Suicide attempt in first-episode psychosis: A 7.4year follow-up study

Robinson, Jo; Harris, Meredith; Harrigan, Susy; Henry, Lisa; Farrelly, Simone; Prosser, A.; Schwartz, Orli; Jackson, Henry; McGorry, Patrick D.

doi:10.1016/j.schres.2009.10.009

Cited by 89 publications

(88 citation statements)

References 32 publications

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“…Moreover, patients with greater severity of SUD require often treatment younger than those with less severity and, therefore, their cognitive functioning could be more preserved of the neurotoxic damage associated with the consumption [3, 31]. However, the results in the DS+ group suggest that negative symptoms may hinder planning for achieving life goals and quality of life [56], which in previous studies has been associated with suicide attempts [18]. However, in the DS- group we found the positive symptoms associated with the current risk suicide, possibly due to an increased impulsivity [9, 17, 27].…”

Section: Discussionmentioning

confidence: 99%

“…Compared with the single condition, in the DS it has been observed a worse global cognitive state [26] with a marked deterioration with age, especially in executive performance [2, 3, 27], and it is considered to be a powerful predictor of maladaptive functioning [26]. Interestingly, higher premorbid intelligence quotient [17, 28], better executive [29, 30] and social premorbid functioning [18], and dysfunctional impulsivity [9, 19, 28] have been hypothesized to predispose for suicidal behavior and could facilitate the illegal substance acquisition. In this context, the primary drug of dependence seems decisive given that alcohol is the substance that has shown greater neurodegenerative brain effects and cognitive impairment [31].…”

Section: Introductionmentioning

confidence: 99%

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Executive Functioning in Men with Schizophrenia and Substance Use Disorders. Influence of Lifetime Suicide Attempts

et al. 2017

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BackgroundLifetime suicide attempts in patients with comorbidity between psychotic disorders and Substance Use Disorder (SUD), known as dual diagnosis, was associated with a worse clinical and cognitive state, poor prognosis and premature death. However, to date no previous study has examined the cognitive performance of these patients considering as independent the presence or absence of lifetime suicide attempts.MethodsWe explore executive functioning differences between suicide attempters and non-attempters in dual schizophrenia (DS) patients and the possible related factors for both executive performance and current suicide risk. Fifty DS male patients in remission of SUD and clinically stables, 24 with and 26 without lifetime suicide attempts, were evaluated. We considered Z scores for all neuropsychological tests and a composite summary score for both premorbid IQ and executive functioning.ResultsDS patients showed low performance in set-shifting, planning and problem solving tasks. Those with suicide attempts presented lower composite summary scores, together with worse problem solving skills and decision-making, compared with non-attempters. However, after controlling for alcohol dependence, only differences in decision-making remained. Executive functioning was related to the premorbid intelligence quotient, and several clinical variables (duration, severity, months of abstinence and relapses of SUD, global functioning and negative symptoms). A relationship between current suicide risk, and first-degree relatives with SUD, insight and positive symptoms was also found.ConclusionsOur results suggest that problem solving and, especially, decision-making tasks might be sensitive to cognitive impairment of DS patients related to presence of lifetime suicide attempts. The assessment of these executive functions and cognitive remediation therapy when necessary could be beneficial for the effectiveness of treatment in patients with DS. However, further research is needed to expand our findings and overcome some limitations of this study.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Executive Functioning in Men with Schizophrenia and Substance Use Disorders. Influence of Lifetime Suicide Attempts

et al. 2017

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“…For example, Haukka and colleagues (Haukka et al, 2008) found that a history of a suicide attempt was the strongest single predictor of a subsequent suicide attempt in 18,199 Finnish patients who were hospitalized due to a suicidal attempt. In an incidence cohort, Robinson and colleagues (Robinson et al, 2010) found that a history of self-harm was a key predictor for suicide in 661 patients with first episode psychosis. Moreover, this finding has been corroborated by large systematic reviews by Beghi and colleagues (Beghi et al, 2013), who included 76 studies in his analysis, and Larkin and colleagues (Larkin et al, 2014), who included 129 studies.…”

Section: Discussionmentioning

confidence: 99%

Predictors of suicide attempts in 3.322 patients with affective disorders and schizophrenia spectrum disorders

Gallego¹,

Rachamallu²,

Yuen³

et al. 2015

Psychiatry Research

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This study explores risk factors for suicide attempts using the electronic health records of 3,322 patients with either schizophrenia spectrum disorders or affective disorders who underwent a comprehensive psychiatric evaluation at the Emergency Department at the Long Island Jewish Medical Center or the Hillside Evaluation Center at The Zucker Hillside Hospital from August 3rd 2011 to July 5th 2012. Multivariate regression analyses showed, after adjusting for sex, that previous suicidal attempts and financial or relationship losses were significantly associated with a current suicidal attempt. Additionally, higher odds of having a suicidal attempt were also found in those subjects with a diagnosis of an affective disorder, compared to a schizophrenia spectrum diagnosis, and those patients in the children/adolescent group compared to those in the adult/elderly group. Our study results confirm and expand results from prior studies. Therefore, physicians should be alert for the presence of any or all of these factors upon evaluation of psychiatric patients, and if present, either psychiatric hospitalization or a close psychiatric follow up in collaboration with family and a therapist would be key in reducing the risk of potential suicidal behavior.

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“…Furthermore, suicide risk is especially elevated in the first 6-12 months following the first episode of psychosis (Fedyszyn et al, 2010). Because psychotic illnesses typically occur in the otherwise physically healthy teenage or early adolescent years of an individual’s life, suicide is the leading cause of premature death in the psychotic-spectrum population (Robinson et al, 2010). …”

Section: Introductionmentioning

confidence: 99%

Are structural brain abnormalities associated with suicidal behavior in patients with psychotic disorders?

Giakoumatos

Tandon

Shah

et al. 2013

Journal of Psychiatric Research

107

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Suicide represents a major health problem world-wide. Nevertheless, the understanding of the neurobiological underpinnings of suicidal behavior remains far from complete. We compared suicide attempters to non-attempters, and high vs. low lethality attempters, to identify brain regions associated with suicidal behavior in patients with psychotic disorders. 489 individuals with schizophrenia, schizoaffective disorder, or psychotic bipolar disorder I and 262 healthy controls enrolled in the B-SNIP study were studied. Groups were compared by attempt history and the highest medical lethality of previous suicide attempts. 97 patients had a history of a high lethality attempt, 51 of a low lethality attempt and 341 had no attempt history. Gray matter volumes were obtained from 3T structural MRI scans using FreeSurfer. ANCOVAs were used to examine differences between groups, followed by Hochberg multiple comparison correction. Compared to non-attempters, attempters had significantly less gray matter volume in bilateral inferior temporal and superior temporal cortices, left superior parietal, thalamus and supramarginal regions, right insula, superior frontal and rostral middle frontal regions. Among attempters, a history of high lethality attempts was associated with significantly smaller volumes in the left lingual gyrus and right cuneus. Compared to non-attempters, low lethality attempters had significant decreases in the left supramarginal gyrus, thalamus and the right insula. Structural brain abnormalities may distinguish suicide attempters from non-attempters and high from low lethality attempters among individuals with psychotic disorders. Regions in which differences were observed are part of neural circuitries that mediate inhibition, impulsivity and emotion, visceral, visual and auditory perception.

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Suicide attempt in first-episode psychosis: A 7.4year follow-up study

Cited by 89 publications

References 32 publications

Executive Functioning in Men with Schizophrenia and Substance Use Disorders. Influence of Lifetime Suicide Attempts

Executive Functioning in Men with Schizophrenia and Substance Use Disorders. Influence of Lifetime Suicide Attempts

Predictors of suicide attempts in 3.322 patients with affective disorders and schizophrenia spectrum disorders

Are structural brain abnormalities associated with suicidal behavior in patients with psychotic disorders?

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