The association between trauma and psychosis outcomes is well-established, and yet the impact of trauma on comorbid clinical symptoms—such as aggression, non-suicidal self-injury behavior (NSSIB), suicide ideation, and suicide behavior—for those with psychosis is unclear. To effectively treat those with first-episode psychosis (FEP) and a history of trauma, we need to understand the impact of trauma on their whole presentation. FEP participants were recruited from an Early Psychosis Program (N = 187, ages 12–35, 72.2% male). Clinicians gathered history of trauma, aggression, and suicide data, and rated current symptom severity and functioning. Data was coded using clinician rated measures, self-report measures, and retrospective clinical chart review. Regression analyses examined whether trauma was associated with a history of aggression, suicidal ideation, suicide behavior, NSSIB, symptoms, and functioning. Trauma was associated with aggression, aggression severity and type of aggression (aggression towards others). Trauma was also associated with depression severity, suicide ideation, most severe suicide ideation, and NSSIB. Trauma was not associated with suicide behavior, severity of suicide behavior or psychosocial functioning. Integrating trauma treatment into FEP care could reduce rates of depression, aggression, suicide ideation, and NSSIB for those with a history of trauma. To reduce suicide attempt occurrence and improve functioning, more research is needed.

No abstract

No abstract

BackgroundPoor mental health is a risk factor for death by suicide, but not all individuals who die by suicide have poor mental health. Suicide itself is not a mental illness, but a behaviour, and the predictors for poor mental health and for suicide risk may vary. These associations are complex given the mediating effect of mental health on suicide risk. This study asks do self-reports of chronic poor mental health relate to subsequent suicide risk and do the social and demographic predictors of suicide and of poor mental health differ?MethodsRecord linkage study utilising the Northern Ireland Mortality Study (NIMS), comprising census returns for the whole enumerated population (March 2011) and subsequently registered deaths (currently 2011–2014). The presence of chronic poor mental health was assessed by a Census question asking about “an emotional, psychological or mental health condition”. The outcome of interest was death by suicide.ResultsOf the 1.22 million individuals aged 16–74 years enumerated in the 2011 Census, 7.5% identified as having chronic poor mental health. A total of 658 individuals completed suicide before December 2014, of which only 31% self-reported poor mental health. Cox regression models determined that individuals with poor mental health were 5 times more likely to die by suicide compared to those with no mental health problems (OR 5.59; 95% CI 4.72, 6.61). The cohort was stratified by mental health status; male gender was still a significant predictor of suicide risk in those who identified as having poor mental health (OR 2.75; 95% CI 2.03, 3.72). Middle age (35–44 years), poor physical health and high socio-economic status were also associated with increased risk of suicide in the poor mental health group but these associations failed to reach significance. Whereas in those individuals who did not identify as having chronic poor mental health the biggest predictors of suicide were male gender (OR 4.06; 95% CI 3.21, 5.13), never being married or separated/divorced (OR 1.94; 95% CI 1.48, 2.56 and OR 2.15; 95% CI 1.55, 2.99), physical illness (OR 1.87; 95% CI 1.25, 2.78), and low socio-economic status (OR 1.92; 95% CI 1.39, 2.65).DiscussionRelationship status, physical health and socio-economic position predict suicide risk in those with good mental health whereas male gender is the biggest predictor of suicide in those with poor mental health. Comparison work on the risk factors for poor mental health and suicide is underway along with further exploration of interactions to be presented at the conference.