Sociodemographic and clinical risk factors associated with suicidal ideation and attempt during a 2-year early intervention program for first-episode psychosis

Laura Moro; Massimiliano Orri; Roxanne Sicotte; Élisabeth Thibaudeau; Ridha Joober; Ashok Malla; Martin Lepage

doi:10.1016/j.schres.2023.07.008

Sociodemographic and clinical risk factors associated with suicidal ideation and attempt during a 2-year early intervention program for first-episode psychosis

Schizophr Res. 2023 Aug:258:61-68. doi: 10.1016/j.schres.2023.07.008. Epub 2023 Jul 26.

Authors

Laura Moro¹, Massimiliano Orri², Roxanne Sicotte³, Élisabeth Thibaudeau⁴, Ridha Joober⁵, Ashok Malla⁵, Martin Lepage⁶

Affiliations

¹ Department of Psychology, University of Montreal, Montreal, Canada; Douglas Research Centre, Montreal, Canada.
² Douglas Research Centre, Montreal, Canada; McGill Group for Suicide Studies, Douglas Mental Health University Institute, Montreal, Canada; Department of Psychiatry, McGill University, Montreal, Canada.
³ Douglas Research Centre, Montreal, Canada; Department of Psychiatry and Addiction, Faculty of Medicine, University of Montreal, Canada.
⁴ Douglas Research Centre, Montreal, Canada; Department of Psychiatry, McGill University, Montreal, Canada.
⁵ Department of Psychiatry, McGill University, Montreal, Canada; Prevention and Early Intervention Program for Psychosis (PEPP), Douglas Mental Health University Institute, Montreal, Canada.
⁶ Douglas Research Centre, Montreal, Canada; Department of Psychiatry, McGill University, Montreal, Canada. Electronic address: martin.lepage@mcgill.ca.

PMID: 37506577
DOI: 10.1016/j.schres.2023.07.008

Abstract

Background: Identifying risk factors for suicidal ideation and attempt among first-episode psychosis patients is essential to prevent suicide in this high-risk population. We investigated risk factors at admission for suicidal ideation and attempt during a 2-year early intervention program.

Methods: Our sample included patients aged 18-35 years who were consecutively admitted to an early intervention program (2003-2017). Sociodemographic and clinical variables were obtained from a longitudinal study, while data on suicidal ideation and attempt were collected via systematic file review. Univariable and multivariable logistic regressions assessed the association of these variables with suicide ideation and attempt.

Results: Of 446 participants, 35 (7.8 %) attempted suicide during the 2-year follow up, including two resulting in death (0.45 %), and 168 (37.7 %) reported solely suicidal ideation. Multivariable analyses indicated living alone (OR = 4.01, CI = 2.11-7.63), affective psychosis (OR = 1.95, CI = 1.22-3.14) and depressive symptomatology (OR = 1.45, CI = 1.13-1.86) were associated with increased risk for suicidal ideation. Attempting suicide close to admission (OR = 10.29, CI = 3.63-29.22), living alone (OR = 4.17, CI = 1.40-12.35), and depressive (OR = 1.67, CI = 1.06-2.63) and positive symptomatology (OR = 1.60, CI = 1.02-2.50) were associated with increased risk for suicide attempt. Attempting suicide close to admission (OR = 11.65, CI = 4.08-33.30), being part of an ethnic minority (OR = 3.71, CI = 1.59-8.63), and presenting lower anxiety (OR = 0.58, CI = 0.36-0.94) were the only factors specifically associated with suicide attempt compared to ideation.

Conclusion: Close monitoring of patients who recently attempted suicide, live alone, are part of an ethnic minority, and present with affective and positive symptomatology may help reduce the risk of suicide-related outcomes during early intervention programs.

Keywords: Early intervention services; First-episode psychosis; Prevalence; Risk factors; Suicidal ideation; Suicide attempt.

Publication types

Research Support, Non-U.S. Gov't

MeSH terms

Early Medical Intervention
Ethnicity
Humans
Longitudinal Studies
Minority Groups
Psychotic Disorders* / epidemiology
Psychotic Disorders* / psychology
Risk Factors
Suicidal Ideation*

Grants and funding

CIHR/Canada