T65. RISK OF SUICIDE ATTEMPTS AND SUICIDAL IDEATION IN AN EARLY INTERVENTION PROGRAM FOR FIRST-EPISODE PSYCHOSIS: A RETROSPECTIVE ANALYSIS

Abstract

Background: Suicide is one of the leading causes of premature death among people diagnosed with schizophrenia spectrum disorders, with first episode psychosis being established as the most at-risk stage of the illness. In the last decades, early intervention for psychosis (EIP) programs have been implanted to improve detection and effective treatment of psychosis. While they have shown promising results in symptoms reduction, treatment adherence and long-term functional outcomes, few studies have investigated the impact of these programs on suicide prevention. This study aimed to assess the prevalence of suicidal behavior among patients admitted to an EIP program for first episode psychosis. Method(s): We examined the prevalence of suicidality in a representative sample of 355 patients admitted to The Prevention and Early Intervention Program for Psychosis of the Douglas Mental Health Institute in Montreal, Canada, from 2006 to 2014. Subjects had never been treated for psychosis nor had taken any antipsychotic medication for more than 30 days prior to admission. Patients who were 18 years and older, had signed consent and were diagnosed with a non-affective psychotic disorder were included in the study. Retrospective data on suicidal behavior were collected from their medical files over a two years period following admission. Reported suicidal ideations, attempts and completed suicides were classified according to the ICD-10 guidelines. Descriptive statistics were calculated to determine means, standard deviations, frequencies and percentages while taking sex differences into account. Result(s): Altogether, there were two suicide victims, both men, representing less than 0.56% of the sample. Surprisingly, women had a higher rate of attempted suicide (18.87%, 20/106) than men (10.84%, 27/249) prior to entry into the service. While 31 men (12.45%) and 16 women (15.10%) made at least one suicide attempt during the two years of the program, the majority of them did so during the very first 45 days of treatment (48.94%, 23/47). Rates of suicide attempts decreased notably and consistently after three months: only 2.81% of men (7/249) and 3.77% of women (4/106) made an attempt during the second year of the program. Onset of illness appears to be a critical window for suicidal ideations too: close to a third of men (27.30%, 67/249) and women (33.02%, 35/106) considered suicide within the first three months after their entry into the program. Women maintained higher rates of suicidal ideations (22.28%) than men (16.78%) during the first six months, both rates decreasing steadily over time. Discussion(s): While prevalence of past suicide attempts in our sample was similar to previous rates published for first episode psychosis populations, this study reports lower rates of completed suicides with a significant reduction of attempts only 45 days after enrollment into the EIP program. Providing better access to effective services for psychosis early on in the course of the illness thus has a beneficial impact on reducing subsequent suicidal behavior. Distinguishing the results by sex allowed us to underline the stronger prevalence of suicide attempts and ideations among women, especially during the first six months of treatment. Further analysis of our sample will examine the influence of psychiatric symptoms' severity and other demographic factors on the incidence of suicidal behavior.