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

Abstract

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. Our sample included patients aged 18-35years 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. 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. 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.