Department of Mental Health and Pathological Addiction, Azienda USL di Parma, Parma, Italy.
Department of Medicine and Surgery, Psychiatric Unit, Università di Parma, Parma, Italy.
Suicide Life Threat Behav. 2020 Aug;50(4):838-855. doi: 10.1111/sltb.12625. Epub 2020 Feb 12.
Although suicide behavior is relevant in first-episode psychosis (FEP), little is known about suicidal ideation and its longitudinal stability. The aim of this study was (1) to assess incidence rates of suicide attempts, completed suicide, and suicidal thinking in FEP individuals at baseline and over a 24-month follow-up period; (2) to explore any significant association of suicidal ideation with psychopathology at baseline; and (3) to monitor longitudinally suicidal thinking along the 2-year follow-up.
Participants (134 FEP patients, aged 13-54 years) were assessed with the Brief Psychiatric Rating Scale (BPRS) and the Positive and Negative Syndrome Scale (PANSS). A Kaplan-Meier survival analysis to calculate cumulative incidence rates of attempted and completed suicide was also performed.
FEP patients showed a 31.3% percentage of suicidal ideation (i.e., BPRS item 4 cutoff score of ≥ 3) and a 2-year cumulative incidence rate of attempted suicide of 11%. No completed suicide was found. In the FEP total sample, suicidal thinking was positively correlated with general psychopathology (especially depression) and negative symptoms.
Suicidal ideation is relevant in FEP patients, supporting a routine monitoring of suicide risk during the baseline assessment of adolescents and adults with early psychosis.
尽管自杀行为与首发精神病(FEP)相关,但对于自杀意念及其纵向稳定性知之甚少。本研究的目的是:(1)评估 FEP 个体在基线和 24 个月随访期间自杀未遂、自杀死亡和自杀意念的发生率;(2)探讨自杀意念与基线时精神病理学之间的任何显著关联;(3)在 2 年随访期间监测自杀意念的纵向变化。
参与者(134 名 FEP 患者,年龄 13-54 岁)接受了简明精神病评定量表(BPRS)和阳性和阴性综合征量表(PANSS)的评估。还进行了 Kaplan-Meier 生存分析以计算自杀未遂和自杀死亡的累积发生率。
FEP 患者有 31.3%的自杀意念(即 BPRS 项目 4 的截断得分≥3),2 年的自杀未遂累积发生率为 11%。未发现自杀死亡。在 FEP 总样本中,自杀意念与一般精神病理学(尤其是抑郁)和阴性症状呈正相关。
自杀意念在 FEP 患者中很常见,支持在青少年和成年首发精神病患者的基线评估期间常规监测自杀风险。