Suicidal Thinking and Behavior in Adolescents at Ultra-High Risk of Psychosis: A Two-year Longitudinal Study

Suicide risk in subjects at Ultra-High Risk of psychosis (UHR) has been rarely assessed in adolescence, but it is of obvious importance for prognostic and clinical care reasons. In this study, we aimed to prospectively assess suicide risk and behaviors in UHR adolescents.

We examined 112 help-seeking adolescents (13-18 years, 50% males, 83.9% Caucasian) that were enrolled in the Reggio Emilia At-Risk Mental States (ReARMS) project and followed up for 2 years. Specific items derived from the Comprehensive Assessment of At-Risk Mental States (CAARMS) and the Beck Depression Inventory-II (BDI-II) were used to assess suicide risk. Suicide attempts and completed suicides were also recorded.

Baseline assessment detected 40 UHR adolescents, 32 FEP (first-episode psychosis), and 40 non-UHR/FEP. We found that 67.5% of UHR adolescents had suicidal ideation, and 18.5% to severe degree. Attempted suicide before enrollment was higher in the UHR group than in non-UHR/FEP peers (17.5% vs. 2.5%). BDI-II suicidal ideation severity was stable at 12-month follow-up and decreased at 24-month follow-up.

A high prevalence of suicidal ideation among UHR adolescents was found and supports the routine monitoring of risk of self-injurious thinking and behavior in this at-risk population.