nach oben

Social Psychiatry and Psychiatric Epidemiology

Erschienen in:

01.02.2015 | Original Paper

Prevalence and risk factors for suicidal behavior in young people presenting with first-episode psychosis in Hong Kong: a 3-year follow-up study

verfasst von: Wing Chung Chang, Emily S. M. Chen, Christy L. M. Hui, Sherry K. W. Chan, Edwin Ho Ming Lee, Eric Y. H. Chen

Erschienen in: Social Psychiatry and Psychiatric Epidemiology | Ausgabe 2/2015

Einloggen, um Zugang zu erhalten

Abstract

Purpose

Individuals with first-episode psychosis (FEP) have markedly elevated risk for suicide. Previous research investigating risk factors of suicidal behavior in FEP mainly focused on western populations. This study aimed to examine the prevalence, and pretreatment and early illness predictors of suicidal behavior in Chinese FEP patients.

Method

Seven hundred participants aged 15–25 years consecutively enrolled in a territory-wide treatment program for FEP in Hong Kong from July 2001 to August 2003 were studied. Baseline and 3-year follow-up variables were collected via systematic medical file review. Suicidal behavior evaluated in this study comprised suicide attempt and completed suicide.

Results

Seventy-four (10.6 %) participants attempted suicide before treatment. Ten percent (n = 70) exhibited suicidal behavior and 1 % (n = 7) committed suicide during 3-year follow-up. The majority of post-treatment suicidal behaviors (51.4 %) occurred in the first year of follow-up. Jumping from a height was the most common method of committing suicide. Multivariate regression analysis indicated that previous suicide attempt, history of substance abuse and poorer baseline functioning were significantly associated with an increased risk for suicidal behavior after treatment initiation.

Conclusion

In a large representative cohort of Chinese young FEP patients, the rates of suicidal behavior before and after treatment and risk factors for post-treatment suicidal behavior were comparable to the findings of previous research on early psychosis conducted in western populations. Close monitoring of high-risk patients with history of attempted suicide or substance abuse, and enhancement of psychosocial functioning may help reduce suicide risk in the early stage of psychotic illness.

Hawton K, Sutton L, Haw C, Sinclair J, Deeks JJ (2005) Schizophrenia and suicide: systematic review of risk factors. Br J Psychiatry 187:9–20PubMedCrossRef

Saha S, Chant D, McGrath J (2007) A systematic review of mortality in schizophrenia: is the differential mortality gap worsening over time? Arch Gen Psychiatry 64:1123–1131PubMedCrossRef

Palmer BA, Pankratz VS, Bostwick JM (2005) The lifetime risk of suicide in schizophrenia: a reexamination. Arch Gen Psychiatry 62:247–253PubMedCrossRef

Harvey-Friedman JM (2006) Can early detection of psychosis prevent suicidal behavior? Am J Psychiatry 163:768–770CrossRef

Dutta R, Murray RM, Hotopf M, Allardyce J, Jones PB, Boydell J (2010) Reassessing the long-term risk of suicide after a first episode of psychosis. Arch Gen Psychiatry 67:1230–1237PubMedCrossRef

Addington J, Williams J, Young J, Addington D (2004) Suicidal behavior in early psychosis. Acta Psychiatr Scand 109:116–120PubMedCrossRef

Barrett EA, Sundet K, Faerden A, Nesvåg R, Agartz I, Fosse R, Mork E, Steen NE, Andreassen OA, Melle I (2010) Suicidality before and in the early phase of first episode psychosis. Schizophr Res 119:11–17PubMedCrossRef

Clarke M, Whitty P, Browne S, Mc Tigue O, Kinsella A, Waddington JL, Larkin C, O’Callaghan E (2006) Suicidality in first episode psychosis. Schizophr Res 86:221–225PubMedCrossRef

Harvey SB, Dean K, Mogan C, Walsh E, Demjaha A, Dazzan P, Morgan K, Lloyd T, Fearon P, Jones PB, Murray RM (2008) Self-harm in first-episode psychosis. Br J Psychiatry 192:178–184PubMedCrossRef

10.

Lui SY (2009) Risk factors for deliberate self-harm and completed suicide in young Chinese people with schizophrenia. Aust N Z J Psychiatry 43:252–259PubMedCrossRef

11.

Nordentoft M, Jeppesen P, Abel M, Kassow P, Petersen L, Thorup A, Krarup G, Hemmingsen R, Jorgensen P (2002) OPUS study: suicidal behavior, suicidal ideation and hopelessness among patients with first-episode psychosis: one-year follow-up of a randomized controlled trial. Br J Psychiatry 181(Suppl 43):98–106CrossRef

12.

Robinson J, Cotton S, Conus P, Schimmelmann BG, McGorry P, Lambert M (2009) Prevalence and predictors of suicide attempt in an incidence cohort of 661 young people with first-episode psychosis. Aust N Z J Psychiatry 43:149–157PubMedCrossRef

13.

Sanchez-Gistau V, Baeza I, Arango C, González-Pinto A, de la Serna E, Parellada M, Graell M, Paya B, Llorente C, Castro-Fornieles J (2013) Predictors of suicide attempts in early-onset, first-episode psychoses: a longitudinal 24-month follow-up study. J Clin Psychiatry 74:59–66PubMedCrossRef

14.

Melle I, Johannessen JO, Friis S, Haahr U, Joa I, Larsen TK, Opjordsmoen S, Rund BR, Simonsen E, Vaglum P, McGlashan T (2010) Course and predictors of suicidality over the first two years of treatment in first-episode schizophrenia spectrum psychosis. Arch Suicide Res 14:158–170PubMedCrossRef

15.

Verdoux H, Liraud F, Gonazles B, Assens F, Abalan F, van Os J (2001) Predictors and outcome characteristics associated with suicidal behavior in early psychosis: a two-year follow-up of first-admitted subjects. Acta Psychiatr Scand 103:347–354PubMedCrossRef

16.

Bakst S, Rabinowitz J, Bromet EJ (2010) Antecedents and patterns of suicide behavior in first-admission psychosis. Schizophr Bull 36:880–889PubMedCentralPubMedCrossRef

17.

Bertelsen M, Jeppesen P, Petersen L, Thorup A, Le Quach P, Christensen TO, Jorgensen P, Nordentoft M (2007) Suicidal behavior and mortality in first-episode psychosis: the OPUS trial. Br J Psychiatry 191(suppl.51):140–146CrossRef

18.

Challis S, Nielssen O, Harris A, Large M (2013) Systematic meta-analysis of the risk factors for deliberate self-harm before and after treatment for first-episode psychosis. Acta Psychiatr Scand 127:442–454PubMedCrossRef

19.

Haw C, Hawton K, Sutton L, Sinclair J, Deeks J (2005) Schizophrenia and deliberate self-harm: a systematic review of risk factors. Suicide Life-Threat Behav 35:50–62PubMedCrossRef

20.

Crumlish N, Whitty P, Kamali M, Clarke M, Browne S, McTigue O, Lane A, Kinsella A, Larkin C, O’Callaghan E (2005) Early insight predicts depression and attempted suicide after 4 years in first-episode schizophrenia and schizophreniform disorder. Acta Psychiatr Scand 112:449–455PubMedCrossRef

21.

Melle I, Johannesen JO, Friis S et al (2006) Early detection of the first episode of schizophrenia and suicidal behavior. Am J Psychiatry 163:800–804PubMedCrossRef

22.

Harris MG, Burgess PM, Chang DC et al (2008) Impact of a specialized early psychosis treatment programme on suicide. Retrospective cohort study. Early Interv Psychiatry 2:11–21PubMedCrossRef

23.

Tang JY, Wong GH, Hui CL, Lam MM, Chiu CP, Chan SK, Chung DW, Tso S, Chan KP, Yip KC, Hung SF, Chen EY (2010) Early intervention for psychosis in Hong Kong: the EASY programme. Early Interv Psychiatry 4:214–219PubMedCrossRef

24.

Chen EYH, Tang JYM, Hui CLM, Chiu CP, Lam MM, Law CW, Yew CW, Wong GH, Chung DW, Tso S, Chan KP, Yip KC, Hung SF, Honer WG (2011) Three-year outcome of phase-specific early intervention for first-episode psychosis: a cohort study in Hong Kong. Early Interv Psychiatry 5:315–323PubMedCrossRef

25.

Xiang YT, Weng YZ, Leung CM, Tang WK, Ungvari GS (2008) Socio-demographic and clinical correlates of lifetime suicide attempts and their impact on quality of life in Chinese schizophrenia patients. J Psychiatric Res 42:495–502CrossRef

26.

Fan Y, Xiang YT, Hou YZ, Ungvari GS, Dixon LB, Chan SS, Lee EH, Li WY, Li WX, Zhu YL, Chiu HF (2013) Suicide attempt and suicidal ideation and their associations with demographic and clinical correlates and quality of life in Chinese schizophrenia patients. Soc Psychiatry Psychiatr Epidemiol 48:447–454CrossRef

27.

Zhang XY, Al Jurdi RK, Zoghbi AW, da Chen C, Xiu MH, Tan YL, Yang FD, Kosten TR (2013) Prevalence, demographic and clinical correlates of suicide attempts in Chinese medicated chronic in patients with schizophrenia. J Psychiatric Res 47:1370–1375CrossRef

28.

Chang WC, Pang SLK, Chung DWS, Chan SSM (2009) Five-year stability of ICD-10 diagnoses among Chinese patients presented with first-episode psychosis in Hong Kong. Schizophr Res 115:351–357PubMedCrossRef

29.

Chang WC, Tang JYM, Hui CLM, Chiu CP, Lam MM, Wong GH, Chung DW, Law CW, Tso S, Chan KP, Hung SF, Chen EY (2011) Gender differences in patients presenting with first-episode psychosis in Hong Kong: a three-year follow-up study. Aust N Z J Psychiatry 45:199–205PubMedCrossRef

30.

Chang WC, Tang JYM, Hui CLM, Lam MM, Chan SK, Wong GH, Chiu CP, Chen EY (2012) Prediction of remission and recovery in young people presenting with first-episode psychosis in Hong Kong: a 3-year follow-up study. Aust N Z J Psychiatry 46:100–108PubMedCrossRef

31.

Chang WC, Tang JYM, Hui CLM, Lam MM, Wong GH, Chan SK, Chiu CP, Chung DW, Law CW, Tso S, Chan K, Hung SF, Chen EYH (2012) Duration of untreated psychosis: relationship with baseline characteristics and three-year outcome in first-episode psychosis. Psychiatry Res 198:360–365PubMedCrossRef

32.

Guy W (1976) Clinical global impression. ECDEU assessment manual for psychopharmacology, revised. National Institute of Mental Health, Rockville

33.

Spearing MK, Post RM, Leverich GS, Brandt D, Nolen W (1997) Modification of the clinical global impression (CGI) scale for use in bipolar illness (BP): the CGI-BP. Psychiatry Res 73:159–171PubMedCrossRef

34.

Goldman HH, Skodol AE, Lave TR (1992) Revising Axis-V for DSM-IV: a review of measures of social functioning. Am J Psychiatry 149:1148–1156PubMedCrossRef

35.

World Health Organization (1992) The ICD-10 classification of mental and behavioral disorders: clinical description and diagnostic guidelines. World Health Organization, Geneva

36.

Chen YY, Yip PSF (2009) Prevention of suicide by jumping: experiences from Taipei City (Taiwan), Hong Kong and Singapore. In: Wasserman D, Wasserman C (eds) Oxford textbook of suicidology and suicide prevention. Oxford University Press, Oxford, pp 569–572

37.

Wong PWC, Caine ED, Lee CKM, Beautrais A, Yip PSF (2014) Suicides by jumping from a height in Hong Kong: a review of coroner court files. Soc Psychiatry Psychiatr Epidemiol 49:211–219PubMedCrossRef

38.

Yip PS, Tan RC (1998) Suicides in Hong Kong and Singapore: a tale of two cities. Int J Soc Psychiatry 44:267–279PubMedCrossRef

39.

Fedyszyn IE, Harris MG, Robinson J, Edwards J, Paxton SJ (2011) Characteristics of suicide attempts in young people undergoing treatment for first episode psychosis. Aust N Z J Psychiatry 45:838–845PubMedCrossRef

40.

Fedyszyn IE, Robinson J, Harris MG, Paxton SJ, Francey S (2012) Predictors of suicide-related behaviors during treatment following a first episode of psychosis: the contribution of baseline, past, and recent factors. Schizophr Res 140:17–24PubMedCrossRef

41.

Muller DJ, Barkow K, Kovalenko S, Ohlraun S, Fangerau H, Kölsch H, Lemke MR, Held T, Nöthen MM, Maier W, Heun R, Rietschel M (2005) Suicidal attempts in schizophrenia and affective disorders with relation to some specific demographical and clinical characteristics. Eur Psychiatry 20:65–69PubMedCrossRef

42.

Kaplan KJ, Harrow M (1999) Psychosis and functioning as risk factors for later suicidal activity. Suicide Life-Threat Behav 29:10–24PubMed

43.

Fenton WS (2000) Depression, suicide and suicide prevention in schizophrenia. Suicide Life-Threat Behav 30:34–49PubMed

44.

Robinson J, Harris MG, Harrigan SM, Henry LP, Farrelly S, Prosser A, Schwartz O, Jackson H, McGorry PD (2010) Suicide attempts in first-episode psychosis: a 7.4 year follow-up study. Schizophr Res 116:1–8PubMedCrossRef

45.

Posner K, Oquendo MA, Gould M, Stanley B, Davis M (2007) Columbia classification algorithm of suicide assessment (C-CASA): classification of suicidal events in the FDA’s pediatric suicidal risk analysis of antidepressants. Am J Psychiatry 164:1035–1043PubMedCentralPubMedCrossRef

Titel: Prevalence and risk factors for suicidal behavior in young people presenting with first-episode psychosis in Hong Kong: a 3-year follow-up study
verfasst von: Wing Chung Chang
Emily S. M. Chen
Christy L. M. Hui
Sherry K. W. Chan
Edwin Ho Ming Lee
Eric Y. H. Chen
Publikationsdatum: 01.02.2015
Verlag: Springer Berlin Heidelberg
Erschienen in: Social Psychiatry and Psychiatric Epidemiology / Ausgabe 2/2015
Print ISSN: 0933-7954
Elektronische ISSN: 1433-9285
DOI: https://doi.org/10.1007/s00127-014-0946-5

Neu im Fachgebiet Psychiatrie

23.04.2024 | Depression antepartal oder postpartal | Nachrichten

Update Psychiatrie

Bestellen Sie unseren Fach-Newsletter und bleiben Sie gut informiert.

Newsletter bestellen

Live-Webinar: Aktuelle Leitlinien bei Herz-Kreislauf-Erkrankungen

Springer Medizin

Prevalence and risk factors for suicidal behavior in young people presenting with first-episode psychosis in Hong Kong: a 3-year follow-up study

Abstract

Purpose

Method

Results

Conclusion

Neu im Fachgebiet Psychiatrie

Weniger postpartale Depressionen nach Esketamin-Einmalgabe

„Psychotherapie ist auch bei sehr alten Menschen hochwirksam!“

Auf diese Krankheiten bei Geflüchteten sollten Sie vorbereitet sein

Hustenstiller lindert Agitation bei Alzheimer

Update Psychiatrie

Live-Webinar: Aktuelle Leitlinien bei Herz-Kreislauf-Erkrankungen

Springer Medizin

Abstract

Purpose

Method

Results

Conclusion

Bitte loggen Sie sich ein, um Zugang zu diesem Inhalt zu erhalten

Weitere Artikel der Ausgabe 2/2015

Relationships of perceived public stigma of mental illness and psychosis-like experiences in a non-clinical population sample

Stigma resistance in eating disorders

Comparing gendered and generic representations of mental illness in Canadian newspapers: an exploration of the chivalry hypothesis

The use of regression methods for the investigation of trends in suicide rates in Hungary between 1963 and 2011

Mortality of people suffering from mental illness: a study of a cohort of patients hospitalised in psychiatry in the North of France

Longitudinal effects of psychological symptoms on non-suicidal self-injury: a difference between adolescents and young adults in China

Neu im Fachgebiet Psychiatrie

Weniger postpartale Depressionen nach Esketamin-Einmalgabe

„Psychotherapie ist auch bei sehr alten Menschen hochwirksam!“

Auf diese Krankheiten bei Geflüchteten sollten Sie vorbereitet sein

Hustenstiller lindert Agitation bei Alzheimer

Update Psychiatrie