Clinical variables associated with suicide attempts in schizophrenia before and after the first episode

Togay, Bilge; Noyan, Handan; Taşdelen, Rümeysa; Üçok, Alp

doi:10.1016/j.psychres.2015.07.025

Cited by 51 publications

(32 citation statements)

References 29 publications

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“…Patients with significant levels of depression had significantly higher levels of suicidal behaviour, whether this was defined categorically or in terms of the number of suicide attempts. The association between depressive symptoms and suicidality in schizophrenia is well-documented in the literature [ 11 , 12 , 29 – 31 ] and our findings are in keeping with them.…”

Section: Discussionsupporting

confidence: 93%

Depressive Symptoms during an Acute Schizophrenic Episode: Frequency and Clinical Correlates

Rajkumar

2015

Depression Research and Treatment

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Introduction. Depressive symptoms are common in schizophrenia and are associated with poorer functioning, lower quality of life, and an elevated risk of suicidal behaviour. There are few studies on the occurrence and correlates of these symptoms in acutely ill patients with schizophrenia. Method. 72 acutely ill patients with schizophrenia were assessed for depression using the Calgary Depression Scale for Schizophrenia (CDSS). A cut-off score of ≥6 on the CDSS was used to identify clinically significant depressive symptoms. The relationship between depression and illness variables, including psychotic symptom dimensions as measured by the Positive and Negative Syndrome Scale for Schizophrenia (PANSS), was examined. Results. Eleven (15.3%) patients had clinically significant depressive symptoms. These patients scored higher on the positive and general psychopathology scales of the PANSS and had higher rates of suicidal behavior and poorer functioning. The severity of depressive symptoms was positively correlated with the PANSS positive subscale and negatively correlated with the PANSS negative subscale. Discussion. These findings confirm previous reports that depressive symptoms in active schizophrenia is related to the severity of positive psychotic symptoms and is a risk factor for suicidal behaviour in these patients.

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Section: Discussionsupporting

confidence: 93%

Depressive Symptoms during an Acute Schizophrenic Episode: Frequency and Clinical Correlates

Rajkumar

2015

Depression Research and Treatment

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“…In the current study, a 4.5% lifetime prevalence of suicide attempts was found in the FEP total group. This finding is much lower than what previously reported, with values ranging from 8.5% to 31% (Addington et al, ; Cohen et al, ; Levine, Bakst & Rabinowitz, ; Robinson et al, ; Tarrier, Khan, Cater & Picken, ; Togay et al, ) (for details, see also Table S1). The Pr‐EP program, including specific strategies of early referral to mental health services and early detection of psychosis, can certainty have contributed to reduce the prevalence rate of attempted suicide.…”

Section: Discussioncontrasting

confidence: 58%

“…This result is much lower that what previously reported in comparable FEP studies, suggesting 2‐year incidence rates ranging from 6% to 12% (Melle et al, ; Sanchez‐Gistau et al, ). Overall, suicide attempt rates in FEP populations differ in the various studies, with values ranging from 3%–11% at 1 year to 3%–36% at 5 years (Addington et al, ; Chang et al, ; Fedyszyn, Robinson, Harris, Paxton & Francey, ; Koreen et al, ; Krausz, Müller‐Thomsen & Haasen, ; Levine, Bakst & Rabinowitz, ; Melle et al, ; Nordentoft et al, ; Robinson et al, ; Togay et al, ; Verdoux, Liraud, Gonzales, Assens, Abalan & van Os, ) (for details, see also Table S1). Thus, our result confirms that attempted suicide may occur, although not frequently, when considering FEP adolescent and adult mixed populations, supporting the importance of a routine monitoring of suicide risk by mental health professionals working with FEP patients (Pompili et al, ).…”

Section: Discussionmentioning

confidence: 99%

Suicidal Ideation in Patients Experiencing a First‐episode Psychosis: Findings From the 2‐Year Follow‐up of the “Parma Early Psychosis” Program

Pelizza

Pellegrini

Quattrone

et al. 2020

Suicide & Life Threat Behav

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Objective 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. Methods 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. Results 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. Conclusions 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.

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“…Serotonin 2A receptor antagonism might account for reduced depressive symptoms. Depressive symptoms are associated with increased risk of suicide,20,21 cognitive impairment, poor subjective well-being, and reduced subjective quality of life,11,12 and so it is vital that medication regimens target depressive symptoms as well as positive and negative symptoms.…”

Section: Discussionmentioning

confidence: 99%

A randomized trial of aripiprazole vs blonanserin for the treatment of acute schizophrenia and related disorders

Kishi¹,

Matsuda²,

Matsunaga³

et al. 2016

NDT

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ObjectiveThere has been no direct comparison of aripiprazole and blonanserin for schizophrenia treatment. We conducted a 24-week, rater-masked, randomized trial of aripiprazole (6−30 mg/d) vs blonanserin (4−24 mg/d) in schizophrenia patients who were not taking any antipsychotic medication for more than 2 weeks before enrollment (UMIN000011194).MethodsThe primary outcome measure for efficacy was improvement of Positive and Negative Syndrome Scale (PANSS) total score at week 24. Secondary outcomes were PANSS subscale scores, 21-item Hamilton Rating Scale for Depression (HAMD-21) score, response rate, discontinuation rate, and individual adverse events.ResultsForty-four patients were recruited. The discontinuation rate was 86.4% in the aripiprazole group and 68.2% in the blonanserin treatment group. There was no significant difference in mean time to discontinuation between the groups. Although both treatment groups showed significant reductions in the PANSS total score, PANSS subscale scores, and HAMD-21 scores at week 24, the magnitudes of the changes did not differ between the groups. There were no significant differences in the incidences of adverse events including somnolence, extrapyramidal symptoms, prolactin-related adverse events, and weight change between the groups.ConclusionOur results suggest similar efficacy and safety profiles of aripiprazole and blonanserin in the patients with schizophrenia. Double-blind controlled studies are needed to further explore the efficacy and safety of aripiprazole and blonanserin in schizophrenia.

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Clinical variables associated with suicide attempts in schizophrenia before and after the first episode

Cited by 51 publications

References 29 publications

Depressive Symptoms during an Acute Schizophrenic Episode: Frequency and Clinical Correlates

Depressive Symptoms during an Acute Schizophrenic Episode: Frequency and Clinical Correlates

Suicidal Ideation in Patients Experiencing a First‐episode Psychosis: Findings From the 2‐Year Follow‐up of the “Parma Early Psychosis” Program

A randomized trial of aripiprazole vs blonanserin for the treatment of acute schizophrenia and related disorders

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