Individual psychotherapy can reduce suicidal ideation in first episode psychosis: Further findings from the 2‐year follow‐up of the ‘Parma Early Psychosis’ programme

Abstract

Introduction: Suicidal thinking is relevant in patients with First Episode Psychosis (FEP). However, longitudinal studies specifically examining treatment response for suicidal ideation in FEP are still relatively scarce, especially with long-term design and in real-world clinical settings. The aims of this research were (A) to longitudinally assess suicidal thoughts in people with FEP along a 2-year follow-up period and (B) to overtime investigate any significant association of suicidal ideation levels with the specific treatment components of an 'Early Intervention in Psychosis' (EIP) protocol along the 2 years of follow-up.Methods: At entry, 232 FEP participants (aged 12-35 years) completed the Brief Psychiatric Rating Scale (BPRS), including a 'Suicidality' item subscore. Multiple linear regression analysis was then performed.Results: Across the follow-up, FEP subjects showed a relevant decrease in suicidal thinking levels overtime. This was specifically predicted by the total number of individual psychotherapy sessions offered within the 2-year EIP protocol and antidepressant dose (at least as regards the first year of our intervention). Conclusion:Suicidal ideation is clinically relevant in FEP but seems to improve overtime together with the provision of specific, patient-tailored and integrated EIP treatments, especially individual psychotherapy.

Suicidal behaviour in first‐episode psychosis: The relevance of age, perceived stress and depressive symptoms

“…As previous studies have reported, years of education (Zhang et al, 2018), DUP, and tobacco and alcohol consumption (Ayesa‐Arriola et al, 2015, 2018; Lopez‐Morinigo et al, 2019; Pelizza et al, 2020; Pelizza et al, 2021) were not related to suicidal behaviour.…”

“…Compared to healthy controls, patients presented more suicidal ideation, suicide attempts, more suicide risk and higher overall scores in the total Plutchik Suicide Risk Scale; which, overall, is congruent with previous research (Dutta et al, 2010; Falcone et al, 2010; Zhang et al, 2018). These results highlight the importance of implementing suicide prevention interventions in people with first episode psychosis (Pelizza et al, 2021).…”

“…Some risk factors associated with suicidal behaviour in FEP encompass the personal history of suicide attempts, depression, hopelessness (Austad et al, 2015; Bakst et al, 2010; Bornheimer, 2019; Chang et al, 2014; Pelizza et al, 2021), substance abuse (Challis et al, 2013) and long duration of untreated psychosis (DUP) (Challis et al, 2013; Clarke et al, 2006; Foley et al, 2008; Melle et al, 2006). A possible influence of symptoms in suicidal behaviour remains unclear.…”

“…During this period, suicidal behaviour is 60% higher than in other stages of the disease (Dutta et al, 2010;Nordentoft et al, 2004;Pompili et al, 2011), which can be traced back to a history of selfharm prior to treatment in 1 out of 5 patients (Challis et al, 2013) and is maintained after FEP as suicidal ideation in 16%-40% of patients (Bornheimer, 2019;Pelizza et al, 2021;Salagre Vila-Badia R. and Kaplan M. contributed equally to the development of this paper. et al, 2021).…”

“…Furthermore, a cohort study conducted in England and Scotland found that mortality from suicide was 12 times higher in the FEP sample than in the general population (Dutta et al, 2010), and the literature has found that suicide rate increases from 1% to 3% in the first 4-5 years (Bertelsen et al, 2007;Clarke et al, 2006;Lui, 2009). Some risk factors associated with suicidal behaviour in FEP encompass the personal history of suicide attempts, depression, hopelessness (Austad et al, 2015;Bakst et al, 2010;Bornheimer, 2019;Chang et al, 2014;Pelizza et al, 2021), substance abuse (Challis et al, 2013) and long duration of untreated psychosis (DUP) (Challis et al, 2013;Clarke et al, 2006;Foley et al, 2008;Melle et al, 2006).…”