Suicide attempts by jumping and psychotic illness

Area of Science:

• Psychiatry
• Public Health
• Trauma Medicine

Background:

• Serious violence, including self-harm, is more prevalent in the initial phase of psychosis compared to later stages.
• Understanding risk factors in first-episode psychosis is crucial for effective intervention.

Purpose of the Study:

• To determine the percentage of individuals with psychotic illness who survived a suicide attempt by jumping from a height without prior antipsychotic medication.
• To investigate the association between untreated psychosis and suicide attempts via jumping.

Main Methods:

• A retrospective audit of medical records for patients surviving jumps exceeding 3 meters was conducted across nine Australian trauma centers.
• Data on jump height, clinical diagnoses (including psychosis), and prior treatment history were extracted using International Classification of Diseases (ICD) codes.

Main Results:

• Out of 160 survivors, 70 (44%) had a psychotic illness. Of these, 31 (44%) were untreated, indicating a first episode of psychosis.
• Approximately 19.4% of all survivors had undiagnosed, untreated psychosis, often featuring severe delusions.
• Nearly half of psychosis patients surviving a jump had no prior antipsychotic treatment.

Conclusions:

• A significant proportion of suicide attempt survivors by jumping have psychotic illness, confirming a link between psychosis and this method of suicide.
• The contribution of schizophrenia to suicide mortality may be underestimated, as some suicides might be linked to untreated psychosis.
• The high rate of untreated psychosis in survivors underscores a substantially elevated suicide risk during the first episode of psychosis.