Potentially lethal suicide attempts using sharp objects during psychotic illness

Recent studies have reported that serious violence toward self and others is more common in the first episode of psychosis than after treatment.

To estimate the proportion of survivors of potentially lethal suicide attempts with sharp objects who have a diagnosis of psychotic illness, and the proportion of those patients who had never received treatment for psychosis with antipsychotic medication.

An audit of the medical records of patients from three major teaching hospitals in Sydney, Australia, who survived a self inflicted stab wound to the abdomen, torso, or a laceration to the neck.

The files of 95 survivors of self-inflicted wounds by cutting or stabbing who met the inclusion criteria for the study were examined. A psychotic illness was diagnosed in 46 cases (48%), of which 26 (57%) had never received treatment with antipsychotic medication and, hence, were in the first episode of psychosis.

Psychosis is strongly associated with potentially lethal suicide attempts using sharp objects and patients who have never received treatment for psychosis appear to be at particular risk.