Predictors of suicide in Asian patients with first episode psychosis. 2013

Natasha Mitter, and Mythily Subramaniam, and Edimansyah Abdin, and Lye Yin Poon, and Swapna Verma
Research Division, Institute of Mental Health, Buangkok Green Medical Park, 10 Buangkok View, Singapore 539747, Singapore. Electronic address: Mitter_Natasha@imh.com.sg.

High rates of suicide have been reported in psychotic disorders, particularly in the early phases. Studies examining suicide risk during the first episode of psychosis (FEP) are lacking, especially in the Asian context. The present study aims to investigate the prevalence of completed suicides and associated risk factors in a multi-ethnic Asian society. METHODS Data from 1397 patients accepted into a local Early Psychosis Intervention Programme (EPIP) was collected. This included sociodemographic and clinical data. Cox proportional-hazards regression models were performed in order to explore factors associated with time to completed suicide. RESULTS The sample comprised of 1397 FEP patients, with 687 females and 710 males. The mean age was 28.2 years. The prevalence of suicide in this sample was 1.9%. Of the 26 FEP patients who committed suicide, data on time to suicide was available for 23 of them. 56.5% committed suicide during the first year of follow-up. A higher risk of suicide was associated with an older age (Hazard Ratio (HR)=1.31, 95% CI, 1.05-1.63), longer DUP (HR=1.05, 95% CI, 1.02-1.11), higher PANSS positive (HR=1.91, 95% CI, 1.37-2.67), higher GAF symptomatology (HR=1.16, 95% CI, 1.04-1.30) and GAF disability scores (HR=1.12, 95% CI, 1.02-1.22). CONCLUSIONS Older patients with longer DUPs, higher PANSS positive and negative scores and better functioning appear to be at higher risk of suicide in this sample. Early intervention services should focus on a thorough risk assessment in order to reduce the risk of suicide during FEP.

UI MeSH Term Description Entries
D008297 Male Males
D011237 Predictive Value of Tests In screening and diagnostic tests, the probability that a person with a positive test is a true positive (i.e., has the disease), is referred to as the predictive value of a positive test; whereas, the predictive value of a negative test is the probability that the person with a negative test does not have the disease. Predictive value is related to the sensitivity and specificity of the test. Negative Predictive Value,Positive Predictive Value,Predictive Value Of Test,Predictive Values Of Tests,Negative Predictive Values,Positive Predictive Values,Predictive Value, Negative,Predictive Value, Positive
D011569 Psychiatric Status Rating Scales Standardized procedures utilizing rating scales or interview schedules carried out by health personnel for evaluating the degree of mental illness. Factor Construct Rating Scales (FCRS),Katz Adjustment Scales,Lorr's Inpatient Multidimensional Psychiatric Rating Scale,Wittenborn Scales,Edinburgh Postnatal Depression Scale,Mini International Neuropsychiatric Interview
D011618 Psychotic Disorders Disorders in which there is a loss of ego boundaries or a gross impairment in reality testing with delusions or prominent hallucinations. (From DSM-IV, 1994) Psychoses,Psychosis, Brief Reactive,Schizoaffective Disorder,Schizophreniform Disorders,Psychosis,Brief Reactive Psychoses,Brief Reactive Psychosis,Disorder, Psychotic,Disorder, Schizoaffective,Disorder, Schizophreniform,Disorders, Psychotic,Disorders, Schizoaffective,Disorders, Schizophreniform,Psychoses, Brief Reactive,Psychotic Disorder,Reactive Psychoses, Brief,Reactive Psychosis, Brief,Schizoaffective Disorders,Schizophreniform Disorder
D005260 Female Females
D006801 Humans Members of the species Homo sapiens. Homo sapiens,Man (Taxonomy),Human,Man, Modern,Modern Man
D000293 Adolescent A person 13 to 18 years of age. Adolescence,Youth,Adolescents,Adolescents, Female,Adolescents, Male,Teenagers,Teens,Adolescent, Female,Adolescent, Male,Female Adolescent,Female Adolescents,Male Adolescent,Male Adolescents,Teen,Teenager,Youths
D000328 Adult A person having attained full growth or maturity. Adults are of 19 through 44 years of age. For a person between 19 and 24 years of age, YOUNG ADULT is available. Adults
D000367 Age Factors Age as a constituent element or influence contributing to the production of a result. It may be applicable to the cause or the effect of a circumstance. It is used with human or animal concepts but should be differentiated from AGING, a physiological process, and TIME FACTORS which refers only to the passage of time. Age Reporting,Age Factor,Factor, Age,Factors, Age
D012189 Retrospective Studies Studies used to test etiologic hypotheses in which inferences about an exposure to putative causal factors are derived from data relating to characteristics of persons under study or to events or experiences in their past. The essential feature is that some of the persons under study have the disease or outcome of interest and their characteristics are compared with those of unaffected persons. Retrospective Study,Studies, Retrospective,Study, Retrospective

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