Temporal pattern of suicide risk in young individuals with early psychosis

Individuals with a first episode of psychotic illness are known to be at high risk of suicide, yet little is understood about the timing of risk in this critical period. The present study aimed to examine the temporal pattern of suicide risk in patients with early psychosis (EP) and to determine whether discrete periods of significantly elevated risk can be identified up to 24 months after commencing treatment. Suicidality ratings collected each month as part of patient routine assessment at the Early Psychosis Prevention and Intervention Centre (EPPIC) were retrieved from the service database for patients treated between December 2002 and December 2005 (N=696). Time-series analysis was performed on suicide risk estimated from the aggregated data of 94 individuals who met the study inclusion criteria. Suicide risk was highest in the first month of treatment, decreasing rapidly over the next 6 months and declining slightly thereafter. A power function adequately described this curvilinear trend. Fluctuations around the trend were unpredictable, except for a mild tendency to reverse from month to month, and did not reach statistical significance. The findings suggest limited scope for preventative interventions driven by chronology alone. Intensive routine suicide screening across the course of treatment may facilitate identification and early management of EP patients at suicide risk.