The evolution of depression and suicidality in first episode psychosis

Acta Psychiatr Scand. 2010 Sep;122(3):211-8. doi: 10.1111/j.1600-0447.2009.01506.x. Epub 2009 Nov 18.


Objective: To have a clearer understanding of the ebb and flow of depression and suicidal thinking in the early phase of psychosis, whether these events are predictable and how they relate to the early course of psychotic symptoms.

Method: Ninety-two patients with first episode psychosis (FEP) completed measures of depression, including prodromal depression, self-harm and duration of untreated psychosis. Follow-up took place over 12 months.

Results: Depression occurred in 80% of patients at one or more phases of FEP; a combination of depression and suicidal thinking was present in 63%. Depression in the prodromal phase was the most significant predictor of future depression and acts of self-harm.

Conclusion: Depression early in the emergence of a psychosis is fundamental to the development of future depression and suicidal thinking. Efforts to predict and reduce depression and deliberate self-harm in psychosis may need to target this early phase to reduce later risk.

MeSH terms

  • Acute Disease
  • Adolescent
  • Adult
  • Comorbidity
  • Depressive Disorder / diagnosis*
  • Depressive Disorder / epidemiology
  • Depressive Disorder / psychology*
  • Female
  • Follow-Up Studies
  • Humans
  • Interview, Psychological
  • Male
  • Psychiatric Status Rating Scales
  • Psychotic Disorders / diagnosis*
  • Psychotic Disorders / epidemiology
  • Psychotic Disorders / psychology*
  • Retrospective Studies
  • Risk Factors
  • Self-Injurious Behavior / diagnosis*
  • Self-Injurious Behavior / epidemiology
  • Self-Injurious Behavior / psychology*
  • Suicidal Ideation*
  • Young Adult