after up to 40 years (mean 13 years) following first presentation. Risk factors were identified from the Operational Checklist for Psychotic Disorders rated for the first year following presentation. Results: Overall, there were 51 suicides and 373 deaths from other causes. Male gender (RR 2.84, 95% Cl 1.20-6.69, p = 0.02) and a cumulative threshold effect of symptoms early in the illness (RR 6.81,95% Cl 2.33-19.85, p < 0.001) were associated with a higher propensity for later completed suicide. There was also a suggestion that early manic symptoms might increase the risk of later suicide irrespective of initial diagnosis. Conclusion: Suicide risk was associated with a cumulative threshold effect of symptoms and manic symptoms. As suicide is a relatively rare event in psychotic disorders, general population-based prevention strategies may have more impact in this vulnerable group as well as the wider population. (C) 2010 Elsevier B.V. All rights reserved.
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