Predictors and outcome characteristics associated with suicidal behaviour in early psychosis: a two-year follow-up of first-admitted subjects

Objective: To assess the baseline characteristics associated with a greater risk of suicidal behaviour (suicide and parasuicide) over the 2 years following a first admission for psychosis, and the associations between suicidality and outcome. Method: First-admitted subjects with psychosis (n = 65) were assessed at 6-monthly intervals over a 2-year follow-up period. Results: Over this period, 11.3% of the patients displayed suicidal behaviour. Baseline predictors of suicidal behaviour were a lifetime history of parasuicide before first admission (OR = 5.9, 95% CI 1.5-23.4), lower Positive And Negative Symptom Scale positive subscores (OR = 0.8, 95% CI 0.6-0.97) and a longer duration of first admission (OR = 1.1, 95% CI 1-1.2). Subjects with suicidal behaviour presented with a longer duration of psychotic symptoms (OR = 1.1, 95% CI 1.02-1.2) and a greater risk of being readmitted (OR = 4.6, 95%CI 1.1-19.1). Subjects with substance misuse over the follow-up period were seven times (95% CI 1.3-39) more likely to engage in suicidal behaviour. Conclusion: Subjects with a previous history of parasuicide, with a deteriorating clinical course, or with substance misuse are at increased risk of suicidal behaviour in the 2 years after the onset of a first psychotic episode.