Breitborde Nicholas J K, Wastler Heather, Pine Jacob G, Moe Aubrey M
Department of Psychiatry and Behavioural Health, The Ohio State University, Columbus, Ohio, USA.
Department of Psychology, The Ohio State University, Columbus, Ohio, USA.
Early Interv Psychiatry. 2021 Jun;15(3):497-504. doi: 10.1111/eip.12967. Epub 2020 Apr 14.
Although suicidal ideation may decrease over the course of participation in specialized clinical programmes for first-episode psychosis (FEP), it is unclear whether such improvements exceed those that occur during treatment as usual. Clarifying the mechanisms underlying reductions in suicidal ideation and behaviour among individuals with first-episode psychosis may highlight important strategies through which specialized clinical programmes can increase the potency of their services to reduce suicidality among this high-risk population. Thus, the goal of this study is to evaluate the longitudinal relationships between suicidality and social problem-solving skills among individuals with FEP participating in Coordinated Specialty Care.
Within-subject mediational and moderational models were applied to explore the interrelationships and longitudinal course of suicidality, social problem-solving and duration of untreated psychosis (DUP).
Over the first 6 months of care, individuals with FEP experienced improvements in social problem-solving skills that were found to mediate concurrent reductions in suicidality. Although longitudinal changes in social problem-solving skills were moderated by DUP, these results should be interpreted cautiously as they may stem in part from a relatively limited number of participants with longer durations of illness.
Improvements in social problem-solving skills during participation in CSC may facilitate reductions in suicidality. Treatments targeting suicidality among individuals with FEP may thus benefit from working to enhance social problem-solving skills among these individuals. Further research is needed to clarify if and how DUP may influence the magnitude of change in social problem-solving skills during participation in CSC.
尽管在参与首发精神病（FEP）的专门临床项目过程中自杀意念可能会减少，但尚不清楚这种改善是否超过常规治疗期间的改善。阐明首发精神病患者自杀意念和行为减少的潜在机制，可能会凸显出一些重要策略，通过这些策略，专门临床项目可以提高其服务效力，以降低这一高危人群的自杀率。因此，本研究的目的是评估参与协同专科护理的首发精神病患者自杀倾向与社会问题解决能力之间的纵向关系。
采用受试者内中介和调节模型来探讨自杀倾向、社会问题解决能力和未治疗精神病持续时间（DUP）之间的相互关系和纵向过程。
在护理的前6个月里，首发精神病患者的社会问题解决能力有所改善，这被发现可中介同时期自杀倾向的降低。尽管社会问题解决能力的纵向变化受到DUP的调节，但这些结果应谨慎解释，因为它们可能部分源于病程较长的参与者数量相对有限。
参与协同专科护理期间社会问题解决能力的改善可能有助于降低自杀倾向。因此，针对首发精神病患者自杀倾向的治疗可能会受益于努力提高这些患者的社会问题解决能力。需要进一步研究来阐明DUP是否以及如何影响参与协同专科护理期间社会问题解决能力变化的幅度。
