Stressful Life Events and Suicidality in First-Episode Psychosis

This study aimed to investigate the association between lifetime cumulative and domain-specific stressful life events (SLEs) and suicidality in individuals with first-episode psychosis (FEP), while accounting for sociodemographic, clinical and psychosocial characteristics.

A descriptive, cross-sectional study was conducted with 97 individuals with FEP (34 females, 63 males) aged 13-51 years from the PROFEP study in Barcelona, Spain. SLEs were assessed with the Questionnaire of Stressful Life Events (QSLE) and suicidality with the Plutchik Scale of Suicide Risk (RS). Multivariate regression models examined associations between SLEs and suicidality, adjusting for sociodemographic, clinical and psychosocial characteristics.

Higher cumulative SLEs were associated with increased suicide risk and with suicide attempts (p = 0.020; p = 0.029, OR = 1.125). Partner- and legal-related SLEs were linked to greater suicide risk (p = 0.022; p = 0.035), whereas educational and family SLEs were linked to suicide attempts (p = 0.034, OR = 2.350; p = 0.004, OR = 2.065). SLEs were not associated with suicidal ideation. Suicide risk was associated with depression and increased perceived stress (both p = < 0.001), suicidal ideation with higher perceived stress and younger age (p = 0.005, OR = 1.107; p = 0.043, OR = 0.935) and suicide attempts with depression and male sex (p = 0.002, OR = 12.493; p = 0.029, OR = 0.075).

Cumulative and domain-specific SLEs, particularly interpersonal, educational and legal events, play a significant role in suicide risk and suicide attempts in FEP. Perceived stress, depression and sociodemographic factors are also associated with suicidality in this population. These findings highlight the importance of screening for SLEs and suicidality and implementing stress-management interventions.